Traditionally, young Inuit women received little information about puberty, fertility, and pregnancy. Consequently, elders describe that it was not uncommon for young women to remain in bed when they reached menarche, believing that they were sick or physiologically different. Once informed, the young woman's mother would instruct her on menstruation practices and often, the camp (or community) would become apprised of her situation. During menstruation, women were expected to follow certain practices including, 1) not sitting where men sat, 2) using rabbit skin, foxes or mosses and other garments, with the exception of men's garments, for sanitary pads, and 3) laying rabbit skin on the bed at night to soak up blood. According to elders, women had to abide by more rules than men because of their menstruation and some rules were not only considered tradition, but also taboo if not followed. For example, using a man's garment for a sanitary pad could prevent the young woman from finding a husband for marriage.
Marriage commonly occurred when the female reached 14–15 years of age and the man reached adulthood, considered around 20 years of age. The marriage was traditionally arranged by the parents of the couple, possibly as early as infanthood, and often reflected a desire to strengthen the bond between families. In some parts of the Arctic, men also practised the tradition of "stealing" their wife from a camp, symbolically showing that the family did not want the daughter to leave their camp. In these cases, the family would later celebrate together and the woman would then join the husband's territory.
Childhood of the Inuit was still very brief the first half of the 20th century. Especially girls entered marriage at an early age. Before the arrival of Christian missionaries, it was mostly the families who decided which children should marry whom, i.e. arranged marriages. Marriages often served to strengthen family ties, and girls had no say in choosing their partners. Sometimes a young man who had not yet been pledged, sent to the parents of the girl, without being personally present in those negotiations. The wedding was completely unceremonial (the same was true for birthdays). After Christianization, the only change was that now the couples also received Christian marriage ceremonies whenever a priest travelled their areas (often months after the actual marriage). When finally government administration had been established, marriages were also registered by the administration, initially by police officers, later by the local administrations. Since moving from the camps to the settlements, more couples live together without marriage. This way, they feel less tied but also less responsible. But still in the 1970s, it was in no way unusual to make agreements regarding newborns about eventual marriages. However, when these promises of marriage became due, fifteen or twenty years later, they were taken less and less seriously. The young people increasingly defied tradition and followed their own wishes.
Before Christianizing (referred to as Siqqitiq by the Inuit), polygamy, more often polygyny, less so polyandry, were not unusual among the Inuit. Extramarital relationships were accepted especially during extensive hunting trips, and there were so-called "lamp extinction games" with ritual partner exchanges. According to a popular theory, these traditions reduced the danger of inbreeding and resulting population bottleneck in small and isolated settlements. With colonization, these customs led to great conflicts: On one hand such traditions were thought by missionaries as sinful, on the other, they were interpreted as sexual arbitrariness and taken advantage of, often leading to prostitution and sexual exploitation.
However, due to men being required to sometimes travel large distances to obtain food the division was not absolute. Men, for example, would need to know how to sew in case repairs were needed to their clothing. At the same time women were required to know how to hunt and be able to help with igloo building.Until the middle of the 20th century, i.e. until the move from disperse camps to settlements, the sexual division of labour between men and women within the families and family groups in northern Canada was traditionally arranged fairly well, and rather different: The men were responsible for the acquisition of food, especially for hunting and fishing, and for technical work (including the construction of igloos, qarmaqs and tents). The Inuit women were predominantly in charge of intra-family concerns, such as caring for little children, taking care of the kill (conservation of meat, cleaning of furs, and the like), the sewing of clothing, fire keeping in the qulliq, etc. (their participation in hunting and fishing was limited). Whenever a family lost its breadwinner (for example in an accident), it was usually dependent on support by other families, and the widow was sometimes adopted as additional wife by a close relative of the deceased (see widow inheritance).
The move from the camps to the settlements, which essentially took place during the 1950s, brought about significant changes in this respect: The Inuit now were immediate subjects of governmental administration and care (also social welfare). By occupations that were completely new to them, like in health care and local administration, but also in Inuit arts, the women with their earned money were able to contribute like the men to the livelihood of their families. Nowadays, the division of tasks and responsibilities between male and female Inuit are, following Canadian legislation, not very different from western industrialized nations, of which the Inuit are considered part. In the Northwest Territories the first female premier was Nellie Cournoyea, an Inuk. In Nunavut, female representatives and ministers are as common as their male counterparts. There are Inuit municipalities with female mayors, for example.
Nunavummiut, 85% of whom identify as Inuit, experience wide gaps in health status and access. The people of Nunavut have a life expectancy which is more than 14 years shorter than the Canadian average (66.8 years vs. 81 years). This is likely affected by its astonishingly high suicide rate, which is eleven times the national average. Smoking rates among females are at 50% versus 20.5% nationally, and the fertility rate is more than twice as high (3.3 vs. 1.5 nationally). Of particular concern in Nunavut is rapid urbanization and subsequent overcrowding, with many homes without improved sanitation facilities. Food insecurity is another concern, with nearly 57% of children living in food insecure households as measured by University of Toronto researchers. This dovetails with Nunavut's high obesity rate, which stands at 45.4%- more than twice the national average of 21.8%.
The Second World War and subsequent Cold War initiated a newfound interest in the Arctic by the Canadian government. Its vast mineral resources and strategic proximity to the USSR brought rapid development to the region. The study of the Inuit people's health outcomes also began, finding vast health disparities between northern and southern Canadians. This prompted the opening of several nursing outposts in the Northwest Territories, including what is now Nunavut to provide primary and some secondary care to the Inuit population. These proved successful, and several studies found that Inuit had better access to primary care than many southern Canadians. To aid in maternity care, the government in Ottawa began recruiting midwives from England and New Zealand to work in the Arctic regions, which preserved the woman-centred midwifery model of care practiced by the traditional Inuit midwives. However, this was short-lived due to more stringent immigration laws passed in the 1970s. The physicians recruited to replace these midwives advocated for a medicalized, tertiary-care level birth, and a de facto policy of flying women to southern hospitals for labour and delivery was adopted. In the 1970s and 1980s, nearly 100% of pregnant women were flown out of their homeland to give birth. The most popular routes-from north to Yellowknife, Ottawa, Ontario; Churchill, Manitoba; or Winnipeg, Manitoba could be more than 1,000 miles.
So common was the fly out to give birth that Inuit culture began to adapt to this almost inevitable fact. To announce a newborn member of their community, many Inuit proclaim "the newborn has arrived" instead of "the baby is born". Due to the fact that the infant is several weeks old when it arrives in its homeland, it is common for members of the community to shake the baby's hand to welcome him or her to the community.
In the early 21st century, about half of Inuit women are flown out from Nunavut to southern hospitals for delivery, and evacuations consume more than 20% of the territory's health budget. They normally leave two to three weeks prior to their due date and return two to three weeks after birth. There are reports of Inuit women returning home after more than one month away to find their house in ruins and their other children poorly cared for. Inuit culture is closely tied to the land and community, and birth outside of this land causes cultural dissonance. Many Inuit women interviewed about the practice remarked that their children born outside of Nunangat were not truly Inuit. Some communities, such as Cambridge Bay, have a birthing centre available for low risk births and in 2014 two local women graduated from Nunavut Arctic College's midwifery program. The centre is available for all communities in the Kitikmeot Region. However, higher risk and first time mothers must still go to the hospital in Yellowknife.
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