Indigenous communities in Canada (First Nations, Inuit, and Métis peoples) have distinct traditional knowledge and practices for pregnancy and birth, and these have sustained healthy and thriving Indigenous communities for millennia. Indigenous midwives historically held a leading role as primary providers of sexual and reproductive healthcare. However, colonial practices severely disrupted the role of Indigenous midwives and the transfer of their knowledge from generation to generation. The obstetric evacuation policy in Canada requires people who live in rural and remote locations to leave their community to have a hospital delivery.

Evidence suggests this policy negatively impacts Indigenous people who desire to give birth in their communities. To implement optimal perinatal care for Indigenous people, Indigenous midwives in Canada seek evidence to answer the following questions: (1) What is the cost of obstetric evacuation, compared to Indigenous midwifery? And (2) What are the health outcomes for obstetric evacuation versus Indigenous midwifery?