Access Barriers Among Indigenous Women Seeking Prenatal Care in Canada: A Literature Review

Abstract

Introduction: Many expecting Indigenous women suffer from disproportionally high risks and adverse outcomes relative to non-Indigenous women when seeking adequate prenatal care due to access barriers in Canada’s healthcare system. Objective: The purpose of this literature review was to identify the barriers Indigenous women face when accessing prenatal care and to investigate programs and possible modifications to the health care system to improve prenatal care access for Indigenous women. The last objective was to determine if utilizing physician assistants may act as a potential solution to improving access to prenatal care for Indigenous women. Methods: A literature search using PubMed, Scopus, and CINAHL databases was performed using key terms pertaining to access barriers to prenatal care among Indigenous women in Canada. Five articles were found to meet the inclusion criteria and were analyzed in this literature review. Results: Three studies explored the challenges that Indigenous women experience when seeking prenatal care in Canada. Two studies investigated potential programming or system modifications to improve safe access to prenatal care among Indigenous women. Limited research was found regarding the use of physician assistants providing prenatal care among Indigenous women in Canada. Conclusion: The barriers to prenatal care among Indigenous women identified in this literature review fit under the social determinants of health, including transportation and geographical location, social support networks with family and providers, and lack of cultural awareness and understanding from providers. Strategies to improve access to prenatal care among Indigenous women included an interdisciplinary team using a holistic approach to provide culturally safe care to Indigenous women.