A large number of Inuit of the Eastern Arctic born since the mid-1960s have Manitoba birth certificates, a situation Inuit women want to see changed.
Speaking before the Royal Commission on Aboriginal Peoples, representatives of Pauktuutit (The Inuit Women's Association) called for changes in mid-wifery practices in the far North.
"To us, healthy children are born into their families and their communities. They are not born thousands of miles from home to an unhappy frightened mother," Pauktuutit Vice-President Martha Greig said.
In many cases, expectant mothers from the Keewatin, Baffin and High Arctic regions of the Northwest Territories are flown, sometimes up to three months in advance, to Winnipeg to give birth. Mothers in the Kitikmeot (central Arctic) are flown to Yellowknife.
These women leave behind their families to give birth among people they cannot even talk to.
The association is calling for the development of regional birthing centres, the provisioning of community nursing stations with the necessary staff and equipment for childbirth and the utilization of Inuit Elders as teachers for midwives.
Greig sees the need to combine traditional methods with Qablunaq or non-Inuit ways of midwifery.
"Natural childbirth worked well for thousands of years or we all wouldn't be sitting here," she said.
The practice of shipping mothers out of their communities to give birth dates back to the earliest days of government service to Northern communities. It was easier to ship mothers out than to province medical facilities.
Up until the 1970s, as each child was born they were issued with a cardboard disk with their number on it. The disks were to be worn at all times and used for identification as government officials had problems with Inuit names.
The ID disks are no longer issued but the women are still shipped out because of the bureaucratic ease it affords.
The Inuit of Northern Quebec were able to pressure the government to provide a birthing centre at the region's hospital, Greig said. The NWT government has only had control of health care since September 1989. Since then they have provided birthing centres in Iqaluit and Rankin Inlet and are developing one in Baker Lake.
The lack of midwifery services in the North only illustrate a larger problem of limited health care in Canada's North.
Commissioner Mary Simon said she could not believe the difficulties involved when she developed an abscess in northern Saskatchewan.
"I was X-rayed by someone in school who said there was absolutely nothing wrong with me. Then I was X-rayed by someone else who said there's nothing wrong
with you! There was something wrong with me - it didn't take a genius to figure that out."
In Yellowknife, home to the largest hospital in the NWT, medical cases of any seriousness are routinely evacuated to Edmonton, an air journey of close to 1,600 kilometres.
Pauktuutit officials feel one of the greatest difficulties in getting their recommendations implemented is the isolation of Inuit communities.
"A person living outside Toronto can just pick up a phone and ask for help and she can drive. But in the North we can't do that," said association President Martha Flaherty.