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A Canadian policy requires the routine evacuation of pregnant First Nations women who live on-reserve in rural and remote regions to larger centres to gain access to perinatal services. Despite this access, First Nations women's health remains poor and the First Nations infant mortality rate remains high. In this paper, we employ First Nations feminist theory to understand why the evacuation policy does not result in good health, especially for First Nations women. Four themes emerge: decolonization, self-determination, land, and community. Based on these results, we argue that First Nations’ concepts of health are largely incongruent with the Euro-Canadian bio-medical model, a model that is foundational to the evacuation policy. Until health policies incorporate and are congruent with First Nations’ epistemologies and related health practices, their health will continue to suffer. Policy recommendations are offered to promote First Nations health in a way that is consistent with First Nations’ epistemologies.

Our study demonstrated that common predictors of PPD including anxiety, experiencing stressful life events during pregnancy, having low levels of social support, and a previous history of depression were consistent among non-Aboriginal women. However, with the exception of the number of stressful events among First Nations offreserve, these were not associated with PPD among Aboriginal women. This information can be used to further increase awareness of mental health indicators among Aboriginal women.

This analysis of urban Indigenous women’s experiences on the Homeland of the Métis and Treaty One (Winnipeg, Manitoba, Canada), Treaty Four (Regina, Saskatchewan, Canada), and Treaty Six (Saskatoon, Saskatchewan, Canada) territories illustrates that Indigenous women have recently experienced coercion when interacting with healthcare and social service providers in various settings. Drawing on analysis of media, study conversations, and policies, this collaborative, action-oriented project with 32 women and Two-Spirit collaborators demonstrated a pattern of healthcare and other service providers subjecting Indigenous women to coercive practices related to tubal ligations, long-term contraceptives, and abortions. We foreground techniques Indigenous women use to assert their rights within contexts of reproductive coercion, including acts of refusal, negotiation, and sharing community knowledge. By recognizing how colonial relations shape Indigenous women’s experiences, decision-makers and service providers can take action to transform institutional cultures so Indigenous women can navigate their reproductive decision-making with safety and dignity.

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