Envisioning a culturally safe midwifery model from the perspective of Indigenous families: A case study of midwifery care in inner city Winnipeg, Manitoba, Canada (original) (raw)
Related papers
2020
Objective Cultural safety is an Indigenous concept that can improve how healthcare services are delivered to both Indigenous and non-Indigenous peoples in Canada. This study explored how Indigenous and non-Indigenous clients at an urban, Indigenous-focused midwifery practice in Toronto, Canada (Seventh Generation Midwives Toronto, SGMT) conceptualised and experienced culturally safe care. Design and setting Interviews were conducted with former clients of SGMT as a part of a larger evaluation of the practice. Participants were purposefully recruited. Interviews were transcribed and analysed thematically using an iterative, consensus-based approach and a critical, naturalistic, and decolonising lens. Participants Saturation was reached after 20 interviews (n=9 Indigenous participants, n=11 non-Indigenous participants). Results Three domains of cultural safety emerged. Each domain included several themes: Relationships and Communication (respect and support for choices; personalised a...
International Journal of Indigenous Health, 2024
Indigenous women and birthing parents in Canada disproportionately face mistreatment in their maternal health care expe-Indigenous maternal health riences due to systemic anti-Indigenous racism, ongoing harmful Midwifery and doula care impacts of settler colonialism, and power differentials inherent in Canadian settler colonialism many health care relationships. Indigenous midwives and doulas Reclamation are important leaders in resisting these conditions and reclaim-Culturally safe care ing traditional Indigenous birth knowledge and practices. Ulti-Anti-racism mately, they work to uphold Indigenous self-determination and Truth and Reconciliation Com-sovereignty. Grounded in an understanding of historical and curmission rent challenges regarding Indigenous maternal health, this qualitative study explored how best to situate oneself as a settler researcher and maternal health practitioner to support Indigenous maternal health in a culturally safe, anti-racist manner. In this article, key insights are shared from semi-structured interviews conducted with five prominent Indigenous scholars, midwives and community leaders. These consultants emphasized the central importance of intentional relationships in advancing the reclamation of traditional birth practices and providing culturally safe care, along with the indispensability of Indigenous midwives and doulas in these processes. Consultants also stressed the critical need for increased numbers of, and accessibility to, Indigenous practitioners in communities across the country. Settler practitioners are urged to understand the historical and contemporary impacts of settler colonialism, and the significance of building culturally safe, anti-racist relationships with their Indigenous colleagues and clients.
In this paper the author focuses on the need for further supports, and training, for Aboriginal midwives in Ontario. The alarming health disparities between Aboriginal and non-Aboriginal people, including devastating stillbirth and infant loss rates, mean that more attention needs to be paid to Aboriginal women's experiences of, and health during, pregnancy and childbirth. The author advocates for the return of birth to communities, which means more funding for Aboriginal midwifery birthing centres and training programmes. Where hospital birth is necessary because of high-risk and low service provisions, hospitals are advised to incorporate culturally appropriate services (such as Elders and Midwives), and the government is urged to increase funding for families to visit or call so women are not alone when they give birth.
Moving Toward Indigenous-Centred Perinatal Care in Urban Quebec
International Journal of Indigenous Health, 2020
This article explores Abinodjic, an initiative of the Native Friendship Centre in Val-d’Or, Quebec, Canada, which aims to move toward Indigenous-centred perinatal care for Indigenous mothers and families. Drawing on the findings of a three-year collaborative developmental evaluation, this article describes the emergence and relevance of a model of perinatal care in which Mino Pimatisi8in (a wholistic view of well-being) is the overarching goal, and where parental experiences, healthy lifestyles, support networks, and cultural knowledges are four interdependent areas of intervention that support children’s well-being, in the context of culturally safe services and approaches. We discuss three key elements significant to the initiative: (a) valuing Indigenous ways of being, (b) centring relationships and supporting the social networks, and (c) being advocates, both directly for community members as well as for Indigenous Peoples generally within the health and social services system. ...
Indigenous mothers’ experiences of using primary care in Hamilton, Ontario, for their infants
International Journal of Qualitative Studies on Health and Well-being
Purpose: Access to primary care can help mitigate the negative impacts of social inequity that disproportionately affect Indigenous people in Canada. Despite this, however, Indigenous people cite difficulties accessing care. This study seeks to understand how Indigenous mothers-typically responsible for the health of their infants-living in urban areas, experience selecting and using health services to meet the health needs of their infants. Results provide strategies to improve access to care, which may lead to improved health outcomes for Indigenous infants and their families. Methods: This qualitative interpretive description study is guided by the Two-Eyed Seeing framework. Interviews were conducted with 19 Indigenous mothers and 5 primary care providers. Results: The experiences of Indigenous mothers using primary care for their infants resulted in eight themes. Themes were organized according to three domains of primary care: structural, organizational and personnel. Conclusions: Primary care providers can develop contextual-awareness to better recognize and respond to the health and well-being of Indigenous families. Applying culturally safe, trauma and violence-informed and family-centred approaches to care can promote equitable access and positive health care interactions which may lead to improved health outcomes for Indigenous infants and their families.
BMC pregnancy and childbirth, 2016
Pregnant Indigenous women suffer a disproportionate burden of risk and adverse outcomes relative to non-Indigenous women. Although there has been a call for improved prenatal care, examples are scarce. Therefore, we explored the characteristics of effective care with First Nations women from the perspective of prenatal healthcare providers (HCPs). We conducted an ethnographic community-based participatory research study in collaboration with a large Cree First Nations community in Alberta, Canada. We carried out semi-structured interviews with 12 prenatal healthcare providers (HCPs) that were recorded, transcribed, and subjected to qualitative content analysis. According to the participants, relationships and trust, cultural understanding, and context-specific care were key features of effective prenatal care and challenge the typical healthcare model. HCPs that are able to foster sincere, non-judgmental, and enjoyable interactions with patients may be more effective in treating pre...
Background: Evidence is emerging of the benefits to students of providing continuity of midwifery care as a learning strategy in midwifery education, however little is known about the value of this strategy for midwifery students. Aim: To explore Indigenous students’ perceptions of providing continuity of midwifery care to Indigenous women whilst undertaking a Bachelor of Midwifery. Methods: Indigenous Bachelor of Midwifery students’ experiences of providing continuity of midwifery care to Indigenous childbearing women were explored within an Indigenous research approach using a narrative inquiry framework. Participants were three Indigenous midwifery students who provided continuity of care to Indigenous women. Findings: Three interconnected themes; facilitating connection, being connected, and journeying with the woman. These themes contribute to the overarching finding that the experience of providing continuity of care for Indigenous women creates a sense of personal affirmation, purpose and a validation of cultural identity in Indigenous students. Discussion and conclusions: Midwifery philosophy aligns strongly with the Indigenous health philosophy and this provides a learning platform for Indigenous student midwives. Privileging Indigenous culture within midwifery education programs assists students develop a sense of purpose and affirms them in their emerging professional role and within their community. The findings from this study illustrate the demand for, and pertinence of, continuity of care midwifery experiences with Indigenous women as fundamental to increasing the Indigenous midwifery workforce in Australia. Australian universities should provide this experience for Indigenous student midwives.
aboriginal policy studies, 2015
It is not only remote Aboriginal communities in Canada that have poorer maternalinfant health status than Canadian averages; residents of First Nation communities located close to large urban centres also experience this health status gap. Alexander, Alexis, Enoch, and Paul First Nations are located within an hour of healthcare services in greater Edmonton. The narratives of 75 predominantly Cree and Stoney women from these communities were gathered through seven talking circles and five semi-structured interviews. The participants described their experiences of loss and separation as pregnancy care and childbirth moved out of the community and into the hospital over the last two generations. This shift was not only a geographic relocation; it also disconnected the childbirth experience from elders, family and community, traditional teachings, and spiritual meaning. Conversely, the participants' hospital experiences were characterized by a limited sense of cultural safety. Participants highlighted the urgent need to reintegrate culturally based community support and health perspectives into the childbirth experience. The implementation of such a culturally integrated healthcare model in all Aboriginal communities-remote, rural, suburban, and urban-may be the key finally to closing the gap between Aboriginal and non-Aboriginal maternal and infant health status in Canada.
2017
Immigrant women’s healthcare has been one of the major areas of research in the literature on settlement in Ontario, but little research exists on the relationship between immigrant women and their healthcare providers, and even less that is from the perspective of the healthcare provider. This study used semi-structured interviews with 10 midwives who serve uninsured immigrant clientele in order to understand how they navigate challenges to provide culturally safe care. Discourse analysis revealed that participants discussed barriers that were both logistical and conceptual in nature when providing care to uninsured immigrant clients. Midwives indicated that logistical barriers and fear of providing insufficient culturally safe care were factors that made practices more reluctant to take on uninsured immigrant clients. Their discussion of culturally safe care was informed by the Ontario midwifery model, but their strategies for delivering culturally safe care often involved a reneg...