Returning birth: The politics of midwifery implementation on First Nations reserves in Canada

Olson, Rachel E.; Couchie, Carol

doi:10.1016/j.midw.2012.12.005

Cited by 18 publications

(19 citation statements)

References 8 publications

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“…The enactment of this policy fulfilled the government’s commitment, set forth in the 1994 public announcement, to regulate midwifery. Manitoba appeared to have a sustainable midwifery implementation strategy, as evidenced by endeavors to publicly fund the service [ 39 ] ensure accessibility to services by the Aboriginal population [ 58 ], and fund a midwifery education program in the North [ 59 ]. However, the findings of this study suggest that these initial and fundamental steps to establish midwifery in the province have not been followed by effective implementation actions over the subsequent 14 years to ensure the growth and sustainability of the profession…”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators related to implementation of regulated midwifery in Manitoba: a case study

Thiessen

Heaman

Mignone

et al. 2016

BMC Health Serv Res

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BackgroundIn 2000, midwifery was regulated in the Canadian Province of Manitoba. Since the establishment of the midwifery program, little formal research has analyzed the utilization of regulated midwifery services. In Manitoba, the demand for midwifery services has exceeded the number of midwives in practice. The specific objective of this study was to explore factors influencing the implementation and utilization of regulated midwifery services in Manitoba.MethodsThe case study design incorporated qualitative exploratory descriptive methods, using data derived from two sources: interviews and public documents. Twenty-four key informants were purposefully selected to participate in semi-structured in-depth interviews. All documents analyzed were in the public domain. Content analysis was employed to analyze the documents and transcripts of the interviews.ResultsThe results of the study were informed by the Behavioral Model of Health Services Use. Three main topic areas were explored: facilitators, barriers, and future strategies and recommendations. The most common themes arising under facilitators were funding of midwifery services and strategies to integrate the profession. Power and conflict, and lack of a productive education program emerged as the most prominent themes under barriers. Finally, future strategies for sustaining the midwifery profession focused on ensuring avenues for registration and education, improving management strategies and accountability frameworks within the employment model, enhancing the work environment, and evaluating both the practice and employment models. Results of the document analysis supported the themes arising from the interviews.ConclusionThese findings on factors that influenced the implementation and integration of midwifery in Manitoba may provide useful information to key stakeholders in Manitoba, as well as other provinces as they work toward successful implementation of regulated midwifery practice. Funding for new positions and programs was consistently noted as a successful strategy. While barriers such as structures of power within Regional Health Authorities and inter and intra-professional conflict were identified, the lack of a productive midwifery education program emerged as the most prominent barrier. This new knowledge highlights issues that impact the ongoing growth and capacity of the midwifery profession and suggests directions for ensuring its sustainability.

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Section: Discussionmentioning

confidence: 99%

Barriers and facilitators related to implementation of regulated midwifery in Manitoba: a case study

Thiessen

Heaman

Mignone

et al. 2016

BMC Health Serv Res

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“…During the critical times post birth when they need to be supported to breastfeed, they are in many cases alone, or have few supportive people with them. Birthing away from support systems is known to result in a low uptake of breastfeeding [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Since the 1970s, women from remote, rural communities in Canada have been required to evacuate to tertiary referral centres. This mandatory policy has shown a cascade of negative social consequences including decreased breastfeeding [ 25 ]. Other research (Veile & Kramer, [ 26 ]) conducted in Mexico focusing on Indigenous women in remote, rural settings demonstrate a connection between transitioning birthing locations and breastfeeding patterns, their findings confirm decreasing durations of breastfeeding, however intensive and prolonged breastfeeding is still the “cultural norm” and there are no taboos which prohibit breastfeeding in public.…”

Section: Introductionmentioning

confidence: 99%

Breast feeding practices as cultural interventions for early childhood caries in Cree communities

Cidro

Zahayko²,

Lawrence

et al. 2015

BMC Oral Health

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BackgroundBreastfeeding is a gift from mother to child and has a wide range of positive health, social and cultural impacts on infants. The link between bottle feeding and the prevalence of early childhood caries (ECC) is well documented. In Aboriginal communities, the higher rates of ECC are linked with low rates of breast feeding and inappropriate infant feeding of high sugar content liquids.MethodsThe Baby Teeth Talk Study (BTT) is one project that is exploring the use of four interventions (motivational interviewing, anticipatory guidance, fluoride varnish and dental care to expectant mothers) for reducing the prevalence of ECC in infants within Aboriginal communities. This research explored cultural based practices through individual interviews and focus groups with older First Nations women in the community.ResultsParticipants in a First Nations community identified cultural based practices that have also been used to promote healthy infant feeding and good oral health. A wide range of themes related to oral health and infant feeding emerged. However, this paper focusses on three themes including: breastfeeding attitudes, social support for mothers and birthing and supporting healthy infant feeding through community programs.ConclusionsThe importance of understanding cultural health traditions is essential for those working in oral public health capacities to ensure there is community acceptance of the interventions.

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“…Lawford's (2011) master's research traced the origin of the practice of maternal evacuation to the year 1892. This is a critical research finding because the practice of evacuation has been described elsewhere as having originated between the 1960s-1980s as a result of institutional changes, primarily in an effort to decrease maternal and infant mortality rates (see, for example, Couchie & Sanderson, 2007;Fletcher, 1994;Olson, 2013;Olson & Couchie, 2013;SOGC, 2010;Van Wagner et al, 2007). A specific case study by Jude Kornelsen and colleagues (Kornelsen, Kotaska, Waterfall, Willie, & Wilson, 2010 Although the practice of evacuation is well documented, Lawford (2016Lawford ( , 2017 has noted that concrete descriptions of the federal policy regime governing evacuation are Health Canada, 2015).…”

Section: The Dis-place-ment Of Birthmentioning

confidence: 99%

“…The available literature positions Indigenous midwifery as playing a vital role in the decolonization and repatriation of birth because it honours the ceremony of birth through its embodiment of traditional knowledge and cultural practices (Carroll & Benoit, 2004;Couchie & Sanderson, 2007;National Aboriginal Health Organization, 2008;Olson, 2013;Olson & Couchie, 2013; Pauktuutit: Inuit Women's Association of Canada, 1995;Skye, 2010;Van Wagner et al, 2007). Lawford and Giles (2012b) assert that returning birth to community "would require a non-hierarchical team approach" (p. 337); possible barriers to implementing such multi-stakeholder care teams include "remuneration between providers, restrictive scopes of practices defined by legislation, and limited understanding and appreciation of the skill sets held by those in various health care professions involved in maternity services" (p. 337).…”

Section: Returning Birth To Community Through the Lens Of Decolonizationmentioning

confidence: 99%

Protecting the providers of Indigenous maternal care

Krzywania¹

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Place is a powerful ontological force which is constitutive of health and well-being for Indigenous peoples. Colonial violence dis-places relationships to land, bodies, and community, leading to the unacceptable and pervasive health inequities suffered by many Indigenous peoples living in the territories now known as Canada. This thesis describes acts of resistance to this dis-place-ment by providers of Indigenous maternal care in their advocacy to return birth to community. By mapping the spatio-legal dimensions of the Indigenous maternal care landscape in Ontario and Québec, this thesis investigates how (neo)colonial governance comes to bear on experiences of providing maternal care.Grounded in the analysis of primary data from interviews with six Knowledge Holders, the findings of this research articulate divergent ontologies of governance within systems of Indigenous and state law. This research calls for a meaningful engagement with Indigenous ontologies of governance to better account for the maternal care needs of pregnant Indigenous women and the providers who care for them.Abstract .

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Returning birth: The politics of midwifery implementation on First Nations reserves in Canada

Cited by 18 publications

References 8 publications

Barriers and facilitators related to implementation of regulated midwifery in Manitoba: a case study

Barriers and facilitators related to implementation of regulated midwifery in Manitoba: a case study

Breast feeding practices as cultural interventions for early childhood caries in Cree communities

Protecting the providers of Indigenous maternal care

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