Strengthening support: service providers’ insights on addressing the complex needs of birthing people facing insecure housing in Winnipeg, Manitoba

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dc.contributor.authorHayward, Ashley
dc.contributor.examiningcommitteeMignone, Javier (Community Health Sciences)
dc.contributor.examiningcommitteeKelly, Lauren ( Pharmacology and Therapeutics)
dc.contributor.examiningcommitteeLawford, Karen (Midwifery, Faculty of Health Sciences, McMaster University)
dc.contributor.supervisorLavoie, Josee
dc.date.accessioned2025-01-03T15:47:31Z
dc.date.available2025-01-03T15:47:31Z
dc.date.issued2024-12-20
dc.date.submitted2024-12-25T17:09:37Zen_US
dc.date.submitted2025-01-02T19:28:28Zen_US
dc.degree.disciplinePeace and Conflict Studies
dc.degree.levelDoctor of Philosophy (Ph.D.)
dc.description.abstractBackground: Pregnant people experiencing housing instability often have complex needs. Urban Indigenous doulas can benefit from the expertise of social service and healthcare providers to learn best practises for supporting this population in the urban centre of Winnipeg, Manitoba. Purpose: The purpose of the study was to gather the experiential knowledge of healthcare and social service providers in inner-city Winnipeg, focusing on their perceptions of essential care practises to support unsheltered Indigenous clients throughout their reproductive experiences. Findings will inform the training curriculum for the She Walks with Me: Supporting Urban Indigenous Expectant Mothers through Culturally Based Doulas project. Methods: A two-phase mixed methods design was used: Phase 1 used a questionnaire as an informal needs assessment scan of current supports available for pregnant people experiencing housing instability and served as a recruitment tool (n=58); Phase 2 involved exploratory qualitative semi-structured interviews with social service and healthcare providers to explore their approaches and challenges in supporting pregnant people facing housing insecurity or unsafe housing (n=16). Thematic analysis was conducted to identify key themes. Results: The questionnaire responses noted various reasons why pregnant people experiencing housing instability seek services at service providers’ workplaces, including accessing mental health services, housing support, and harm reduction supplies. Interviews revealed best practises and approaches to care that emphasise cultural safety, compassion, and interprofessional collaboration. Participants shared nuanced approaches for supporting pregnant people with housing instability, highlighting that care should be nonjudgmental, provide resources and referrals, foster trust, incorporate harm reduction practises, and be client-led. They also identified critical gaps, such as the need for a supportive housing shelter for families that offers onsite support for mental health and substance use through an interprofessional wrap around model of care as a best practise. Further, providers offered practical strategies for self-care to avoid burnout when supporting birthing folks with complex circumstances. Conclusion: The study highlights the importance of trauma-informed, anti-racist, and client-led care practises in supporting pregnant people facing housing instability in Winnipeg, while recognising urban Indigenous doulas need to foster relationships, provide anti-racist and trauma informed care, and advocate for this population's unique needs.
dc.description.noteFebruary 2025
dc.description.sponsorshipThe University of Manitoba Indigenous Students Doctoral Award The University of Manitoba James Gordon Fletcher PhD Fellowship for Research in Aboriginal Issues The Prairie Indigenous Knowledge Exchange Network (PIKE-Net) Program The University of Winnipeg Weweni Future Scholars Award The Mauro Institute Kanee Mauro Scholars Fellowship
dc.identifier.urihttp://hdl.handle.net/1993/38740
dc.language.isoeng
dc.rightsopen accessen_US
dc.subjectIndigenous Peoples
dc.subjectWinnipeg, Manitoba
dc.subjectInterprofessional
dc.subjectDoulas
dc.subjectSocial Service
dc.subjectMaternal healthcare
dc.titleStrengthening support: service providers’ insights on addressing the complex needs of birthing people facing insecure housing in Winnipeg, Manitoba
dc.typedoctoral thesisen_US
local.subject.manitobayes
oaire.awardNumber433666
oaire.awardTitleVanier Canada Graduate Scholarship
oaire.awardURIhttps://vanier.gc.ca/en/scholar_search-chercheur_recherche_2020.html
project.funder.identifierhttp://dx.doi.org/10.13039/501100000024
project.funder.nameCanadian Institutes of Health Research
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