746 births over 36 years: Inuk midwife long served her remote community

Akinisie Qumaluk is a household name in her home community of Puvirnituq, Que.

She was there for 746 births as a midwife over her 36-year career working at the Inuulitsivik Health Centre in the village of about 2,000 people in the northern Quebec region of Nunavik.

While she can’t remember every birth, she’s kept careful records. And many in the community hold fond memories of her.

“They always come up to me and shake my hands, [saying] ‘do you remember the birth I had with you?'” said Qumaluk.

“I can never remember … I’ve been through so many births.”

Surprise twins, breech births, haemorrhaging and no access to emergency planes in the dead of winter are among the challenges Qumaluk faced since the community’s maternity centre opened in 1986.

Qumaluk says prayer got her through the tough moments.

“I have often kneeled down … He often answered our prayers and I’m so grateful,” said Qumaluk.

Even after retiring in July following a heart attack in the fall of 2021, Qumaluk still gets stopped by expecting mothers.

“Women come up to me and [say] ‘look, I’m pregnant and I want you to be my midwife.’ But I can’t now because I’m retired,” said Qumaluk.

“I guess they love the way I was so passionate about midwifery.”

A family connection

Qumaluk jokes she was “meant to be a midwife” because she is a light sleeper — waking up at the slightest noise or phone call.

Her passion for maternal care was partly inspired by a family member, after the birth of her fourth child.

“I had a small boy and I was breastfeeding and I must have been crazy to apply, but I’m grateful that I did,” said Qumaluk. She started getting hands-on training when the maternity centre opened and graduated in 1991.

Qumaluk says she didn’t know what she was getting herself into at the time, but felt a unique connection to the profession through the legacy of her grandmother, Karula Uqaituk, who was a lay midwife in Nunavik.

“She used to travel by foot or dog team to labouring women,” said Qumaluk.

She says their shared profession makes her feel close to her ancestor.

“We have it easier now … when my grandmother was a lay midwife there were no houses,” said Qumaluk.

“I’ve always admired women who [gave] birth during the December, January, February months when they used to live in igloos.”

A mentor to colleagues

Qumaluk vaguely remembers the first baby she delivered all those years ago.

“I remember sweating on my face and being nervous, but after that, I’ve learned,” said Qumaluk.

She became a mentor and teacher at the centre, where she could work in her own language, Inuktitut. She says that was part of why she loved her job.

Nellie Iqiquq, another midwife at the centre, was one of Qumaluk’s students when she first started. Now she has 15 years of experience herself.

Iqiquq says she followed Qumaluk’s lead and kept track of the more than 100 babies she helped.

“[Qumaluk] taught us to write notes of which [births] you were attending in the delivery,” said Iqiquq.

Qumaluk is a very respected elder, says Katryna van Vliet. Filling in as an assisting midwife, van Vliet worked with Qumaluk for over two years.

“We’d ask her a lot of the time just for her opinion and her advice about different clinical cases,” said van Vliet, adding that Qumaluk is also “hilarious.”

“As much as she is this very accomplished midwife with a lot of skills and a lot of experience she’s also just really funny and lighthearted as well.”

She admired Qumaluk’s unique approach to caring and interacting with newborns, treating them with respect as if they were “fully developed people.”

“I started doing a bit more myself, like actually talking to them … I think it’s good for them to have people pay that special attention,” said van Vliet.

But Qumaluk’s technical skill stood out, too. Van Vliet noted that Qumaluk was the only midwife trained in external cephalic version, when a baby is rotated from a breech position in the womb.

She says such skills are essential when the maternity ward has no surgical capacity.

Feeling supported while in labour

Qumaluk heard of many negative experiences from those who travelled to Montreal for their deliveries because of various risk factors.

“When they were in labour, they were labouring alone,” said Qumaluk. She would hear that doctors would also sometimes speak harshly to their patients.

That was the case for Dora Pukalak, an administrator at the maternity ward in Puvirnituq.

Pukalak was a post-natal worker for nine years. She worked with Qumaluk and had her deliver two of her children.

But Pukalak’s two youngest children were premature, and she had to deliver in Montreal — an experience she described as much less supportive.

“I received more help here than in the south,” she said. “Only when I’m pushing, they come.… [Qumaluk] always supported me during the whole labour.”

‘Hard to say goodbye’

Pukalak says things haven’t been the same since Qumaluk’s departure.

“It was hard to say goodbye to her. She has always been a good role model to our student midwives,” she said.

But Pukalak says Qumaluk continues to share her knowledge; midwives will call Qumaluk when there’s something they don’t know how to do.

“It’s really weird not having her,” said Pukalak.

As difficult as it was to leave, Qumaluk says she has been trying to get into a new routine, sewing outdoor clothes for her 13 grandchildren and five great-grandchildren — some of whom she delivered herself.

She notes that a chapter of her life came to an end this year.

“My turn is done. That’s what I always tell myself,” said Qumaluk. “Now it’s their turn.”