Identity matters: Aboriginal mothers' experiences of accessing health care

Herk, Kimberley Anne Van; Smith, Dawn; Andrew, Caroline

doi:10.5172/conu.2010.37.1.057

Cited by 30 publications

(9 citation statements)

References 9 publications

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“…Articles that provide historical context and insight into the influence’s colonization has on health outcomes and/or access to health care services indicate that these structural determinants play a significant role in the health and well-being of Indigenous women within Canada [ 19 , 21 , 45 , 61 – 65 ]. A number of articles mentioned the impact of intergenerational trauma, residential schools, racism, and discrimination negatively shaped access to health care services for Indigenous mothers [ 21 , 45 , 66 ].…”

Section: Resultsmentioning

confidence: 99%

Indigenous maternal health and health services within Canada: a scoping review

Bacciaglia

Neufeld

Neiterman

et al. 2023

BMC Pregnancy Childbirth

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Background Globally, there are disparities in access to maternal health care services and equity in maternal health outcomes between Indigenous and non-Indigenous populations. While the literature is growing, it has not been systematically synthesized. This review addresses this gap by synthesizing the existing literature on the organizational structure of maternity care, accessibility and delivery of services, and clinical disparities impacting Indigenous maternal health within Canada. It also identifies current knowledge gaps in research on these topics. Methods A scoping review was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines and the extension for scoping reviews. The search for relevant papers was performed in PubMed, CINAHL, and SCOPUS electronic databases and included any empirical literature written in English and published during 2006 – 2021. The research team inductively coded 5 articles to develop a coding scheme, which was then applied to the remaining articles. Results A total of 89 articles were included in the review, of which 32 were qualitative papers, 40 quantitative, 8 were mixed-methods publications, and 9 were review papers. The analysis of the articles resulted in identifying a range of overarching themes pertaining to the maternal health of Indigenous women within Canada including provision of services, clinical issues, education, health disparities, organization, spatial context, and impact of informal support. The results suggest that physical, psychological, organizational, and systemic barriers inhibit the quality-of-care pregnant Indigenous women receive, and that maternal health services are not consistently provided in a culturally safe manner. Results also suggest that, compared to non-Indigenous pregnant women, Indigenous women are more likely to develop clinical complications during pregnancy, reflecting the structural impacts of colonization that continue to negatively influence Indigenous maternal health and well-being. Conclusions There are many complex barriers that prevent Indigenous women from receiving high quality and culturally appropriate maternal care. Possible areas that could address the service gaps illuminated through this review include the implementation of cultural considerations across health care jurisdictions within Canada.

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Section: Resultsmentioning

confidence: 99%

Indigenous maternal health and health services within Canada: a scoping review

Bacciaglia

Neufeld

Neiterman

et al. 2023

BMC Pregnancy Childbirth

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“…Some previous studies have identified factors which may potentially exacerbate adverse maternal and infant health outcomes among Canadian Indigenous populations 32 . These factors include socio-cultural and socio-economic status, which may affect diet and lifestyle [32][33][34][35][36][37][38][39][40][41][42] , accessibility to healthcare services [43][44][45][46] , incidence of gestational infections and illnesses 47,48 , prevalence of smoking and alcohol consumption during pregnancy [49][50][51] , as well as presence of hazardous environmental contaminants [52][53][54][55][56] , which all directly and indirectly impact the health and wellness of Indigenous Canadian women. However, there is a knowledge gap that precludes a comprehensive understanding of maternal health among indigenous women in Canada.…”

mentioning

confidence: 99%

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

Sharma¹,

Kolahdooz²,

Launier³

et al. 2016

Divers Equal Health Care

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Development of policies and interventions to address health disparities between Indigenous and non-Indigenous populations requires a comprehensive understanding of Indigenous people's experiences and perspectives of healthcare services. We systematically reviewed the published literature on Canadian Indigenous women's experiences and perspectives of maternal healthcare during pregnancy, childbirth, and the postpartum period. Major bibliographic databases (including PubMed, CINAHL, EMBASE, SCOPUS, and SSCI) were searched for published studies (1990( -March 2015 in English. Reference lists of identified articles were searched to identify additional articles. 92 articles were retrieved for further review, of which 16 studies were included: 8 on maternal healthcare and/or medical evacuation; 3 on gestational diabetes mellitus; 3 on the impact of policies on maternal health; and 2 on maternal weight changes and/or breastfeeding. The included studies described 1043 participants: Indigenous peoples (n=918) and non-Indigenous peoples (n=125) who were mothers or pregnant women (n=814), healthcare providers or workers in a health-related field (n=132), and fathers, Elders, or other community members (n=97). Availability of healthcare resources, healthcare services' consideration of socio-economic or lifestyle barriers to health, and the impact of colonization on interactions with healthcare providers were main factors that impacted Indigenous women's maternal health experiences. Medical evacuation was often due to limited maternity care options available in remote communities, and was associated with emotional, physical, and financial stress. This review highlights the importance of consistent health policies and practices for maternal health in Canada and providing culturally safe and patient-centered maternity healthcare services within indigenous communities.

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“…Indigenous mothers who have experienced racism and discrimination in the healthcare system have difficulty trusting health providers (Denison, Varcoe, & Browne, ; Smith et al., ; Van Herk, Smith, & Andrew, ; Van Herk, Smith, & Tedford Gold, ). This phenomenon is not unique to Canada; globally, Indigenous people cite racism as a common reason for mistrusting health providers (Waterworth, Dimmock, Pescud, Braham, & Rosenberg, ).…”

Section: Discussionmentioning

confidence: 99%

“…Strength‐based approaches can be part of culturally safe care for Indigenous women, as it has been advocated for in the literature (McCalman et al., ; Smith et al., ; Van Herk et al., , ). As desired by the mothers in this study, ACPs can build a mother's confidence in her parenting by helping her find her voice through listening, validating her concerns and actively engaging her in decision‐making.…”

Section: Discussionmentioning

confidence: 99%

“…As desired by the mothers in this study, ACPs can build a mother's confidence in her parenting by helping her find her voice through listening, validating her concerns and actively engaging her in decision‐making. Building on strengths, like a social network, knowledge of their infant's health, and their ability to problem solve, helps to improve self‐esteem and encourages mothers to return for future care (McCalman et al., ; Smith, Edwards, Martens, & Varcoe, ; Smith et al., ; Van Herk et al., , ).…”

Section: Discussionmentioning

confidence: 99%

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Indigenous mothers' experiences of using acute care health services for their infants

Wright

Jack

Ballantyne

et al. 2019

Journal of Clinical Nursing

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Aims and Objectives To develop an understanding of how Indigenous mothers experience selecting and using health services for their infants can assist nurses in improving their access to care. This understanding may ultimately lead to improved health outcomes for Indigenous infants and their families. Background Access to acute care services is important to minimise morbidity and mortality from urgent health issues; however, Indigenous people describe difficulties accessing care. Indigenous infants are known to use the emergency department frequently, yet little is known about the facilitators and barriers their mothers experience when accessing these services. Design This study undertook a qualitative, interpretive description design. Methods This article adheres to the reporting guidelines of COREQ. Data collection methods included interviews and a discussion group with Indigenous mothers (n = 19). Data analysis was collaborative and incorporated both Indigenous and Western ways of knowing, through the application of Two‐Eyed Seeing. Results A thematic summary resulted in six themes: (a) problematic wait times; (b) the hidden costs of acute care; (c) paediatric care; (d) trusting relationships; (e) racism and discrimination; and (f) holistic care. Conclusions The experiences of Indigenous mothers using acute care services for their infants suggest a role for culturally safe and trauma and violence‐informed care by health providers in the acute care context. Relevance to Clinical Practice Nurses can improve access to acute care services for Indigenous mothers and infants through the provision of culturally safe and trauma and violence‐informed approaches care, by building rapport with families, providing care that is respectful and nonjudgemental, eliminating fees associated with using acute care services and linking families with cultural resources both in hospital and within the community.

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Identity matters: Aboriginal mothers' experiences of accessing health care

Cited by 30 publications

References 9 publications

Indigenous maternal health and health services within Canada: a scoping review

Indigenous maternal health and health services within Canada: a scoping review

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

Indigenous mothers' experiences of using acute care health services for their infants

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