Help bring back the celebration of life: A community-based participatory study of rural Aboriginal women’s maternity experiences and outcomes

BMC Pregnancy and Childbirth

Miranda Tallio¹  Thelma Harvey²  Betty Calam³  Helen Brown⁴  Colleen Varcoe⁴ 

[1] Family Support Worker, Box 132, Bella Coola, BC VOT 1CO, Canada;Community Health Representative, Box 463, Bella Coola, BC VOT 1CO, Canada;Department of Family Practice, University of British Columbia, British Columbia, Canada;University of British Columbia School of Nursing, T149 - 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada

关键词: Critical ethnography;    Colonialism;    Outcomes;    Maternity care;    Rural;    Aboriginal;   

Others  :  1151117
DOI  :  10.1186/1471-2393-13-26

 received in 2012-09-15, accepted in 2013-01-21,  发布年份 2013

【 摘 要 】

Background

Despite clear evidence regarding how social determinants of health and structural inequities shape health, Aboriginal women’s birth outcomes are not adequately understood as arising from the historical, economic and social circumstances of their lives. The purpose of this study was to understand rural Aboriginal women’s experiences of maternity care and factors shaping those experiences.

Methods

Aboriginal women from the Nuxalk, Haida and 'N

a

m

g

is First Nations and academics from the University of British Columbia in nursing, medicine and counselling psychology used ethnographic methods within a participatory action research framework. We interviewed over 100 women, and involved additional community members through interviews and community meetings. Data were analyzed within each community and across communities.

Results

Most participants described distressing experiences during pregnancy and birthing as they grappled with diminishing local maternity care choices, racism and challenging economic circumstances. Rural Aboriginal women’s birthing experiences are shaped by the intersections among rural circumstances, the effects of historical and ongoing colonization, and concurrent efforts toward self-determination and more vibrant cultures and communities.

Conclusion

Women’s experiences and birth outcomes could be significantly improved if health care providers learned about and accounted for Aboriginal people’s varied encounters with historical and ongoing colonization that unequivocally shapes health and health care. Practitioners who better understand Aboriginal women’s birth outcomes in context can better care in every interaction, particularly by enhancing women’s power, choice, and control over their experiences. Efforts to improve maternity care that account for the social and historical production of health inequities are crucial.

【 授权许可】

   
2013 Varcoe et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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