Indications for transfer for childbirth in Inuit women at the Innuulisivik Maternity

The Innuulisivik Maternity is a northern-based service in Povungnituk, Quebec, which serves the Inuit women of the Hudson Coast. Although most women stay in the North for childbirth, others are transferred south. This paper will describe the experience of the Innuulisivik Maternity, which uses committee-based risk assessment for transfer decisions. Data for the three-year period 1989-1991 were examined. Descriptive statistics were used to compare the observed differences in the distribution of several variables according to birthplace. Data were available for 411 women. Three hundred fifty (85.2%) of the births occurred at Innuulisivik: 44 (10.7%) women were transferred and 17 (4.1%) were nursing station births. In 80% of transfers, clinical conditions were identified which in themselves usually require transfer. Premature labor was prevalent in the transfer group. The data demonstrate that risk scoring by consensus is a viable option for northern birthing units. Finally, logistical and cultural factors should be included for meaningful risk assessment in the North.