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Holistic Midwifery Care

We honour and incorporate local indigenous knowledge during the spiritual, emotional, mental and physical experiences of a pregnant person during their childbearing year.

Available 24/7

Midwives are on call 24/7. They are there for you on weekdays, weekends and holidays. They are always there for you when you need them. This helps reduce emergency room and hospital visits.

After Care

Midwives provide up to 6 weeks post-pardum care. The midwifery model of care means that rates of interventions, like c-sections, are low (about half the provincial average).

Home & Office Visits

We can come and visit you in your environment too! Pregnant people will have about 12 prenatal visits with a midwife before their baby is born. Appointments last 30 to 45 minutes.


Our mission is to provide quality medical midwifery care, support and guidance to pregnant people, their families, and communities in a safe and culturally appropriate setting open to traditional teachings and ceremonies. We honour and incorporate local indigenous knowledge in relation to the spiritual, emotional, mental and physical experiences of people during their childbearing year.


Routine Check Ups

A client will have about 12 prenatal visits with a midwife before their baby is born.  Midwives arrange prenatal tests and routine prenatal testing, blood tests, ultrasounds, genetic screenings and standard laboratory and diagnostic tests.

photo credit: Natalie Lucier


Home/Clinic/Hospital Birth

With low risk pregnancies most people can choose to have their birth at home, in clinic, or at the hospital. Midwives in Ontario are trained in hospital and out-of-hospital birth, including birth at home and birth centres.

photo credit: Liz Lott Photography



Midwives provide on-call care; including prenatal, care during birth, and postpartum care. Midwives provide care to both the pregnant person and baby for up to six weeks after birth.

photo credit: Natalie Lucier


Breastfeeding Support

Midwives provide support, information, instructions and resources on breastfeeding. They provide personal assistance on techniques. Over 90% of midwifery clients are breastfeeding after six weeks, compared with a provincial average of about 60%.

photo credit: Natalie Lucier

''It all starts with good beginnings.'' - Carol Couchie B.H.Sc., R.M


K’Tigaaning is an Anishnaawbemwin word which translates  to “In the Garden.” In a garden, we came and in a garden – we grow. Midwives work with pregnant people who are cultivating new life within them that will change their life path forever, expand their families and help build their communities. Each client Midwives work with helps them grow professionally as well. Midwives are in the business of nurture and life.

We provide midwifery clinic services through our clinic on Nipissing First Nation, ON and at our Powassan site as well. Our mission is to provide quality midwifery care, support and guidance to pregnant people, their families, and communities in a safe and culturally appropriate setting open to traditional teachings and ceremonies. We honour  and incorporate local indigenous (First Nation) knowledge in relation to the spiritual, emotional, mental and physical experiences of a pregnant person during their childbearing year . We endeavour to provide training and mentorship, and provide an environment conducive to inter professional development to initiate post-colonial and community-based healing and wellness in the area of maternal health and well-being.

Mother-daughter midwifery team Carol Couchie and Rachel Dennis have a combined experience of more than 20 years. They are both members of Nipissing First Nation. They have worked on First Nations and in large city centres across Canada. shortly after opening their clinic in Powassan, they were joined by midwife Audrey ten Westeneind who has been working as a midwife for over 15 years.

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1. Provide quality midwifery care, support and guidance to expecting women, their families, and communities;

2. Provide a safe and culturally appropriate medical setting open to traditional teachings and ceremonies;

3. Provide training and mentorship applicable to inter-professional development and First Nation midwifery education;

4. Provide an environment which initiates post-colonial and community-based healing, and wellness in the area of maternal health and wellbeing;

5. Work with community and integrated health contacts/programs to promote maternal health benefits of First-Nation specific midwifery client care.

– Customized personal care

-Prenatal, care during birth, postpartum care

– Safe & enjoyable

– Customized birth plans

– High standards

– In home/clinic/hospital births

– Lower rate of C-sections and intervention

– Midwives’ expertise includes vaginal birth after C-section (VBAC)

– Routine prenatal tests: Midwives arrange all routine prenatal testing including blood tests, ultrasounds and genetic screenings as well as standard laboratory and diagnostic tests.

*photo credit: Dark Woods Photography

Our Team


Carol Couchie, B.Sc., RM

Carol graduated midwifery school from Ryerson University in 1998. Carol is the new Member at Large on the Association of Ontario Midwives Board, and her particular interest is to support and advance the board’s strategic goal around restoring birth to Indigenous communities. Enthusiastic about association-level work, she is a founding member of the National Aboriginal Council of Midwives (NACM). She has served as a board member for women’s shelters, the College of Midwives of Manitoba, the Canadian Association of Midwives, and is an elder member of the core leaders of NACM. Carol has co-chaired the Society of Obstetricians and Gynecologists of Canada’s  (SOGC) Aboriginal Women’s Health Committee and helped write the SOGC recommendations on returning birth to rural and remote Aboriginal communities, as well as recommendations for rural and remote maternity care. Carol is passionate about being a good midwife and a strong traditional teacher. She comes from a Family tradition of Midwifery, as her great grandmother was a midwife on Nipissing First Nation, her niece Evelyn George is a midwife who works in a First Nation in BC, and Carol is extremely proud to practice with her daughter, Rachel Dennis.


Ahnii, I’m Rachel. I graduated midwifery school from Ryerson University in 2012. In my senior year, I trained at Seventh Generation Midwives Toronto (SGMT), an Indigenous focused midwifery practice servicing the Greater Toronto Area. I continued to work at SGMT for my first year and a half of practice after graduating. I credit my experience working with the midwives as well as the clients at SGMT, as being pivotal to the development of my craft, and navigating the areas of care where midwives can provide additional support.

As I am very passionate about bringing birth back to Indigenous communities, in the very infant stages of my midwifery career I endeavored to open a midwifery practice in my family’s home community of Nipissing First Nation with my mother. Although my blood is from Nipissing, my roots also lie in Toronto’s Indigenous community. This has provided a broader understanding of the positive outcomes associated with being cared for by Indigenous people in your own community. The value of this work was especially instilled in me when I worked as a research assistant in the Inuulitsivik Health Centre in Nunavik.

My mother and I have succeeded in continuing the matrilineal lines of midwifery practice, and are thrilled that we were able to open the doors of K’Tigaaning Midwives, located on Nipissing First Nation (NFN) in November 2016. It has been an honor and pleasure to plan and design the clinic on NFN, and continue to be responsible for the day-to-day business administration. As a result of this, I feel enthusiastic about sharing my experiences with other Indigenous midwives to help encourage the growth of midwifery in all Indigenous communities.

Having worked at a camp as a teenager for intercity Indigenous youth, including a specialized camp for children with FASD, I have also developed a dedication for supporting and working with teens and marginalized youth.

I have two beautiful children that I was fortunate enough to have at home, supported by my partner and 4 generations of family members.


Audrey tenWesteneind

I studied to become a midwife at Ryerson University in Toronto and graduated in 1998. I have practiced midwifery since then – my first 3 years in Toronto and the remainder in North Bay. I was raised, and lived for many years in southern Ontario, (Oshawa, the Kawarthas and then Toronto) in both urban and rural settings. I have spent much time in Temagami, Ontario, and was drawn to living in the North. Hence my move to North Bay in 2001. Throughout my life I have been in touch with Indigenous culture and this includes spending time with some of the Indigenous families of Bear Island in Temagami, practicing midwifery in Attawapiskat during Locums, and working with a Native housing agency in Toronto. This experience rooted my passion to educate myself, and continuously work on accepting feedback in order to be a friend and ally.

As a younger person, I always enjoyed travelling and learning languages, and this included living and studying in Quebec. I also lived in South America for over a year, specifically in Colombia and Peru, and can speak French, Spanish and some Dutch. As a midwifery student, I did a placement in the Netherlands in the community where my father was born and raised. As a working midwife, I have had the opportunity to work with Spanish speaking midwives in Toronto’s Hispanic community. Also, as mentioned earlier, in the last few years I have worked as a Locum midwife with the Cree of the James Bay Coast in Attawapiskat. Working elsewhere can teach us so much about ourselves and enhance our skills. I believe it helps us see ourselves better to ask us why we do the things the way we do. I am humbled by how much we can continue to learn as our pregnant clients and their babies teach us new things every day.

I am grateful to my supportive partner and teen son……who endure my many absences from home. Together we enjoy being active outdoors – biking, running, skiing, paddling.

Being a midwife can be challenging, but more so, it is such a privilege and a joy. We get to share in a life transforming experience with a range of diverse families.  My days are never dull; quite the opposite actually…. I get to learn about life, love, families, health, birth, babies, breast feeding, social strife, pain and all the complexities in between.

I joined K’Tigaaning Midwives in April 2015 and am excited about all of the practices future endeavors.


I am a mum of many daughters. I was born and raised in Australia, and moved to Canada in 1996. In Australia, I experienced being cared for by midwives during my labours. After moving to Canada, I had the privilege of caring for many children though the foster care system. This amazing, loving, and extremely educating time in my life gave me the opportunity to work with, and begin to have an understanding of Indigenous families in Canada (as well as my home of Australia), and the injustice they continue to experience due to the impacts of colonialism.

Working within the foster care system, and my continued work with K’Tigaaning Midwives, challenges me to remain open to learning. I have a deep willingness to be a trusted advocate and ally, always ready to learn from my mistakes.

I moved to Ontario in 2009 and met Carol Couchie and Rachel Dennis in 2013. That year provided many experiences that challenged, inspired, and enriched my life. Providing care to pregnant people and their families, as well as support to the midwives, has made me feel that I am on the right life path. I currently live on a beautiful property in Astorville, with my many animals and my beautiful daughters.


I’m Irene Lariviere, originally from Toronto. My family and I moved to North Bay in the mid 90’s.   We settled here because my parents had purchased a large parcel of farmland in Lavigne, Ontario in the mid 70’s and we wanted to be closer to the ‘farm’.

As a nursing student I loved the learning experience in Maternal Care so much that I asked to complete my working consolidation in this area, and fortunately being an older student with decent performance levels my Dean said yes!  Humber College offered amazing opportunities and instruction to achieve excellence in Nursing.   

During my final year as a pregnant student caring for expecting mothers I had foundational experiences that more deeply engrained my love for maternal care.  While working at Northwestern General Hospital in Toronto, my manager at the time said I had a unique rapport with my patients because I could more closely relate to all of their biopsychosocial changes.

My work experiences have been in Pediatrics, Maternal Care, Labour and Delivery, Medicine and Telemedicine.   A five-year stint in Labour and Delivery at Northwestern General Hospital was and still is my most loved experience from my entire nursing practice. I was very blessed to be able to work with midwives and nurses from Jamaica, the Philippines and England; these diligent and resourceful women lovingly harnessed my passion for assisting in births and patiently taught me all they could.  The time of mentorship with them was and still is a treasure beyond riches.

Since 2013 I have been employed as a Second attendant with K’Tigaaning Midwives.  I am very grateful for every opportunity to be working with this excellent team of Midwives.  Finally, I want to thank everyone for the opportunity to care for you and serve you during one of life’s most awesome experiences! 


Currently, there are 97 midwifery clinics across the province, providing care to women and babies in urban, rural and remote communities.

Midwifery is a growing profession: there are currently about 625 registered midwives in the province, anticipated to   grow to over 1000 by 2015.


Great things are happening at K'tigaaning Midwives!

Find out more about the new Nipissing First Nation location.grandopening1


40 Couchie Industrial Rd. S

North Bay, ON

P1B 8G5


Fax: 705-476-2470