“My advice to other Indigenous people wanting to get into health care would be, it feels worth it to me, it feels really meaningful. I'm really grateful to be in this role and to be able to provide care to my relatives and my community,” shares Keisha Amanda Charnley, a registered midwife and member of the Katzie First Nation and lives in Vancouver.

She has a practice at BC Women's Hospital and attends home births, too. Registered midwives are primary care providers like doctors with similar scope of practice. Specialists in healthy pregnancy, birth and postpartum, they are a baby’s primary care provider for the first eight weeks. Charnley knew early on she wanted to follow this path.

When her Uncle Bob was passing away when she was just ten, she spent a lot of time at the hospital and she wanted to advocate to make hospitals safer for Indigenous people. She was nervous of the responsibility of care and didn’t know much about birth but the idea of a culturally safe midwifery practice that could be fun and also honouring of her people excited her. Her passion drove her to make that dream come true.

Charnley had to wait until she was 18 to take doula training. A family friend’s birth was her first and it confirmed she was on the right path. She volunteered as a doula while she worked at Starbucks and she realized she was going to have to quit her job because she can’t just leave when someone is in labour. She wasn’t sure how to support herself doing that work, so she stopped for a while.

The Native Youth Sexual Health Network in Toronto’s doula training was a game changer for her. She learned about birth work approaches consistent with her own ways and Charnley was motivated to start again. Together with other Indigenous birth workers, they created the Ekw'í7tl Indigenous Doula Collective, building a community and momentum towards their dreams.

She didn’t feel ready to become a midwife at first and becoming a doula was a great first step. Doulas offer non medical support and can be trained in a weekend to provide emotional, mental, spiritual and social support. The informal learning Charnley did, learning from her elders and family, were even more impactful for her.  “I don't think I could be a good midwife without that kind of education and support,” she recalls.

In midwifery school, she was told she needed to get through the program and then she could be the kind of midwife she wanted to be. Until then, Charnley had to assimilate into the western medical system. She was uncomfortable with the business model, the lack of relationships that could happen in hospitals and she found the program hard.

“I felt oftentimes the most important parts of me were invisible, and not relevant and not respected and by extension, those people I care about, my community and my family.”

While registered midwifery comes with beneficial elements, she hopes the system will become more inclusive and safe. She wanted to become a midwife after seeing the power imbalance between doctors and patients and saw how midwives practice through informed choice decision making where clients are drivers of their own care.

She was also attracted to the financial sustainability. Funding under MSP meant patients don’t have to pay for her services and she’s part of the universal healthcare system. “I think I'm in the right place for my own gifts and what I have to offer, but I also see that I'm kind of also still a doula,” Charnley reflects, seeing birthwork as more of a spectrum than a dichotomy, just as it had always been in her community.

“Every day, it's a challenge to try to figure out how to move forward and really center clients in the work that I'm doing.”

Her biggest challenges have been around figuring out how to be true to herself and her ancestors in the way she practices. It’s been a journey of walking in two worlds and in the world of her people, her accountability is to her family, friends and community. She’s still learning how best to serve her community and navigating the tension between what she knows is right and what the medical system normalizes.

“It's okay to be a complex human. That's what birth teaches us, too. Hard stuff happens and you get through it."

When she was younger, Charnley felt she had to become a good person to become a midwife: someone smarter, more mature, more professional and only then could she do the work. She’s learned she needed to give herself more credit, knowing she was a good person already. In witnessing birth, she  learned to be gentler with herself and wishes she could have practiced that gentleness earlier on.

“We knew each other and we had these deep relationships, deep trust and that's what makes Indigenous midwifery so powerful to me.”

Reflecting on the tradition of birth in her community, where community members held knowledge and sisters delivered each other’s babies, she sees the beauty of the way it has been traditionally. “There's this deep level of accountability and reciprocal vulnerability that happens when we just know each other, we know each other's flaws, we know each other's complexities and, and that's unconditional love,” Charnley beams.

Balancing mental health as a midwife is important being on call and not always sleeping well. Being physically active helps her mental wellness and energy. She likes to pick medicines and have fun, too, finding joy in her work and her personal life.

Her biggest inspiration has been her great grandmother, the anchor in her family. Great Grandma Mandy was knowledgeable and gifted, blind, delivered babies, cooked and took care of everyone and the stories she heard when she was growing up made her Charnley’s hero. Wanting to be like her helped confirm she was on the right path in wanting to deliver people’s babies.

In a worthwhile, meaningful career in the field of healthcare, Keisha Amanda Charnley is grateful to be able to care for her family and community. It’s been a hard journey and there are always challenges, but for Charnley, it’s been worth it. She’s been able to experience the births of babies and her own midwifery practice, a career and a way of life that honour the people she loves most, giving them the care they deserve but often can’t find in a culturally unsafe system.

Thanks to Alison Tedford Seaweed for authoring this article.