Through its publicly funded health care system, Canada is committed to offering accessible, quality maternity health services to all its citizens, yet this remains a challenge in its First Nations, rural and immigrant communities. With the implementation of midwifery as a self-regulating health profession in Manitoba, Canada, in 2000, initiatives were incorporated into the structure of the profession to try to address this issue. This qualitative investigation documents and explores these initiatives through a case study combining semistructured interviews and documentary sources. The innovations discussed include the development of an Aboriginal midwifery degree program, the supports put in place to assist rural midwifery practices, and the efforts to increase ethnic diversity and cultural competence within the midwifery profession. What unites these efforts is a community building approach which attempts to strengthen communities through local midwifery services and midwives drawn from community members.