Heading out the door at 430am - the start of 18 hours of daylight
Student Susan May, with her baby Peter 'Nanuq' - born at home with the midwives. (Peter is wearing his cool sealskin boots made by grandmother Eva).
One of two delivery rooms.
Transport equipment and supplies at the back door ready for medevac. There's a heater to the right that holds expired iv bags - used as hot water bottles to pack around the patient for the trip out.
But what about the 6 hour transport time on a good day and the inherent risk of giving birth. It seems that with good prenatal care, preventative measures, and referring at-risk women to deliver in PUV with a little extra technology available, or in Montreal with a lot of technology available, the outcomes are very good. And when something comes up quickly, you manage it and it resolves, or stabilize them and move them, or you stabilize them and then sit tight through the night until the skies clear.
The most recent data by Luo, up to 2000, found that there was no difference in perinatal mortality rates among infants born in the north, compared to aboriginal infants and non-aboriginal infants born in the south (Montreal). They did however find that infants born to Inuit mothers, when adjusted for infant's sex, parity, maternal age and education, and marital status, had 4x higher risk of postnatal infections and sudden infant death compared to non-aboriginal infants in the south. Limitations in the data did not permit the researchers to control for maternal smoking in pregnancy. And 99% of women here smoke in pregnancy, and presumably in the postpartum too - though in the last 10 years, there has been a very successful public health campaign to get people to smoke outside (yes, all year) if they have young children in the house.
What is somewhat hidden in this paper is that ~70% of all women in the north and aboriginal women in the south had <11 years of schooling, whereas ~10% of non-aboriginal women in the south had <11 years of schooling...and given that the Auditor General of Canada in 2004 estimated that if all things remain the same - this gap will take another 28 years to close...we likely won't see a change in these numbers for a generation, as maternal education is closely linked to both neonatal deaths (<28 days), and infant deaths (<1 year).
