Heeding warnings from the canary, the whale, and the Inuit

There is a tension between traditional and modern definitions of reproductive risk and normalcy. This excerpt describes that tension as it plays out among the Inuit of Northern Canada from the perspective of a community midwife who has worked with the Inuit. She presents an analytical framework which classifies and illuminates the types of logic that compete in most birth settings around the world-a framework useful for showing how some types of logic can be supervalued while others, such as cultural or intuitive logic, are devalued or simply ignored, often at great cost. The forced evacuation of all pregnant Inuit women from Northern Canada for the "privilege" of a hospital birth in the South illustrates the imbalance created when decisions purported to be based on one kind of logic (scientific) are in reality based on another (e.g., legal and clinical), or when any type of logic is given undue authority. After presenting the analytical framework and describing some of the history of Inuit childbirth, the author tells the story of one Inuit settlement's attempt to re-integrate the authoritative knowledge of the community by allowing Inuit midwives to choose their own criteria for balancing the imperatives of each kind of logic in decision-making for birth.