Bringing Safety and Responsiveness Into the Forefront of Care for Pregnant and Parenting Aboriginal People

Abstract

Poor access to prenatal care for Aboriginal people is well documented, and is explicated as an unethical barrier to care resulting from colonial and neocolonial values, attitudes, and practices. A postcolonial standpoint, participatory research principles, and a case study design were used to investigate 2 Aboriginal organizations' experiences improving care for pregnant and parenting Aboriginal people. Data were collected through exploratory interviews and small-group discussions with purposefully selected community leaders, providers, and community members. The study found that safety in healthcare relationships and settings, and responsiveness to individuals' and families' unique experiences and capacities must be brought into the forefront of care. Results suggest that the intention of care must be situated within a broader view of colonizing relations to improve early access to, and relevance of, care during pregnancy and parenting for Aboriginal people.

Canadian Indigenous Womens Perspectives of Maternal Health and Health Care Services: A Systematic Review

“…Medical evacuation was described in five studies [65][66][67][68][69] . Medical evacuation was often due to the limited maternity care options available in remote communities.…”

“…Medical evacuation was often due to the limited maternity care options available in remote communities. Pregnant and postpartum women who left their communities to give birth experienced emotional, physical and financial stress, and women did not feel in control of their birthing experiences [65][66][67][68][69] . Mothers felt disconnected and isolated from their family, community, and culture; they were required to give birth in an unfamiliar environment without the support of their families and often expressed concern about children left at home [65][66][67][68][69] .…”

“…Pregnant and postpartum women who left their communities to give birth experienced emotional, physical and financial stress, and women did not feel in control of their birthing experiences [65][66][67][68][69] . Mothers felt disconnected and isolated from their family, community, and culture; they were required to give birth in an unfamiliar environment without the support of their families and often expressed concern about children left at home [65][66][67][68][69] . Some medical costs of birthing outside the community are covered by the government or band councils, but additional financial burdens included the cost of childcare, loss of income if their -From the perspective of losing local services, participants expressed the importance of a local birth in reinforcing the attributes that contributed to their identities including the importance of community and kinship ties, and the strength of ties to their traditional territory.…”

“…;seven articles on experiences of birthing and maternal healthcare [57][58][59][60][61][62][63] ; and eight articles that presented data relevant to both categories [64][65][66][67][68] (Table 1). These articles were further classified by the primary area of research described in the study: eight articles on maternal healthcare and/or medical evacuation [65][66][67][68] ; three articles on the impact of policies on maternal health [59][60][61][62][63] ; three articles on gestational diabetes mellitus (GDM) 61,62 ; and two articles on maternal weight changes and/or breastfeeding [66][67][68] .…”

“…These articles were further classified by the primary area of research described in the study: eight articles on maternal healthcare and/or medical evacuation [65][66][67][68] ; three articles on the impact of policies on maternal health [59][60][61][62][63] ; three articles on gestational diabetes mellitus (GDM) 61,62 ; and two articles on maternal weight changes and/or breastfeeding [66][67][68] . The included studies described 1043 participants, of which 918 were identified as being Indigenous peoples or from an Indigenous community.…”