Giving birth in a good way when it must take place away from home: Participatory research into visions of Inuit families and their Montreal‐based medical providers

Author:

Silver Hilah1ORCID,Tukalak Sophie23,Sarmiento Iván14ORCID,Budgell Richard1,Cockcroft Anne1,Vang Zoua M.5,Andersson Neil16

Affiliation:

1. Department of Family Medicine McGill University Montréal Québec Canada

2. McGill University Health Centre Research Institute Montréal Québec Canada

3. Indigenous Maternal Infant Health & Well‐being (IMIHW) Lab McGill University Montréal Québec Canada

4. Escuela de Medicina y Ciencias de la Salud Universidad del Rosario Bogotá Colombia

5. Department of Sociology McGill University Montréal Québec Canada

6. Centro de Investigación de Enfermedades Tropicales – CIET Universidad Autónoma de Guerrero Acapulco Mexico

Abstract

AbstractBackgroundTransferring pregnant women out of their communities for childbirth continues to affect Inuit women living in Nunavik—Inuit territory in Northern Quebec. With estimates of maternal evacuation rates in the region between 14% and 33%, we examine how to support culturally safe birth for Inuit families when birth must take place away from home.MethodsA participatory research approach explored perceptions of Inuit families and their perinatal healthcare providers in Montreal for culturally safe birth, or “birth in a good way” in the context of evacuation, using fuzzy cognitive mapping. We used thematic analysis, fuzzy transitive closure, and an application of Harris' discourse analysis to analyze the maps and synthesize the findings into policy and practice recommendations.ResultsEighteen maps authored by 8 Inuit and 24 service providers in Montreal generated 17 recommendations related to culturally safe birth in the context of evacuation. Family presence, financial assistance, patient and family engagement, and staff training featured prominently in participant visions. Participants also highlighted the need for culturally adapted services, with provision of traditional foods and the presence of Inuit perinatal care providers. Stakeholder engagement in the research resulted in dissemination of the findings to Inuit national organizations and implementation of several immediate improvements in the cultural safety of flyout births to Montreal.ConclusionsThe findings point toward the need for culturally adapted, family‐centered, and Inuit‐led services to support birth that is as culturally safe as possible when evacuation is indicated. Application of these recommendations has the potential to benefit Inuit maternal, infant, and family wellness.

Funder

Canadian Institutes of Health Research

Publisher

Wiley

Subject

Obstetrics and Gynecology

Reference23 articles.

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

2. Remote Midwifery in Nunavik, Québec, Canada: Outcomes of Perinatal Care for the Inuulitsivik Health Centre, 2000-2007

3. Childbirth evacuation among rural and remote Indigenous communities in Canada: A scoping review

4. Statistics Canada. Nunavik Quebec.Aboriginal Population Profile 2016 Census. Accessed December 10 2022.https://www12.statcan.gc.ca/census‐recensement/2016/dp‐pd/abpopprof/details/page.cfm?Lang=E&Geo1=AB&Code1=2016C1005084&Data=Count&SearchText=Nunavik&SearchType=Begins&B1=All&GeoLevel=PR&GeoCode=2016C1005084&SEX_ID=1&AGE_ID=1&RESGEO_ID=1

5. Fuzzy cognitive mapping: An old tool with new uses in nursing research

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