Have you ever wondered what it takes to make health care truly inclusive?
In Squamish, midwives and health care leaders are coming together to answer that question.
Local midwife Kazuko Hiroe, who has worked in the industry for nearly two decades, and in Squamish for two years noted the importance of understanding and addressing barriers Indigenous families face.
“It’s not just about providing care—it’s about listening to the communities and understanding what they need,” she said.
Building relationships through midwifery
Hiroe, who delivered 15 babies in Squamish in June alone, shared how midwifery is all about building trust and strong connections with families.
“When I work with Indigenous families, it often feels like I’m providing care for the whole community—not just one individual,” she said.
According to Hiroe, midwifery care is “fundamentally built on respect, collaboration, evidence-based practice, and client-centred care.”
“When working with Indigenous communities, it’s especially important to take the time to build relationships. That trust forms the foundation for collaboration between provider and client,” she said.
Hiroe also believes “these inequities often stem from historical experiences Indigenous families have had with health care and other systems.”
The found that racism is a widespread problem in 小蓝视频’s health care system. It revealed that 84% of Indigenous people surveyed had experienced discrimination while seeking medical care.
Listening to Indigenous voices in Squamish
According to Hiroe, historically, midwives in Squamish have had few Indigenous clients.
Upon asking the S岣祑x瘫wú7mesh Úxwumixw (Squamish Nation) for feedback, they discovered one significant barrier: geography.
“Our practice used to be on Tantalus Road in Garibaldi Estates, which was simply too far for many families. Accessing prenatal appointments became too challenging,” Hiroe said.
The feedback prompted a re-evaluation of the approach.
“A simple modification like offering care on a reserve, visiting homes, or being in an environment where families feel supported and safe could make a big difference,” she said.
In addition, many Indigenous families who travel to Squamish for prenatal care are from northern communities like Mount Currie.
“Squamish isn’t their home community. Their families and housing are not here, yet they’re sometimes required to stay in Squamish for four or more weeks before giving birth,” Hiroe said.
This extended stay creates significant stress for families.
Hiroe and her team are working to better understand and address these challenges.
“We’re trying to find ways to support these families during that time, whether it’s making them feel more comfortable in our hospitals or at prenatal appointments or helping them with practical needs like access to vehicles to get to their appointments,” she said.
Hiroe stressed that these changes must come from the community itself.
“Right now, we’re trying to work with the S岣祑x瘫wú7mesh Nation by asking what their needs are and what they would find helpful,” she said.
“It’s about being allies, not leaders, and really listening to what the S岣祑x瘫wú7mesh Nation and other Indigenous communities tell us they want and need.”
How 小蓝视频CNM is supporting change
British Columbia College of Nurses and Midwives regulates over 75,000 nurses and midwives in 小蓝视频.
A recent article, ‘A Continuous Journey: Addressing Indigenous-Specific Racism as a Nursing and Midwifery Regulator,’ co-authored by Louise Aerts and Cynthia Johansen, among others from the 小蓝视频CNM, highlights how racism in health care impacts Indigenous birthing individuals.
“We’re committed to eliminating systemic racism and supporting Indigenous communities. It’s not enough to articulate our commitment; we must demonstrate it through real action,” said Johansen, 小蓝视频CNM’s registrar and CEO.
“We’ve set standards for cultural safety, cultural humility, and anti-racism that every nurse and midwife in 小蓝视频 must follow.”
To help midwives and nurses meet these new standards, 小蓝视频CNM offers resources like handbooks and training.
Honouring Indigenous knowledge
Aerts, 小蓝视频CNM’s chief officer of strategy, reconciliation, and transformation, said that Indigenous midwifery often focuses on the whole community, which fits well with midwifery’s client-centred approach.
"It’s about supporting autonomous decision-making while honouring cultural traditions," she said.
小蓝视频CNM has also worked with knowledge keepers from local Nations, including Squamish, Musqueam, and Tsleil-Waututh.
“For so long, the truth was hidden,” Johansen said. “Now that we know it, we must act differently—not just as a college but as a country.”
Bhagyashree Chatterjee is The 小蓝视频’s Indigenous affairs reporter. This reporting beat is made possible by the .
