Development of a framework of improved childbirth care for First Nation women in Manitoba: A First Nation family centred approach
This paper reports on a qualitative exploratory study focusing on the childbirth experiences of women and their families from a northern isolated community in Manitoba - who had to leave or were about to leave home to give birth. Perspectives from critical medical anthropology, cultural relativism and human ecological theory provided the theoretical foundation for this study. This study utilized ethnographic approaches to explore the perspectives of the women, their families and “significant others” and how they have been affected by policies, practices and structures at all levels of their environment in an attempt to gain a better understanding of the type of support and services that could potentially improve this experience. Presently, women from northern, rural and/or isolated communities leave home from a period of a few days up to 10 weeks to deliver their babies in an urban tertiary centre. They stay in boarding homes with others who have left home to obtain medical care, or with family and friends. During this period of time the women often do not access prenatal support or services within the regional health authority, other than medical care from a primary care provider (whom they may not have seen prior in their pregnancy) or to receive specialized medical intervention and monitoring. The boarding homes where they often stay do not offer any prenatal support or outreach services and are not conducive to housing women so close to delivering a baby. The women spoke of their experiences of giving birth marred by memories of fear, anger, frustration, tears and longing for family. They also spoke of a renewed sense of hope and excitement at the opportunity to share their ideas about possible ways that their experience could be improved. This paper breathed life into their thoughts and brought their ideas together to develop a new vision towards a system of supportive childbirth care for First Nation women in Manitoba, and more specifically, for women who are medically evacuated from the north to deliver their babies in urban Manitoba. For the Faculty of Medicine, it is a Master’s thesis, but for me and the many women and residents of Berens River, it is an opportunity for First Nation women to participate in shaping policy and influencing the direction for care and services that is created for them. It is important to acknowledge that evacuation and temporary relocation for birth is not an issue unique to First Nation women, it impacts hundreds of other northern and rural Métis and non-First Nation women every year. However, their experience is not included in this study. This paper suggests immediate and interim solutions for women who must leave home to give birth, albeit, the ultimate aim is to return birthing services closer to home.
First Nations, Women, Prenatal Support, Medical Evacuation Policy