THE STANDING SENATE COMMITTEE ON HUMAN RIGHTS
EVIDENCE
OTTAWA, Monday, May 9, 2022
The Standing Senate Committee on Human Rights met with videoconference this day at 5:01 p.m. [ET] to examine such issues as may arise from time to time relating to human rights generally.
Senator Salma Ataullahjan (Chair) in the chair.
[English]
The Chair: I am Salma Ataullahjan, a senator from Toronto and chair of this committee. Today we’re conducting a meeting of the Standing Senate Committee on Human Rights, and I would like to introduce the members of the committee who are participating in this meeting.
We have Senator Boyer from Ontario; Senator Francis from Prince Edward Island; Senator Gerba from Quebec; Senator Hartling from New Brunswick; Senator Omidvar from Ontario; and Senator Wells from Newfoundland and Labrador.
Welcome to all of you and those viewing these proceedings on senparlvu.parl.gc.ca. Today we’re continuing our study, which began in 2019, on the forced and coerced sterilization of persons in Canada. The committee tabled an interim report on this topic in June 2021, and this is our third meeting on this topic in this parliamentary session.
Our June 2021 report underlined the importance of hearing from survivors about their experiences. Today, our committee is responding to these recommendations by hearing from women who have agreed to share their stories and their views.
I would like to sincerely thank our witnesses for agreeing to participate in this important study, and I will now introduce our first panel of witnesses: Gerri Sharpe, President, Pauktuutit Inuit Women of Canada, accompanied by Shauna-Marie Young, Director of Programs, and Madeleine Redfern, President, Amautiit Nunavut Inuit Women’s Association.
Welcome to all of you and thank you for being with us. Madam Sharpe, you have the floor.
Gerri Sharpe, President, Pauktuutit Inuit Women of Canada: It’s a pleasure to join you and your colleagues today from here in Yellowknife. Pauktuutit is pleased to present to the committee for a second time on the issue of forced and coerced sterilization of persons in Canada. With me today is Shauna-Marie Young.
Pauktuutit is the national voice of Inuit women. Our voice has representatives from the four regions of Inuit Nunangat: Inuvialuit, Nunavut, Nunavik and Nunatsiavut, as well as urban centres and youth representatives.
For almost 40 years, Pauktuutit has worked to protect and promote the human rights of Inuit women and girls in areas of health, education, economic and social development and safety and security. We also work to empower the voices of women and girls so our lived experiences, values and ideas are represented at every level of governance. Pauktuutit is also active on the international stage on the rights of Indigenous women. Every year Pauktuutit participates in the sessions of the Commission on the Status of Women and the UN Permanent Forum on Indigenous Issues.
I would like to begin by thanking members of the committee for your ongoing work to stop this horrific practice of forced and coerced sterilization of Indigenous women.
As this committee found in its June 2021 report, the full scope of this problem is not well understood, with incidences of forced and coerced sterilization of Indigenous women being under-reported and underestimated. The precise number of Inuit women subjected to forced or coerced sterilization in Canada is unclear because of the glaring lack of data. In an act of genocide and colonialism, Karen Stote reports between 1966 and 1976 more than 70 sterilizations were performed on women in Nunavut, one of the four Inuit regions. We are wondering what’s happening to Inuit women in the other regions.
While the true extent of this horrendous and torturous practice is unknown, two things are clear: one, colonization, racism and patriotism have legitimatized obstetric violence against Inuit women; and, two, irreversible and illegal actions have been imposed against the rights, values and bodies of Inuit women for decades.
For Pauktuutit’s board of directors, advancing the return of Inuit midwifery to the communities is among the highest priorities, in part because access to traditional care of Inuit midwives is an effective solution to ending obstetrical racism, including the horrific practice of forced and coerced sterilization of Inuit women.
As this committee works to form recommendations for substantive solutions, such as the return of Inuit midwifery services, it is important to understand the cultural context around maternal and infant care and childbirth for Inuit.
Until the 1960s, Inuit were living on the land, and traditional childbirth practices were the centre of our way of life. The imposition of Western colonial health systems undermines the traditional culture of midwifery, childbirth and infant care. These practices removed our rights and the abilities of Inuit to make our own health care decisions.
It is difficult for expectant mothers to build trusting relationships with health care providers because most Inuit community health centres are staffed by non-Indigenous nurses who rotate in and out of the remote communities. Likewise, as senators know, the majority of expectant mothers living in Inuit Nunangat are forced to travel to distant facilities to give birth in southern or regional hospitals, away from their families, their homes, their culture, their traditions, their language and their support network. This forced medical evacuation takes place many weeks in advance of their delivery date.
When expectant Inuit are in urban or regional hospitals, many do not fully understand their rights and do not know that they can ask for a second opinion when they feel unsure, unsafe or afraid. They are often treated by health providers who demonstrate a lack of cultural understanding, kindness and compassion. This makes us question our ability to make decisions about our own health and our own bodies and jeopardizes our abilities to communicate and provide our free, prior and informed consent.
Additionally, unjust pressure has and continues to be imposed on Inuit women to undergo sterilization according to the biases and beliefs of individual health care providers who operate in systems that remain culturally uninformed and unresponsive.
Pauktuutit heard the concerns repeatedly during the environmental scan that we conducted on Inuit women’s access to sexual and reproductive health care services. This research included interviews with 22 key contacts in sexual reproductive health services in Inuit Nunangat and in southern referral centres. Additionally, we held meetings and interviews with Inuit women and health care providers in Rankin Inlet, Inuvik, Iqaluit, Kuujjuaq and Nain. The findings of our research are summarized in our report, Access, Respect, Consent, which is available on our website.
In addition to championing the return of Inuit midwifery services to all communities across Inuit Nunangat, Pauktuutit’s work in response to forced and coerced sterilization of Inuit women also includes advocacy for the implementation of the following five measures.
One, mandatory Inuit cultural competency and safety training for all health care providers working in the North and in southern service hubs. Two, that information on medical procedures and consent forms be made available in regional dialects of Inuktitut and is fully and be orally explained by health care providers and professional interpreters or health system navigators. Three, simplification and timely access to medical complaint processes. Four, public education to ensure Inuit women understand and exercise their reproductive rights. Five, an increased number of Inuit health care providers in all roles.
Pauktuutit has been working in collaboration with Inuulitsivik midwifery services in Nunavik on a Canadian Institutes of Health Research project called “Assessing the Economic Costs of Obstetric Evacuation and Outcomes/Experiences of Indigenous Midwifery in Urban, Rural and Remote Indigenous Communities.” Through our work informing the federal government’s co-development of distinction-based health legislation, we are planning to hold community engagement sessions with the focus on midwifery services, education and reproductive health.
Creating systematic change to ensure access to Inuit midwifery services across Inuit Nunangut is a key solution to ensuring Inuit women or girls will never again be subjected to forced or coerced sterilization. We cannot do this alone.
The federal, provincial and territorial governments must invest in the training of new Inuit midwives. Jurisdictions must remove barriers and adequately fund Inuit midwifery services, and other health providers must value and integrate the roles of Inuit midwives in all health facilities and settings where expectant mothers and their newborn babies can receive care.
As well, health care providers must fulfill their professional obligations to obtain free, prior, informed consent, without a personal bias, and when they do not, they must be held accountable by their licensing and accrediting colleges, the health care institutions where they practise and the legal system.
In closing, Pauktuutit asks members of the committee to support the return of Inuit midwifery services to the communities across the Inuit Nunangut. Senators can play an important role in this solution by, firstly, making increased access to Inuit midwifery services a prominent recommendation in your next report; secondly, highlighting the importance of access to Inuit midwifery services in media interviews that you give on the subject and your remarks in and outside of the Senate Chambers; and lastly, raising this issue in your formal and informal communications with decision makers at all levels of government, including Indigenous governments and other partners.
Qujannamiik again for this opportunity to appear before your committee. Shauna-Marie and I look forward to answering any questions that you may have.
The Chair: Thank you very much. We will now turn to Madeleine Redfern. You have the floor.
Before we do that, could I just acknowledge that we’ve been joined by Senator Audette. Welcome.
You have the floor, Madeleine.
Madeleine Redfern, President, Amautiit Nunavut Inuit Women’s Association: Thank you. I join you from Iqaluit, Nunavut, as the President of the Amautiit Nunavut Inuit Women’s Association, which is a not-for-profit organization dedicated to advancing self-determination for Nunavut Arnait, which are Inuit women, in all areas of life. Amautiit focuses on advocacy efforts to improve conditions for Nunavut Inuit women and their families.
Through our research, analysis and advocacy, the organization builds on alliances and partnerships with like-minded organizations and individuals in and outside of Nunavut. As one of our strategies to support and advocate for the rights and needs of Nunavut Inuit women and their families, Amautiit receives financial support from the Government of Canada through NWAC, the Native Women’s Association of Canada, as a territorial member association.
I want to speak or acknowledge first Father Robert Lechat, a Roman Catholic priest who in the 1970s advocated stopping the practice of illegal sterilization of Inuit women who went south for medical care. In an inquiry that was done in the 1970s, it was determined that hundreds of Indigenous women from 52 Northern communities were sterilized. Through her research, Dr. Karen Stote, a professor at Wilfrid Laurier University, was able to determine, through looking at the historical records, that at least 70 Inuit women were sterilized. In Igloolik, 26% of women between the ages of 30 and 50 were sterilized. In Naujaat, formerly known as Repulse Bay, almost 50% of women in the 30 to 50 age group were sterilized. In Gjoa Haven, 31% of women had been sterilized. More than 25% of women in Chesterfield Inlet and Kugaaruk had been sterilized. Those are the only ones that were well documented, but we know that there were a lot more.
Other data from the Minister of National Health and Welfare indicates that at least 470 Inuit and Aboriginal women were sterilized in 1972 alone. In addition, it would be remiss if we didn’t acknowledge that some men were also given vasectomies and sterilized without their knowledge or consent.
I was the executive director of the Qikiqtani Truth Commission, which was set up as an Inuit-funded and Inuit-led inquiry that looked into government policies, decisions and actions or inaction that affected Inuit in the eastern Arctic from 1950 to 1975. This was a period of dramatic transition: Inuit who had previously lived a nomadic life on the land were moved into permanent settlements. It was also a period of transition for Canada as the country introduced universal programs in health, social welfare, old age pension, child tax benefits, disabilities, education and others.
The Government of Canada was a primary agent of change that swept throughout the North. One of the goals or the stated purposes was to make life in the North more like the South, in effect make Inuit more like southern Canadians.
While most officials convinced themselves that they were acting in the best interests of Inuit, often their plans were mismanaged or underfunded and were designed and implemented without consulting Inuit or even really caring about the short-term let alone the long-term effects.
Another major factor or contributor to things not being done properly was the government’s desire to save money, which was accomplished by spending the least amount of money on Indigenous peoples.
It is important to understand that the commission was looking at all government policies and decisions, everything from health care, what happened to the dogs, relocations, policing, justice, economic development, education — effectively almost every aspect of Inuit lives — and what we saw were clearly unbalanced and unhealthy power dynamics between government and Inuit. Almost every aspect of our lives was dictated and decided by government officials, including where Inuit lived, who got housing, who got training, who got the jobs and whether or not children were sent to school, and if so, whether they were sent away from their families or their community. The government also controlled whether and how we got health care, including diagnoses and even the forms of treatment. This included reproductive health and forced sterilization.
One of the reasons why it’s so hard to know exactly how many Inuit women were sterilized is that many Inuit women were sent to the South for other medical reasons, such as tuberculosis. The administrators, health professionals and social workers often simply decided and dictated what would happen to Inuit not only in regard to their health care treatment but also in regard to their bodies — unfortunately, something that many Inuit still experience today. One of the biggest barriers or contributors to this problem is the language and cultural barriers between our non-Inuit health professionals and our Inuit.
Barry Gunn, a former regional administrator in Iqaluit, claimed that many women “agreed” to sterilization procedures by signing forms to that effect, but due to language barriers, it was almost certain that most women did not realize what they were agreeing to.
Medical personnel often explained or argued that the policy was not rooted in malice. I quoted J.R. Lotz of Northern Affairs in my written submission, but I want to highlight a segment of what he said, which is that “no amount of propaganda would change women’s minds or behaviour to help keep the population down. There was government preoccupation about how to keep native people from reproducing.”
From the 1970s, even until today, there often remains a paternalistic attitude. It hasn’t stopped. It hasn’t gone away, and, unfortunately for some, it is part of our health care profession. It usually stems from the notion that Inuit are still too uneducated, undereducated, living in overcrowded housing or homeless or living in poverty. Therefore, the humane thing to do is to lessen the burden, the hardship and the challenges of adding another child or more children to the same family or household or even to our communities.
Some women have also complained about other reproductive services, such as abortion. Some Inuit have complained that the health professionals, from nurses to doctors, repeatedly ask, “Are you sure you want an abortion?” While, understandably, this stems primarily from a Western concept that it is important to ensure that consent is given and that women do not change their mind and from the historical practice of not obtaining consent. However, this also fails to understand that for many Inuit women, once they have made a decision, they do not necessarily want to revisit it or the associated feelings or the context that has led to this decision. They do not want to feel belittled and disrespected, and they do not want to be made to feel that their decision is uncertain, that they have made the wrong decision or that it’s a decision that is not liked or supported by health professionals.
Another related issue is that there are some Inuit women who have said that they wish to be sterilized, and they will not allow the woman to have this procedure, even though that is her choice. She may not want any other form of birth control. This too goes against the individual Inuit woman’s choice over her autonomy.
One of the solutions for this ongoing issue that we face with the dynamics between our health care professionals, who are predominantly non-Inuit, and Inuit patients is that we need to build Inuit health professionals. This includes nurses and doctors. We simply need to have more.
If the patient speaks English, even if they don’t speak proficiently, there’s often an inclination not to use interpreters. In Nunavut where Inuktitut or Inuktut is an official language, many Inuit still struggle to be served in their language of choice, especially in their own language. Also, there are simply not enough medical interpreters. It is important to understand that simply being able to speak Inuktitut does not make you an interpreter and does not make you a medical interpreter. There’s an overreliance by the health care system on the notion that family members, including medical escorts who travel with the family member who is a patient, will interpret. That is not appropriate.
The former Nunavut languages commissioner Sandra Inutiq issued a report in October 2015 called, If you cannot communicate with your patient, your patient is not safe. Being able to speak in one’s mother tongue when it concerns health is not asking a favour of health care professionals or organizations. On the contrary, it is a basic issue of accessibility, safety, quality and equity of services. Therefore, there’s a desperate need to educate, train and hire many Inuit in the health profession. Unfortunately, there has not been enough of a commitment by our governments to allocate the necessary resources and time to ensure that there is solid cultural orientation happening in the health care profession.
There could also be tremendous value in and need for creating Inuit health care client liaison staff members and health care advocates to help bridge the cultural gaps that exist.
In closing, colonialism is real. It continues today. It’s not part of just the distant past. Paternalism is real. It perpetuates the power imbalance between government officials, including our health professionals, and Inuit. Nunavut Inuit women and families have the right to determine their own medical treatments and to understand the options, the pros, the cons, the different treatments, the risks and effects and the consequences, because, ultimately, it is the patient and the families who will bear the effects.
One of the basic tenets in a democracy is that individuals have freedom of choice irrespective of race, colour, ancestry, creed, place of origin, ethnicity, gender, age, marital status, family status, disability or economic status, especially when government is part of providing a service.
We must ensure that government officials, including health care professionals, never try to undermine, coerce, threaten, manipulate or violate anyone’s right. It’s not only against the law, it’s also racist and sexist, and decisions that are made or actions that are taken that are racist and sexist are rarely ever in the best interest of the person that the decision is about.
Unfortunately, we also need to face the reality that racism and sexism continue to exist, not only in Canada’s health care system but also here in Nunavut. We have to face our history. We have to face our reality. We have to figure out how to deal with these power dynamics and cultural disconnections that happen between those who are supposed to provide safe and equitable service to our people and the people themselves.
I know this is an uncomfortable topic and one that we largely avoid, not only Inuit but also Canadians and health care professionals. We have to figure out how to bring about systemic change. We have to stop presuming that these actions and these attitudes are a thing of the past. A lot of Indigenous women continue to be marginalized, disrespected, violated and harmed, all in the name and the practice of Canadian health care. That is my submission, and I will be open to questions. Thank you.
The Chair: Thank you very much.
Senator Boyer: Thank you President Sharpe and President Redfern for your compelling testimony. It’s sometimes difficult to hear the realities of what is going on with the women who are being sterilized.
My question is for you, President Redfern. I know that other survivors of this practice have talked about criminalizing forced or coerced sterilization. They want to see it in the Criminal Code. I’d like to know what your opinion is on that, please, President Redfern.
Ms. Redfern: Thank you, Senator Boyer, for the question. Effectively, doing any procedure without valid consent is assault. This includes a procedure done by government. However, it becomes extremely difficult to bring about criminal charges under the current Criminal Code for any treatment that an individual is subjected to, either in the past or even today. I’m not entirely sure how the additional change to the Criminal Code would assist. It would require a little more research, seeing what other countries have done, if they have enacted laws to extend to unwanted or medical treatment where there was clearly no or inadequate consent.
I can tell you that in Nunavut, leaving it simply to the tort system or civil law, where someone could actually sue the hospital, the government or the health care professionals that were involved in a treatment that someone did not ask for is not only exceptionally difficult, it’s virtually impossible. Most people don’t have access to a lawyer who practises in the medical malpractice area. They don’t have the minimum $5,000 payment just for the lawyer, and most of the lawyers will tell you that won’t even last five days of initial work. It’s a highly specialized field. As a result, there’s been lots of medical malpractice issues in Nunavut that never see any form of justice because people simply can’t afford access to a lawyer. So I’m not entirely sure what the most appropriate response is, but right now, leaving it to a civil response means no response.
Senator Boyer: Thank you. I would like to hear from President Sharpe if she has any opinion about how effective she thinks criminalization may be.
Ms. Sharpe: First off, I would like to say that I think that our legal counsel would also have an opinion on this, and we would like to forward that to you as well.
When it comes to criminalization of this issue, there is currently an Inuvialuit woman who is suing the government for forced sterilization, and that same doctor who did that to her is on record as saying, “Let’s see if I can find a reason to remove her other egg.” So this is not something that happened 40 years ago. This is something that’s happened in the last five to eight years.
Ms. Redfern mentioned something about the numbers of sterilizations that took place in Gjoa Haven. Gjoa Haven is my home community. Growing up, it was common knowledge that if you went out for any type of abortion of any sort, even if it was life threatening or as a result of a rape, you would likely come back sterilized. This is something I grew up knowing was common knowledge. This is something that women feared. They didn’t want to go out, but they were forced to go out. Very few women were able to stay home in their communities to deliver.
It’s not their option. Today it’s still not their option to go out and deliver their babies. Today I have one of my cousins coming in from Gjoa Haven. She’s four weeks away from her due date. If that child is late, it will be at least two months before she can go home. It’s only been in recent years that they have started covering the costs of an escort to go with them. One spouse can go with them. So for that very important part of their life, they are being removed from that. This is why it’s so critical to have midwifery services back in the communities. So criminalizing this, yes. This should happen.
Senator Boyer: Thank you.
Senator Omidvar: I’d like to thank Ms. Redfern and Ms. Sharpe for appearing before us on this very difficult subject. We appreciate your wisdom as we try to seek a path forward.
I want to ask you a question about if you have seen any improvements since 2019 when we embarked on our study and an interim report was published. We’ve also heard from Indigenous Services Canada that the federal government has committed $33.3 million for Indigenous midwifery and doula initiatives.
I want to ask you whether any of this money has filtered through to Inuit women and if there has been an impact, even at the early stage. Have you observed any points of light as a result of the federal funding?
Ms. Redfern: Thank you. I do think that as a result of this work that it is becoming more publicly known that forced sterilization did occur, and not even that long ago. It’s opened up questions for some women who have wondered if they were sterilized and that is why they stopped having children.
As I said earlier, a lot of times these procedures happened without the women even knowing about it. I haven’t actually seen any of the funding that you speak of make it to most of our women in the communities to allow reaching out even just to ask women if they think they may have been sterilized or to provide access to the medical records to see if sterilization did occur, let alone any sort of form of counselling and/or compensation.
I don’t know if it’s a question of the fact that the federal government is working through our national or regional Inuit associations, but I can tell you that for the women we have engaged with, it’s opened up more questions about their own potential family or individual status, but nothing beyond that that I’m aware of.
Senator Omidvar: So, Ms. Redfern, if and when the money comes to Inuit women, how would you and your association or Ms. Sharpe and her association want to invest it so that it does have an impact?
Ms. Redfern: I think it would be important for Pauktuutit, Amautiit and the [Technical difficulties] status women and other regions and women’s organizations to find a way collaboratively to develop some sort of program that helps women come forward. Being able to access their medical records has been a real challenge. Being able to inspect those records is important, especially if women have a suspicion that maybe they were sterilized because they stopped having children even though they hadn’t reached menopause and that stage of their life.
I do think that there is an opportunity to work collaboratively, to do it well. As I said, there may be some women that voluntarily choose not to know because it might just actually be too painful, so it’s offering that option. In addition, counselling is incredibly important because learning that the government did this to you, where you may have not known or just simply suspected, is very, very painful.
We need the full services. In Nunavut, up to 50% of our mental health counselling positions have usually been vacant for the last 25 years. It may even be worse since COVID.
Money alone doesn’t necessarily help an individual deal with all the emotional revelations that come with learning that information. We need to be very careful about how we would develop a program and support.
Senator Omidvar: Thank you.
Senator Hartling: Thank you, Ms. Sharpe and Ms. Redfern, for being with us tonight and for explaining to us some of the serious issues that you know better than any of us do.
I like that you brought forward some solutions to us. For example, Ms. Sharpe, you spoke about midwifery and, Ms. Redfern, you spoke about the need for health care professionals and the need to have language services available to people to be able to understand what’s going on.
If each of you could answer — there may be different answers — what needs to happen for more midwives, health professionals and language services to be there? What is the need? What are the barriers? What do you need for that to happen? Are there people ready to go into training? Can you tell us a little bit about what would happen if that could happen, how it would happen, please?
Thank you.
Ms. Sharpe: There are a number of things that Pauktuutit is doing, including doing some research in this area. We brought together women to collaborate on this topic.
We would also like to see the systematic barriers removed through initiatives such as increasing education access, not just in Nunavut but also in all areas of Inuit Nunangat. So that means accessing education, people who are able to provide the training that’s required for Inuit midwifery services, which would include elders and access to those elders.
Infrastructure would be the next area that’s needed. There would also need to be a way to break down the colonial barriers in having to have a doctor say, “Okay, you’re allowed to be delivered by a midwife. You don’t have to be sent out.”
I actually also wanted to touch on the last point regarding whether there have been increases for the better. From my point of view, here in Yellowknife, aside from expectant mothers being allowed to have their escorts, their spouse, come with them to deliver, there has been no visible increase to midwifery services from what was existing in 2019. In fact, from December last year to April of this year, here in Yellowknife, all women had to be sent out to Edmonton because of the shortage of health care staff. Imagine how Inuit midwifery services would reduce that need by allowing women to stay in their home communities and not have to be sent to Edmonton.
Now, bear in mind that in Nunavut you have three regions: the Kitikmeot, Kivalliq and the Qikiqtani.
Those from the Kitikmeot region — from places like Gjoa Haven, Cambridge Bay, Baker Lake — all come here to Yellowknife. So that’s already outside of the province. They still had to go to another province to deliver. This past January through April, women here in Yellowknife got a taste of that, and they did not like it.
Senator Hartling: Yes, that’s tough. That’s really hard, to go away from your family. Thank you.
Would Ms. Redfern like to answer that as well?
Ms. Redfern: Yes. I was working at Nunavut Tunngavik Inc. at the time the Government of Nunavut was working on the Nunavut Midwifery Profession Act. I was actually quite concerned that the new legislation, while grandfathering existing Inuit midwives being allowed to continue to practise, made it much more difficult for new people to become Inuit midwives without having to go through either being sent down south for a nationally recognized midwifery school or program or a much more difficult process — sort of a systemic, non-Inuit process — for an Inuk to apprentice under an existing Inuk or Inuit midwife. That caused me some great concern.
Last year, the Inuit midwives left the Rankin Inlet Birthing Centre on the allegations that they suffered years of mistreatment, racism and a lack of support from their government and, effectively, their employer.
Even when we manage to train Inuit — and these were Inuit who had been nationally trained, because they had left the territory and come back — we still have to deal with the systemic issues that our own Inuit staff face within the health care system.
If our goal is to increase Inuit within the health care profession, the last thing that we need and want is to see these initiatives result in women leaving this valuable profession; it then leaves women in our own regions and communities from being able to access something that is, or was, such a successful program.
I would only add one thing to what Pauktuutit President Gerri Sharpe said. Presuming that all pregnancies, all Inuit pregnancies, are high risk — and, therefore, forcing women to leave, usually a minimum of 30 days prior to their due date, to go to Iqaluit, Ottawa, Rankin, Yellowknife or Edmonton — rather than actually doing the individual assessment is highly problematic.
It’s incredibly stressful and traumatic for a woman to leave not only her family support system but also her community support system and her culture simply to do something as natural as having a child. So we need to do much better on creating Inuit midwives in all our communities and all the necessary resources that requires.
The Chair: Thank you, Ms. Redfern. We have ten minutes left in this session. I have two senators who have questions. If the questions and answers can be brief, it would be appreciated.
Senator Wells, to be followed by Senator Francis.
Senator Wells: Thank you, chair.
I want to thank President Sharpe and President Redfern, as well as Ms. Young, for the work and important advocacy that you’re doing. I do it every time, and I must do it now, I want to thank Senator Boyer for her important work on this.
I want to return to a line of questioning that Senator Omidvar brought up, and that was the question of the $33 million that’s been assigned. To me, when I look at the problem or the issue or the circumstance, I see you don’t just need midwives but you need Indigenous midwives — midwives that have that knowledge, specific training, language, cultural training and social training and who bring the elder knowledge.
This doesn’t just happen. I recognize that. So it seems to me that a better system has to be established whereby the services the system provides Indigenous women have to be a lot more extensive than they are. Not only that, they have to span northern Canada and also southern Canada, because it’s not just a northern Canada problem. It extends from British Columbia to my province of Newfoundland and Labrador, and I recognize that.
What are the systems that could be set up — aside from possible prosecutions and things that might also be considered — that aren’t set up now? Certainly, $33 million wouldn’t cover it, let alone the possibility of compensation, which seems entirely justified. But what are the physical systems that would allow patients to be empowered to make those decisions? And someone mentioned an excellent term; it seems appropriate for more than just this one topic: system navigation.
How big is this? How big does this need to be?
Ms. Sharpe: The question is not “how big should this be?” You should be asking what knowledge we should uncover again. Nunavut, the Northwest Territories, Nunavik, Nunatsiavut — we already had this knowledge. This is something that the federal government told us we were not allowed to do. The federal government and the residential schools came in and told Inuit that they have to deliver in the communities, that it has to be by a doctor and that it cannot be by Inuit anymore.
As we’re living and breathing right now, our elders are dying. My grandfather was a midwife. I could tell you stories about what my grandfather diagnosed just by looking at me, and he was right on the money. He had so much more knowledge than the other doctors I had to see, and all of that knowledge is dying off because it’s not being shared or the elders feel that it’s not at the level that it needs to be because they have been told by the government that their knowledge is not useful anymore.
Our elders need to be encouraged to share that knowledge so that we can bring it back into the communities, and our people can trust our elders. They trust them. The people that have grown up with the elders will trust the words they say, so that’s what you need to bring back. You need to put it back in the hands of the elders so that traditional knowledge once again has its place in our lives.
Senator Wells: Okay, thank you for that. President Redfern?
Ms. Redfern: The problem with working with an initial amount — $33 million — is that you try to figure out what you can do for $33 million rather than setting that aside and asking how much it would actually cost to build a proper Indigenous midwifery program in all our regions and do it in a way that Indigenous peoples would want to design and deliver those programs.
If we did that, then we would be able to come back to you and tell you what the proper plan is and how much it would actually cost. At this point in time, we haven’t done that. I would recommend that we do that.
Senator Wells: I just want to make one comment, chair, and I’ll be only seconds.
I’ve been around government and the Senate for a while, and $33 million sounds like a lot of money. It’s not a lot of money for a problem of this magnitude, a problem that’s caused by the system that was established by the government. I just want to leave our witnesses with that. I can’t speak for my colleagues, but you would certainly have my support.
Senator Francis: Thank you both for sharing your testimony with us here today. I know it takes a lot of strength and courage to speak up on these types of issues.
I would like both of you to comment for the record on whether the use of coerced or forced sterilization is an example of ongoing genocide of Indigenous people. I ask you this because the legal definition of genocide includes imposing measures to prevent births within a group.
The Chair: Who would like to go first? Madam Sharpe?
Ms. Sharpe: I’m going to say that, yes, it is a form of genocide. I do recall when I was growing up that it was a measure, a way, to stop all of those women having so many babies from so many different men. I’ll say that again. It was a way to stop those women from having so many babies by so many different men.
It takes two to make a child, so when it comes to men, men should play an equal role in this — not just the women. But it was mainly the women who were coerced and sterilized.
It wasn’t just women, as Ms. Redfern has mentioned, but it was mainly women that I’m aware of, and it was because they were unmarried and had multiple partners and multiple children. So yes, it was a form of genocide, in my mind.
Senator Francis: Thank you.
The Chair: Ms. Redfern, would you like to respond to that question?
Ms. Redfern: Well, effectively the government decision, as President Sharpe indicated, was, as I quoted earlier, a government preoccupation with how to keep Native people from reproducing. I know from the Qikiqtani Truth Commission that there was an obsession with how to reduce the cost of government services to Indigenous peoples in almost all areas. Having fewer Indigenous people would save the government money — less housing, less health care and fewer people to educate.
If you can reduce a population by forced sterilization, you are effectively reducing the number of people in our society and not through the choice of the individual or of our collective. It was a choice of government officials who simply did not see the value of our lives, our society and our culture as part of Canada.
The Chair: Thank you. The final question goes to Senator Gerba.
[Translation]
Senator Gerba: Thank you to the witnesses for talking to us today.
My question is for Ms. Sharpe. Like you, we all agree that racism must be stopped, that systemic racism must be stopped.
The witnesses who have appeared before our committee have told us why they can’t or won’t come forward. How do you think we can stop systemic racism if the victims of this inappropriate treatment don’t come forward?
[English]
The Chair: Who would like to respond to this?
Ms. Redfern: This is partly why the Qikiqtani Truth Commission was an Inuit-led and Inuit-funded commission. Inuit felt much more comfortable being able to share all the things that the government had done that had caused so much harm. This is why people who have been victims of government need a safe place in which to be able to share, and that usually means creating a place that is filled by Inuit for Inuit.
The Chair: Thank you.
Ms. Sharpe: From my point of view, having been a human rights commissioner for five years, people will not complain if they don’t know what their rights are. So first and foremost, people need to know what their rights are. Then they realize when they have been wronged. Then they can speak about it in a setting where they feel safe, which is around other Inuit. This is a problem right across Canada, so it would need to be with other Indigenous women. They need to share their stories, before they even realize they have been wronged. That’s when we can then move forward with identifying that and moving forward with reconciliation.
In my mind, it seems very wrong to speak of reconciliation before we even identify what the systematic barriers are. Reconciliation and moving forward have to start with recognizing what has happened and acknowledging it so that other people can be aware of what has happened, and maybe they can realize that it has happened to them as well.
The Chair: Thank you very much. I would like to thank the witnesses very much for your testimony. Your contributions to our study are greatly appreciated.
We are continuing our review of the forced and coerced sterilization of persons in Canada. As mentioned earlier, our June 2021 report underlined the importance of hearing from survivors about their experiences. Today, our committee is responding to this recommendation by hearing from women who have agreed to share their stories and their views.
I would like to introduce our second panel. On our second panel is Witness A, who wants to remain anonymous. I want to take this opportunity to welcome you, Witness A. Thank you for being with us today, and you have the floor.
Witness A, as an individual: Hello. I didn’t really know how to start off my statement, so I wrote a birth story of my youngest son.
I was born in August 1993 in Regina, Saskatchewan, and I am a proud Saulteaux woman from Zagime Anishinabek First Nation. I’m a mother of two wonderful boys and the oldest of six children. I am currently focusing on going back to school to study, and hopefully begin a career, in the field of medical laboratory studies.
I’ll start off with my pregnancy. I found out I was pregnant fairly early, about four to five weeks along, in late September 2017. The doctor that I chose was in the same doctor’s office that I went to with my first son. She wasn’t the same doctor as my first, but she worked in the same office, and I liked her a lot. She listened to a lot of my concerns and addressed any of hers. A tubal ligation was not once brought up.
Around 30 to 31 weeks, my pregnancy became looked at as high risk, because I started to develop gestational hypertension. Around 35 to 36 weeks, she told me that she wanted to avoid a Caesarean section because it would be more difficult for me as I’m a large woman. At 37 weeks, she told me she wanted me to be induced at 38 weeks, so my last appointment was set up around then.
Moving on to my induction process. It began on June 20, 2018. I got called in on the night of June 19, and I was told that I would be called that night or the next morning to start my induction. I was called the next morning and told to go to triage to come up with an induction plan. I waited a few hours and was seen and spoken to about the induction process. The doctor or nurse told me first that they would have to check my cervix to see what path we would go down. After they checked my cervix, I was still closed, and I was advised that I would have to be gelled in order to soften my cervix and then moved to the labouring room.
After my first attempt, they told me I was one centimetre, and I was able to be moved into the labouring room, and further induction efforts would be told to me. After that, I was told that the induction method I would be having would be described as a “flat insert” that would be used to further dilate me. I remember my contractions started pretty early, and I was started on the oxytocin, or the drip, and it was increased pretty frequently.
One of the moments that I remember clearly was when the head nurse and the doctor entered my room and were discussing what type of induction would work best for me, and they wanted to check my dilation before they made their decision. So they did, and I was roughly three centimetres dilated, and without warning, the doctor and the nurse broke my water. They were communicating with each other and leaving me in the dark. I remember joking with the nurse who was assigned to me that if I knew they were going to break my water, I would have taken off my socks, because they were drenched in fluids.
For the next 30 plus hours, I was monitored for high blood pressure and blood sugar and had one failed epidural attempt and one successful epidural attempt.
On the afternoon or evening of June 23, 2018, after my successful epidural, I started feeling off. I started feeling shaky and fevered. I felt like something wasn’t right. My mom was in the room with me, with my partner, and she realized that my water was broken for over 30 hours. My baby’s heart rate went up to 220 beats per minute. I was checked for dilation, and I was told my cervix was “cone-shaped” and that it felt like it was four to five centimetres. However, not long before, my cervix was only dilated two to three centimetres, which didn’t really make sense. It was also confirmed that I had meconium in my waters. That means the baby used the bathroom while in the womb.
Around 6 to 7 p.m., I was approached by the doctor, who told me that I would likely have to have an emergency C-section, because it was clear my baby was in distress, and that my body had a chance of going into septic shock. I agreed to the procedure, and they told me I would need to sign papers before.
Before they brought me the papers to sign, they brought up a tubal ligation. Since they would already be operating on me, they said that this would be a quick process. Prior to hearing this, I never had any thoughts about a tubal ligation and, honestly, I had no clue about what a tubal ligation was. I remember asking what that meant, and the answer I got seemed very vague and cruel. The doctor told me that the person performing the surgery had a very good reputation and that it was a safe surgery. They explained to me that they cut my Fallopian tubes and sear them closed and made a joke about how nothing would be getting through them. At that point, I didn’t second-guess my decision, because the only thing that was on my mind was surviving and the survival of my unborn child.
I signed without reading as I felt like the life of my unborn child was in my hands if I didn’t sign the documents fast enough. After I agreed, I remember the doctor and the nurse entering the room and asking my partner, who was also clearly Indigenous, to leave the room and give us a few moments alone. He left without incident. However, my mother stayed in the room with me. They started asking me if this was what I really wanted and how I could change my mind, because I might regret my decision later on. They also said I couldn’t change my mind if I happened to find a new partner and wanted a child with them. This was kind of said in a worst-case scenario type of way, like “if your partner leaves you, and you decide later on that you want a child with a new partner . . .” That’s the kind of tone that they had. I was completely caught off guard, and I felt like they were trying to safeguard themselves by making me almost fight for my tubal ligation. At that moment, I felt like I had to prove myself to them and prove how serious and committed I was to my partner.
I couldn’t stop shaking, and I could barely speak as my teeth were chattering from the epidural and the other drugs, like morphine, that I’d been given. I remember I waited for what felt like hours to finally be wheeled off to the operating room, and I had a few doctors give me looks as I’m a bigger woman. They seemed uncomfortable when having to lift my stomach to perform the Caesarean section. The surgery itself almost felt dreamlike. I remember fading in and out of consciousness, and I remember the tugging and pulling of my baby being removed from my body and the moment of horror when I didn’t hear his cries. I remember the doctors and nurses talking amongst themselves and saying, “That wasn’t as hard as I thought it would be,” when they were finished the surgery. Right after I gave birth, my baby couldn’t suck a bottle, and he was breathing really rapidly, so almost instantly, they brought him to the newborn intensive care unit, or NICU, and I wasn’t able to see him until the next day because of this.
I was expected to stay in the hospital for two to three days for antibiotics for a suspected infection. They didn’t tell me what suspected infection I had, and I was supposed to be given medications to prevent any blood clotting. I’m sure that’s normal in Caesarean sections. However, I was visited by my own doctor, since she didn’t deliver my baby. She came and checked to see how I was doing and asked me if I needed any form of birth control and that she could write me a prescription for one. I told her about my tubal ligation, and she looked horrified. She didn’t want to make eye contact after that. She apologized and left quickly, and I always wondered why her warm atmosphere quickly changed, and now, I realize why. A tubal ligation was never discussed, and I was under the age of 30 with only two children. I believe she knew that this practice was a bad decision from the hospital.
Since the sterilization, roughly four years ago today, I have been at a loss with my identity as a woman. I don’t believe it gets any easier knowing I can no longer do what women were made to do, and that is to carry life. The realization appears in waves of grief. Most days, I’m content and grateful with the two healthy boys I have. However, other days I feel like breaking down, because I feel as if I failed my family and myself.
After my youngest son was born, I didn’t feel a connection with him. I would cry during his first milestones, because I knew those would be the last first milestones I would ever get to experience. I had a hard time bonding with him due to this and would break down any time he would hit a new milestone. It wasn’t until he was roughly two years old that I finally felt that maternal connection with him. I remember holding him, and it felt like he sank a little deeper into my arms. When I looked at him and he stared back, I saw my baby and felt the same love I felt with my first son. I admired every part of his body and forgot about the sterilization for a while.
Today, thinking about the sterilization, I still feel heartbroken about it and probably will for a long time. However, I feel like I’m ready to speak about it and share my experience with whoever cares to listen. My hope is for my story is to educate at least one person about this ongoing issue we as Indigenous women face when it comes to forced and coerced sterilization.
Thank you.
The Chair: Thank you very much, Witness A. That was powerful testimony, and like you said, we need to hear these stories. When we hear these stories, we can take action, and maybe the story that you’ve told will compel others to come forward and tell their stories. I thank you. You were really great.
We’ll proceed now to questions from the senators. We have a bit of a time crunch, so four minutes for questions and answers. Thank you.
Senator Boyer: Thank you, Witness A, for your testimony. I know how difficult it was, and I want to assure you that your testimony has quite possibly saved the lives of other women by us having listened to you. Your bravery coming forward has possibly saved those lives.
I have a question about what kind of resources you could possibly think of that may assist you in any kind of recovery. Has in vitro fertilization, or IVF, ever crossed your mind, a reanastomosis of your Fallopian tubes or anything else that might assist you with your recovery at this time?
Witness A: Thank you, Senator Boyer. My partner and I have discussed IVF, because I’m still young. I’m only 28, so I’m still in the prime of my baby-carrying stage. We’ve discussed that a lot. People in my family have volunteered to carry my baby if that is something I want. However, IVF and those kinds of things are expensive, but I would love to be able to experience them eventually.
That’s currently why I’m trying to go back to school. My partner is also trying to go back to school so we can eventually have enough money saved up so we can go through with the procedures. Thank you again.
Senator Boyer: Thank you very much for that testimony. It’s my understanding that it’s between $10,000 and $15,000 for that surgery. Is that what you’re saving up for?
Witness A: Yes, that’s exactly what we hope to save up for. Because — thank you.
Senator Wells: I’ll be one minute, and I’d be happy to give whatever extra time I have back to Senator Boyer.
Witness A, thank you so much for the courage you have expressed in your written and spoken words. You were concise, you were clear, you were informative, and I thank you for that. I thank you for moving us all closer to a solution and giving strength to others in your situation.
Witness A: Thank you for your comments. When I spoke to other women, the one thing I really wanted to do was to help educate other people and make it known that this is still happening. This just happened four years ago, and I hope to continue to educate people about this concern throughout Canada. Thank you.
Senator Wells: Thank you.
Senator Omidvar: Thank you so much to our witness for providing this difficult testimony to us, both through the written word and the spoken word. The written word helped us prepare for this. I read it before the meeting.
Clearly, the health care system let you down. What action have you taken against the hospital and the medical professionals involved? There was a breach of duty. They did not discuss with you appropriately the impact of what they were suggesting. They used medical terminology without providing you a choice or even time to process it. You weren’t able to speak to your partner about it. Can you help us understand what action you have taken against the system — in this case the hospital — and the medical professionals?
Witness A: Thank you for your question. Honestly, it took a long time for me to even trust the health care system again. I haven’t really taken a stand against the hospital. I have been discussing things with my lawyer, Alisa Lombard, but I haven’t made a complaint or anything. It took until last year for me to finally go to the doctors for my mental health. I discussed with them that I have distrust of most hospitals and doctors because of this. I didn’t even want to go back to the doctor for my six-week check-up. I just went to get my staples removed from my stomach.
I felt like they really failed me. I have been scared to bring my baby for his check-ups. It has just created a huge distrust in the health care system. I feel as if they let me down, and I don’t know if I’ll ever be able to trust them fully again.
Senator Omidvar: Clearly, they did let you down.
We’re preparing a report with recommendations. What recommendations would you like to see in the report, based on your own personal experience?
Witness A: I feel the health care system needs to better communicate with their patients. For women’s health or women’s reproductive rights, I believe that a tubal ligation should never be brought up to the patient. I feel that’s the patient’s choice, if she wants, or if they want, a tubal ligation. I believe that’s 100% their own decision, and it should never be brought up, especially while you’re expecting or in the care of the health care system.
Senator Omidvar: Thank you.
Witness A: Thank you.
[Translation]
Senator Gerba: I think Senator Omidvar asked all my questions.
I’d just like to know this: what made you come and share your story with us today?
[English]
Maybe you would like me to ask my question in English.
Witness A: Yes, please.
Senator Gerba: What made you come and tell us about your experience?
Witness A: A year after I gave birth to my son, I didn’t think it was an issue. I thought that I was just feeling something normal. I thought I was just feeling that regret the doctors were talking about. Honestly, I didn’t know I was wronged until I reached out.
I saw the movement against forced sterilization and coercion. My mother was actually looking into it. I had been telling her how I was feeling, and she told me I should speak to someone about it. I was told that I have a right to feel the way I feel because something bad happened to me. Just knowing that, it felt like a weight was lifted off my chest. I felt as if I could breathe and that I had a right to feel the way I felt.
Just knowing that, it made me want to educate other people. It made me want to, hopefully, relieve the stress from other women who also feel the same way I do. That’s why I chose to share my experience, so it can help other women. I hope that other women will share their stories and experiences and realize that it’s not a feeling of regret, but it can also be against their rights, and they should speak up if they feel they were wronged as well.
Senator Gerba: Thank you.
Senator Audette: I don’t have a question, but I just want to say Tshinashkumitin, Witness A and the two other amazing women who spoke before. Talking is a way of healing. Your voice is helping not only Indigenous women but all of us. As an Innu woman, I now have the responsibility to carry your voice every day, so I’ll do my best. [Indigenous language spoken]
Witness A: Thank you so much for that.
Senator Boyer: Witness A, what do you think of the criminalization of the people who did this to you? How do you feel about that?
Witness A: When I discussed this with my lawyers, they told me that could be a possibility. A part of me knows that not all of the personnel involved were aware of it. That makes me feel bad, because I did have a few really great nurses throughout the days I was there, but I do know of some women who seemed almost malicious towards me and my partner, and I do believe that some of the people involved should be held criminally responsible for what they have done. I feel bad about it, but I don’t think that they really thought about me while I was in their care. I do believe that some people should be held responsible for their decisions, yes.
Senator Boyer: Thank you.
Witness A: Thank you.
The Chair: That brings us to the end of today’s testimony.
Witness A, I want to applaud you for your courage in sharing your story with us. Having heard your story, it’s our responsibility to retell it and make sure that what happened to you doesn’t happen to others. We can try. We look forward to the study.
I want to take this opportunity, as you suggested, Senator Boyer, to hear from survivors. This has been a great learning experience for all of us.
I want to thank you, Witness A. Your stories will assist us when we write our report.
Honourable senators, our next meeting on this topic is scheduled for Monday, May 16, 2022, when we will continue to hear from survivors and provide drafting instructions for our report on this subject to the analysts. Details about the other activities of RIDR will be provided later, once steering has met.
(The committee adjourned.)