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

Abstract

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.

Spurring the Uptake of Maternal Healthcare Services in Culturally Endowed Communities in Elgeyo Marakwet, Kenya

“…This finding supports the results of Rono et al, that reports that Marakwet women may shun hospitals adrift of social and cultural values (18). Sharma et al, adds that, the current maternity approaches of women giving birth without the support of families disconnects and segregates mothers (19).…”

“…The study infers that support services bestow native Marakwet woman power to exercise while passing along a modicum of labour and childbirth. This narrative is well documented (19,20,21). Furthermore, cultured birthing centre is known to provide greater involvement, satisfaction and attachment (19) as well as enhanced uptake of services (20).…”

“…This narrative is well documented (19,20,21). Furthermore, cultured birthing centre is known to provide greater involvement, satisfaction and attachment (19) as well as enhanced uptake of services (20). Gibson-Helm et al, infers that cultured birthing centre offers continuous quality improvement initiative (21).…”

A Novel Approach to Transforming Smoking Cessation Practice for Pregnant Aboriginal Women and Girls Living in the Pilbara

“…Returning again to the international literature, a systematic review addressing Canadian Indigenous women’s perspectives of maternal health care services [ 57 ] considered the policy environment which interrupts women’s access to appropriate health care, including access to smoking cessation programs. The review found that inconsistent advice provided to pregnant women who smoked, as well as factors such as substance abuse, unstable domestic situations and low socio-economic circumstances compromised the ability of women to attend cessation programs.…”

Settler Colonialism and the Contemporary Coerced Sterilizations of Indigenous Women

“…Sharma et al 2016's work is premised on the understanding the disparities of maternal health in Canada for Indigenous people and non-indigenous populations. Sharma et al (2016) find that "inconsistent and non-comprehensive policies" cause impediments to maternal health and healthcare access (341). Interestingly, Hole et al 2015's analysis of Indigenous peoples and culturally safe and unsafe care, contextualize the culturally unsafe care in the bureaucratic biomedical systems and which are physically placed in buildings that were the houses of colonist institutions (1668).…”