Pregnancy in the North
Josh and I have five children. Four of our children were born in Yellowknife at Stanton Territorial Hospital (2018, 2021, 2022 - foster care, and 2023) and one was born in Ontario (2020).
During each pregnancy, the child and I were healthy. We had no complications during the pregnancy, no complications during birth, and no complications postpartum.
How does it work being pregnant in a remote, northern Canadian community?
Prenatal appointments are with a RN at the Community Health Center. If there are concerns from the RN, they would request an appointment with a doctor in Yellowknife.
Ultrasounds are at Stanton Territorial Hospital in Yellowknife. Follow-up appointments for the ultrasound are with an RN at the hospital, on the same day.
Confinement in Yellowknife at the boarding home or a hotel begins at 36 weeks. I have recently heard this referred to as Canada's Evacuation for Birth Policy, however I have found little evidence to support that exact title and never heard that name in every day talk. Ultimately, it means that pregnant women are sent to Yellowknife at 36 weeks (or earlier if there are concerns) to await the arrival of their baby. This is because, while the Community Health Center could delivery a baby in an emergency, that is not ideal. On page 12-6 of the First Nations and Inuit Health Branch Clinical Practice Guidelines for Nurses in Primary Care (2011), under the subsection titled Prenatal Care it states that "transfer to hospital" for delivery should be arranged at 36-38 weeks' gestational aged, according to the regional policy.
Some women are sent to Edmonton for their confinement if there is greater concern about the health of the mother or the baby and Stanton Territorial Hospital is not able to provide proper care. There is no NICU at Stanton Territorial Hospital.
At the time of our first 2 Territorial births, we had to contact Medical Travel after being discharged and they arranged for our flight home as soon as possible. There were not flights every day into Whati, so we stayed additional nights at the hospital or hotel until the next flight. **In November 2021, Whati opened its all-season road, so we could drive back as soon as we were discharged from the hospital.
What is Medical Travel?
The Government of the Northwest Territories (GNWT) provides benefits to people who must travel in order to "access necessary and appropriate insured health services" that are not available in the home community.
Medical travel is used to arrange transportation (and if necessary, accommodation) for the ultrasounds, any check-ups with a doctor, and for the confinement.
Medical travel does not cover the cost of any dependants. You must pay out of pocket if your other children are travelling with you. Sometimes medical travel covers the costs for an escort (for example - confinement), but not always (for example - they don't cover the costs for Josh to come to ultrasounds).
New Sympathies
Moving away from home during the final weeks of pregnancy is not ideal, for anyone. For me, I am away from my home and away from Josh. Thankfully, my mom has always generously offered to come and stay with me. Having my mom with me during Marlene's pregnancy was great because she could be with me while I was in labor until Josh was able to arrive by plane from Whati. For Liddell and Clive, she stayed with our kids at the hotel while I was in labor and waited for Josh to arrive from Whati by car.
Not all expectant mothers have someone with them during confinement.
Not all expectant mothers are able (or choose) to bring their other children with them to Yellowknife during confinement, so they are separated from their kids for about 1 month.
Travelling for 45 mins on a 10-seater plane 36 hours after giving birth is not ideal. Marlene was born midday on a Thursday. We were discharged from the hospital on Saturday and the next available flight home to Whati wasn't until late afternoon on Sunday. My milk had come in Sunday morning and I remember sitting in the backseat of our truck outside the hanger, holding Marlene, abundant with milk, asking my mom how I was supposed to get on that tiny plane and not draw attention to myself. Aside from the milk waterfall situation, I was sore and I was about to have to sit in a tiny seat with my new born and fly at low altitude home. We bought her noise cancellation headphones for the flight, but between my parka (it was -35 celcius), her many layers, her baby balaclava, and me trying to breast feed her during take off (first-time breast feeding mom), there was little chance those headphones were staying on.
The desire to go home after weeks away was so strong that it overpowered any discomfort or stress I had. But still, flying home so soon after delivering a child is really not the greatest way to kick-off your postpartum healing.
Rebecca
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