What makes Inuulitsivik midwifery successful and sustainable? How an Inuit-led care model brought birth back to our remote arctic communities.

Nunavik (Québec, Canada) has been inhabited by Inuit for over 4,000 years. Inuit midwives assisted in childbirth for centuries before colonization removed birth from our communities. In the 1980s, after years of evacuation for birth to southern hospitals, local women and Inuit leaders brought birth back to our remote Hudson Coast and Hudson Strait villages. As Inuit midwives, we have continuously offered local midwifery care to the population since that time, supported by southern midwives and an interprofessional team. Our midwifery service is nationally and internationally recognized as a model for returning childbirth to remote communities and reclaiming Indigenous midwifery. Inuulitsivik midwifery demonstrates that birth services and midwifery education can be integrated into health care systems in remote communities with safe outcomes. To understand the factors that contribute to our success and sustainability, we brought together experienced midwives and student midwives and met in person, by teleconference and online. Themes that emerged include Inuit values and language; Inuit leadership; local midwifery education; an adapted role for midwives in remote communities; flexibility in the organization and implementation of practice; midwifery-led interdisciplinary care and strategic collaboration with southern Canadian and international allies. We explore these themes and use common frameworks for policy analysis to consider effectiveness; impacts on the experience of pregnant women and families; health equity and access to services; costs; feasibility and acceptability. Our local midwifery service makes an important contribution to meeting the calls to Action of the Truth and Reconciliation Commission of Canada.