Accessing Maternity Care in Rural Canada: There's More to the Story Than Distance to a Doctor

Sutherns, Rebecca; Bourgeault, Ivy Lynn

doi:10.1080/07399330802269568

Cited by 39 publications

(28 citation statements)

References 33 publications

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“…However, following three decades of declining rural maternity services in Canada [20-22] each community was grappling with stresses associated with birthing including dwindling birth and economic resources. Although all communities had some prenatal education and care, there was variation in other services such as ultrasound, transportation for prenatal diagnostic services, and supplementary income for nutrition.…”

Section: Resultsmentioning

confidence: 99%

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

Varcoe

Brown

Calam

et al. 2013

BMC Pregnancy Childbirth

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BackgroundDespite 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.MethodsAboriginal women from the Nuxalk, Haida and 'Namgis 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.ResultsMost 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.ConclusionWomen’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.

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Section: Resultsmentioning

confidence: 99%

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

Varcoe

Brown

Calam

et al. 2013

BMC Pregnancy Childbirth

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“…Women living in rural areas experienced similar ‘costs’ for travelling long distances to obtain healthcare services (Leipert et al . , Sutherns & Bourgeault ), as did women seeking cardiac rehabilitation services (Rolfe et al . ).…”

Section: Resultsmentioning

confidence: 99%

“…Women in rural settings also described accepting or continuing to rely on healthcare they perceived as substandard because of a lack of other alternatives. For instance, new mothers in rural Ontario remarked that they felt ‘lucky’ to have a physician, given the limited resources available in their areas (Sutherns & Bourgeault , p. 869), even if the healthcare options were not ideal; as one woman remarked about the only lactation consultant available in her area, she ‘wouldn't send her worst enemy to see her’ (Sutherns & Bourgeault , p. 871). In other cases, women simply endured negative encounters in accessing healthcare, including poor patient–provider communication (Friedman & Hoffman‐Goetz , Ahmad et al .…”

Section: Resultsmentioning

confidence: 99%

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Women's strategies to achieve access to healthcare in Ontario, Canada: a meta-synthesis

Lombardo

Angus

Lowndes

et al. 2014

Health Soc Care Community

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As part of a mixed methods study on women's access to the healthcare system in Ontario, Canada, we undertook a qualitative meta‐synthesis to better understand the contextual conditions under which women access healthcare. An earlier phase of the synthesis demonstrated a series of factors that complicate women's access to healthcare in Ontario. Here, we consider women's agency in responding to these factors. We used meta‐study methods to synthesise findings from qualitative studies published between January 2002 and December 2010. Studies were identified by searches of numerous databases, including CINAHL, MEDLINE, Scopus, Gender Studies Database and LGBT Life. Inclusion criteria included use of a qualitative research design; published in a peer‐reviewed journal during the specified time period; included a sample at least partially recruited in Ontario; included distinct findings for women participants; and in English language. Studies were included in the final sample after appraisals using a qualitative research appraisal tool. We found that women utilised a spectrum of responses to forces limiting access to healthcare: mobilising financial, social and interpersonal resources; living out shortfalls by making do, doing without, and emotional self‐management; and avoiding illness and maintaining health. Across the studies, women described their efforts to overcome challenges to accessing healthcare. However, there were evident limits to women's agency and many of their strategies represented temporary measures rather than viable long‐term solutions. While women can be resourceful and resilient in overcoming access disparities, systemic problems still need to be addressed. Women need to be involved in designing and implementing interventions to improve access to healthcare, and to address the root problems of these issues.

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“…A contrario, des études menées au Royaume-Uni ne trouvent pas d'association significative entre temps de trajet à la maternité la plus proche et état de santé de l'enfant à la naissance (Parker et al, 2000 ;Dummer et Parker, 2004). Des recherches complémentaires sont donc encore nécessaires pour analyser les relations entre distance d'accès à la maternité et état de santé périnatale ainsi que la question de l'accessibilité, au sens large, aux maternités lors de l'accouchement (Penchansky et al, 1981 ;Sutherns et Bourgeault, 2008). De telles analyses sont en cours pour la région Bourgogne dans le cadre du présent projet de recherche « Territoires de vie, santé périnatale et adéquation des services de santé ».…”

Section: Discussion Et Conclusionunclassified

Une géographie de l’offre de soins en restructuration : les territoires des maternités en Bourgogne

Charreire

Combier²,

Michaut³

et al. 2012

cgq

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Mots-clésMaternité, accessibilité spatiale, inégalités, aires d'attraction, flux, Bourgogne. Axe 2 Territoires d' études, territoires d' action, acteurs en présence -L' espace quotidien et l' accessibilitéVersion originale soumise en mars 2011. Version révisée reçue en septembre 2011. Cahiers de géographie du QuébecVolume 55, numéro 156, décembre 2011 AbstractThe organization of perinatal healthcare services in France is undergoing significant change due to the restructuring of maternity healthcare services and in particular the closure of small and medium sized maternity units. Beyond the strong local reactions and debate provoked by the closure of these maternity units, is it reasonable to say that changes of this kind affect access to maternity care by expectant mothers during pregnancy or delivery ? The goal of our study is to examine changes in the impact of successive closures of maternity units on spatial accessibility for pregnant women and identify the corresponding new catchment (service) areas. The study covers the Burgundy region, a heterogeneous combination of urban, suburban and rural enclaves, all of which are subject to centrifugal forces. The study highlights spatial inequalities in access to perinatal care and identifies factors that policy makers and public health professionals must take into consideration when addressing equity issues. KeywordsMaternity unit, spatial accessibility, inequality, catchment area, flux, Burgundy. ResumenEn Francia, la organización de servicios de salud perinatal atraviesa actualmente profundas transformaciones ocasionadas por la restructuración de la oferta de servicios sanitarios, debido principalmente del cierre de medias y pequeñas maternidades. Más allá de la polémica provocada, se pregunta si tales restructuraciones repercuten en la accesibilidad de las parturientas a las maternidades.Después que varias maternidades han cerrado, una después de la otra, este estudio tiene por objetivo de presentar la recomposición de las prácticas espaciales de las mujeres y de leer cuales son las nuevas áreas de atracción.La región del estudio es la de Bourgogne, territorio heterogéneo con fuerzas centrífugas que asocian zonas urbanas, periurbanas y enclaves rurales. Se pone igualmente en evidencia las desigualdades espaciales de acceso a los servicios sanitarios y provee elementos de análisis sobre cuestiones de equidad que dirigentes y profesionales en salud pública se plantean. Palabras clavesMaternidad, accesibilidad espacial, desigualdades, áreas de atracción, flujo, Bourgogne.

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Accessing Maternity Care in Rural Canada: There's More to the Story Than Distance to a Doctor

Cited by 39 publications

References 33 publications

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

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

Women's strategies to achieve access to healthcare in Ontario, Canada: a meta-synthesis

Une géographie de l’offre de soins en restructuration : les territoires des maternités en Bourgogne

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