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Canada's evacuation policy for pregnant First Nations women: Resignation, resilience, and resistance.

https://arctichealth.org/en/permalink/ahliterature289757
Source
Women Birth. 2018 Feb 10; :
Publication Type
Journal Article
Date
Feb-10-2018
Author
Karen M Lawford
Audrey R Giles
Ivy L Bourgeault
Author Affiliation
School of Indigenous and Canadian Studies, Carleton University, Dunton Tower 1221, 1125 Colonel By Drive, Ottawa, ON K1S 5B6, Canada. Electronic address: karen.lawford@carleton.ca.
Source
Women Birth. 2018 Feb 10; :
Date
Feb-10-2018
Language
English
Publication Type
Journal Article
Abstract
Aboriginal peoples in Canada are comprised of First Nations, Métis, and Inuit. Health care services for First Nations who live on rural and remote reserves are mostly provided by the Government of Canada through the federal department, Health Canada. One Health Canada policy, the evacuation policy, requires all First Nations women living on rural and remote reserves to leave their communities between 36 and 38 weeks gestational age and travel to urban centres to await labour and birth. Although there are a few First Nations communities in Canada that have re-established community birthing and Aboriginal midwifery is growing, most First Nations communities are still reliant on the evacuation policy for labour and birthing services. In one Canadian province, Manitoba, First Nations women are evacuated to The Pas, Thompson, or Winnipeg but most - including all women with high-risk pregnancies - go to Winnipeg.
To contribute scholarship that describes First Nations women's and community members' experiences and perspectives of Health Canada's evacuation policy in Manitoba.
Applying intersectional theory to data collected through 12 semi-structured interviews with seven women and five community members (four females, one male) in Manitoba who had experienced the evacuation policy. The data were analyzed thematically, which revealed three themes: resignation, resilience, and resistance.
The theme of resignation was epitomized by the quote, "Nobody has a choice." The ability to withstand and endure the evacuation policy despite poor or absent communication and loneliness informed of resilience. Resistance was demonstrated by women who questioned the necessity and requirement of evacuation for labour and birth. In one instance, resistance took the form of a planned homebirth with Aboriginal registered midwives.
There is a pressing need to improve the maternity care services that First Nations women receive when they are evacuated out of their communities, particularly when understood from the specific legal and constitutional position of First Nations women in Manitoba.
PubMed ID
29439924 View in PubMed
Less detail

Canada's evacuation policy for pregnant First Nations women: Resignation, resilience, and resistance.

https://arctichealth.org/en/permalink/ahliterature298294
Source
Women Birth. 2018 Dec; 31(6):479-488
Publication Type
Journal Article
Date
Dec-2018
Author
Karen M Lawford
Audrey R Giles
Ivy L Bourgeault
Author Affiliation
School of Indigenous and Canadian Studies, Carleton University, Dunton Tower 1221, 1125 Colonel By Drive, Ottawa, ON K1S 5B6, Canada. Electronic address: karen.lawford@carleton.ca.
Source
Women Birth. 2018 Dec; 31(6):479-488
Date
Dec-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Canada
Delivery, Obstetric
Female
Health Policy
Health Services Accessibility
Health Services, Indigenous
Humans
Indians, North American
Interviews as Topic
Inuits
Male
Midwifery - methods
Parturition - ethnology
Politics
Pregnancy
Pregnant Women - ethnology - psychology
Qualitative Research
Resilience, Psychological
Rural Population
Young Adult
Abstract
Aboriginal peoples in Canada are comprised of First Nations, Métis, and Inuit. Health care services for First Nations who live on rural and remote reserves are mostly provided by the Government of Canada through the federal department, Health Canada. One Health Canada policy, the evacuation policy, requires all First Nations women living on rural and remote reserves to leave their communities between 36 and 38 weeks gestational age and travel to urban centres to await labour and birth. Although there are a few First Nations communities in Canada that have re-established community birthing and Aboriginal midwifery is growing, most First Nations communities are still reliant on the evacuation policy for labour and birthing services. In one Canadian province, Manitoba, First Nations women are evacuated to The Pas, Thompson, or Winnipeg but most - including all women with high-risk pregnancies - go to Winnipeg.
To contribute scholarship that describes First Nations women's and community members' experiences and perspectives of Health Canada's evacuation policy in Manitoba.
Applying intersectional theory to data collected through 12 semi-structured interviews with seven women and five community members (four females, one male) in Manitoba who had experienced the evacuation policy. The data were analyzed thematically, which revealed three themes: resignation, resilience, and resistance.
The theme of resignation was epitomized by the quote, "Nobody has a choice." The ability to withstand and endure the evacuation policy despite poor or absent communication and loneliness informed of resilience. Resistance was demonstrated by women who questioned the necessity and requirement of evacuation for labour and birth. In one instance, resistance took the form of a planned homebirth with Aboriginal registered midwives.
There is a pressing need to improve the maternity care services that First Nations women receive when they are evacuated out of their communities, particularly when understood from the specific legal and constitutional position of First Nations women in Manitoba.
PubMed ID
29439924 View in PubMed
Less detail

Kivalliq Inuit Centre boarding home and the provision of prenatal education.

https://arctichealth.org/en/permalink/ahliterature279877
Source
Int J Circumpolar Health. 2016 Jan;75(1):32213
Publication Type
Article
Date
Jan-2016
Author
Karen M Lawford
Audrey R Giles
Source
Int J Circumpolar Health. 2016 Jan;75(1):32213
Date
Jan-2016
Language
English
Publication Type
Article
Abstract
The Kivalliq Inuit Centre (KIC), a boarding home in Winnipeg, Manitoba, is unique in its provision of a pilot prenatal education class and public health nursing services for Nunavummiut who are beneficiaries of the Nunavut Land Claim Agreement. Through a critical review of literature, policies and interviews related to evacuation for birth, we argue that the pilot at the KIC has the potential to play an important role in improving maternal child health for residents of Nunavut.
PubMed ID
28156430 View in PubMed
Less detail

Kivalliq Inuit Centre boarding home and the provision of prenatal education.

https://arctichealth.org/en/permalink/ahliterature277974
Source
Int J Circumpolar Health. 2016;75:32213
Publication Type
Article
Date
2016
Author
Karen M Lawford
Audrey R Giles
Source
Int J Circumpolar Health. 2016;75:32213
Date
2016
Language
English
Publication Type
Article
Abstract
The Kivalliq Inuit Centre (KIC), a boarding home in Winnipeg, Manitoba, is unique in its provision of a pilot prenatal education class and public health nursing services for Nunavummiut who are beneficiaries of the Nunavut Land Claim Agreement. Through a critical review of literature, policies and interviews related to evacuation for birth, we argue that the pilot at the KIC has the potential to play an important role in improving maternal child health for residents of Nunavut.
PubMed ID
27938641 View in PubMed
Less detail

Kivalliq Inuit Centre boarding home and the provision of prenatal education.

https://arctichealth.org/en/permalink/ahliterature289504
Source
Int J Circumpolar Health. 2016; 75:32213
Publication Type
Journal Article
Review
Date
2016
Author
Karen M Lawford
Audrey R Giles
Author Affiliation
Institute of Feminist and Gender Studies, University of Ottawa, Ottawa, ON, Canada; klawf073@uottawa.ca.
Source
Int J Circumpolar Health. 2016; 75:32213
Date
2016
Language
English
Publication Type
Journal Article
Review
Keywords
Female
Humans
Inuits
Manitoba
Maternal health services
Nunavut
Patient transfer
Pregnancy
Prenatal Education - methods
Residential Facilities
Abstract
The Kivalliq Inuit Centre (KIC), a boarding home in Winnipeg, Manitoba, is unique in its provision of a pilot prenatal education class and public health nursing services for Nunavummiut who are beneficiaries of the Nunavut Land Claim Agreement. Through a critical review of literature, policies and interviews related to evacuation for birth, we argue that the pilot at the KIC has the potential to play an important role in improving maternal child health for residents of Nunavut.
Notes
Cites: Can Nurse. 2009 Jun;105(6):17-9 PMID 19583047
Cites: BMC Pediatr. 2012 Dec 12;12:190 PMID 23231747
PubMed ID
27938641 View in PubMed
Less detail

Kivalliq Inuit Centre boarding home and the provision of prenatal education.

https://arctichealth.org/en/permalink/ahliterature289662
Source
Int J Circumpolar Health. 2016; 75:32213
Publication Type
Journal Article
Review
Date
2016
Author
Karen M Lawford
Audrey R Giles
Author Affiliation
Institute of Feminist and Gender Studies, University of Ottawa, Ottawa, ON, Canada; klawf073@uottawa.ca.
Source
Int J Circumpolar Health. 2016; 75:32213
Date
2016
Language
English
Publication Type
Journal Article
Review
Keywords
Female
Humans
Inuits
Manitoba
Maternal health services
Nunavut
Patient transfer
Pregnancy
Prenatal Education - methods
Residential Facilities
Abstract
The Kivalliq Inuit Centre (KIC), a boarding home in Winnipeg, Manitoba, is unique in its provision of a pilot prenatal education class and public health nursing services for Nunavummiut who are beneficiaries of the Nunavut Land Claim Agreement. Through a critical review of literature, policies and interviews related to evacuation for birth, we argue that the pilot at the KIC has the potential to play an important role in improving maternal child health for residents of Nunavut.
Notes
Cites: Can Nurse. 2009 Jun;105(6):17-9 PMID 19583047
Cites: BMC Pediatr. 2012 Dec 12;12:190 PMID 23231747
PubMed ID
27938641 View in PubMed
Less detail

Mental health indicators among pregnant Aboriginal women in Canada: results from the Maternity Experiences Survey.

https://arctichealth.org/en/permalink/ahliterature294504
Source
Health Promot Chronic Dis Prev Can. 2018 Jul/Aug; 38(7-8):269-276
Publication Type
Journal Article
Author
Chantal Nelson
Karen M Lawford
Victoria Otterman
Elizabeth K Darling
Author Affiliation
Public Health Agency of Canada, Ottawa, Ontario, Canada.
Source
Health Promot Chronic Dis Prev Can. 2018 Jul/Aug; 38(7-8):269-276
Language
English
French
Publication Type
Journal Article
Abstract
There is little research done on mental health among pregnant Aboriginal women. Therefore, the purpose of the study was to examine the prevalence of postpartum depression (PPD) and its determinants, including pre-existing depression among non-Aboriginal and Aboriginal women in Canada.
The Maternity Experiences Survey (MES) is a national survey of Canadian women's experiences and practices before conception, up to the early months of parenthood. Predictors of PPD were calculated using the Mantel-Haenszel correction method relative to the risk estimates based on the odds ratio from adjusted regression analysis. The analysis was conducted among women who self-identified as Aboriginal (Inuit, Métis or First Nations living off-reserve) and those who identified as non-Aboriginal.
The prevalence of pre-existing depression was higher among self-reported First Nations off-reserve and Métis women than non-Aboriginal women. Inuit women had the lowest prevalence of self-reported pre-existing depression, and Aboriginal women reported a higher prevalence of PPD than non-Aboriginal women. Pre-existing depression was not a predictor for PPD for Inuit or Métis women in this study but was a positive predictor among First Nations off-reserve and non-Aboriginal women. A disproportionally higher number of Aboriginal women reported experiencing abuse, as compared to non-Aboriginal women.
Our study demonstrated that common predictors of PPD including anxiety, experiencing stressful life events during pregnancy, having low levels of social support, and a previous history of depression were consistent among non-Aboriginal women. However, with the exception of the number of stressful events among First Nations offreserve, these were not associated with PPD among Aboriginal women. This information can be used to further increase awareness of mental health indicators among Aboriginal women.
On dispose de peu de recherches sur la santé mentale chez les femmes autochtones enceintes, ce qui nous a conduit à examiner dans cette étude la prévalence de la dépression post-partum (DPP) et ses déterminants, en tenant compte des antécédents de dépression chez les femmes non autochtones et autochtones du Canada.
L’Enquête sur l’expérience de la maternité (EEM) est une enquête nationale portant sur l’expérience et les pratiques des femmes canadiennes préalablement à la conception et jusqu’aux premiers mois de la maternité. On a calculé, à l’aide de la méthode de correction Mantel-Haenszel, les estimations du risque pour les facteurs de prédiction de la DPP en se basant sur les rapport de cotes de l’analyse de régression ajustée. L’analyse a été menée auprès de femmes s'étant auto-identifiées comme autochtones (Inuites, Métisses ou membres des Premières Nations vivant hors réserve) ou comme non autochtones.
La prévalence d'antécédents dépression était plus élevée chez les femmes s'étant auto-identifiée comme membre des Premières Nations vivant hors réserve ou métisses que chez les femmes non autochtones, les femmes inuites offraient la plus faible prévalence d'antécédents de dépression autodéclarée. Les femmes autochtones avaient une prévalence plus élevée de DPP que les femmes non autochtones. La présence d'antécédents de dépression n'était pas un facteur de prédiction de DPP chez les femmes inuites et métisses, mais s'est révélée en être un chez les femmes des Premières Nations vivant hors réserve et chez les femmes non autochtones. Un nombre disproportionnellement plus élevé de femmes autochtones que de femmes non autochtones ont déclaré avoir été victimes de violence.
Notre étude a montré que les facteurs usuels de prédiction de DPP que sont l’anxiété, les événements stressants de la vie pendant la grossesse, un faible niveau de soutien social et des antécédents de dépression étaient bien présents chez les femmes non autochtones mais que, à l’exception du nombre d’événements stressants chez les femmes des Premières Nations vivant hors réserve, ces facteurs n'étaient pas associés à la DPP chez les femmes autochtones. Ces résultats incitent à développer la sensibilité des indicateurs de santé mentale pour les femmes autochtones.
Notes
Cites: JAMA. 1998 Nov 18;280(19):1690-1 PMID 9832001
Cites: Am J Public Health. 2012 Oct;102(10):1893-901 PMID 22897526
Cites: J Clin Nurs. 2012 Feb;21(3-4):388-97 PMID 21435059
Cites: Psychosom Med. 2001 Sep-Oct;63(5):830-4 PMID 11573032
Cites: Matern Child Health J. 2012 Jan;16(1):158-68 PMID 21165763
Cites: Nurs Womens Health. 2014 Feb-Mar;18(1):38-46 PMID 24548495
Cites: J Obstet Gynaecol Can. 2008 Mar;30(3):207-216 PMID 18364098
Cites: BMC Pregnancy Childbirth. 2014 Mar 18;14:106 PMID 24641703
Cites: BMC Public Health. 2011 May 11;11:302 PMID 21569372
Cites: Gen Hosp Psychiatry. 2004 Jul-Aug;26(4):289-95 PMID 15234824
Cites: Am J Epidemiol. 2004 May 1;159(9):872-81 PMID 15105180
Cites: J Affect Disord. 2008 May;108(1-2):147-57 PMID 18067974
Cites: J Obstet Gynecol Neonatal Nurs. 2006 Jul-Aug;35(4):491-8 PMID 16881993
PubMed ID
30129714 View in PubMed
Less detail

Mental health indicators among pregnant Aboriginal women in Canada: results from the Maternity Experiences Survey.

https://arctichealth.org/en/permalink/ahliterature296844
Source
Health Promot Chronic Dis Prev Can. 2018 Jul/Aug; 38(7-8):269-276
Publication Type
Journal Article
Author
Chantal Nelson
Karen M Lawford
Victoria Otterman
Elizabeth K Darling
Author Affiliation
Public Health Agency of Canada, Ottawa, Ontario, Canada.
Source
Health Promot Chronic Dis Prev Can. 2018 Jul/Aug; 38(7-8):269-276
Language
English
French
Publication Type
Journal Article
Keywords
Adolescent
Adult
Canada - epidemiology - ethnology
Depression - epidemiology - ethnology
Depression, Postpartum - epidemiology - ethnology
Female
Humans
Indians, North American - psychology
Inuits - psychology
Mental health
Middle Aged
Pregnancy
Prevalence
Psychiatric Status Rating Scales
Risk factors
Social Support
Spouse Abuse - ethnology
Stress, Psychological - epidemiology - ethnology
Surveys and Questionnaires
Young Adult
Abstract
There is little research done on mental health among pregnant Aboriginal women. Therefore, the purpose of the study was to examine the prevalence of postpartum depression (PPD) and its determinants, including pre-existing depression among non-Aboriginal and Aboriginal women in Canada.
The Maternity Experiences Survey (MES) is a national survey of Canadian women's experiences and practices before conception, up to the early months of parenthood. Predictors of PPD were calculated using the Mantel-Haenszel correction method relative to the risk estimates based on the odds ratio from adjusted regression analysis. The analysis was conducted among women who self-identified as Aboriginal (Inuit, Métis or First Nations living off-reserve) and those who identified as non-Aboriginal.
The prevalence of pre-existing depression was higher among self-reported First Nations off-reserve and Métis women than non-Aboriginal women. Inuit women had the lowest prevalence of self-reported pre-existing depression, and Aboriginal women reported a higher prevalence of PPD than non-Aboriginal women. Pre-existing depression was not a predictor for PPD for Inuit or Métis women in this study but was a positive predictor among First Nations off-reserve and non-Aboriginal women. A disproportionally higher number of Aboriginal women reported experiencing abuse, as compared to non-Aboriginal women.
Our study demonstrated that common predictors of PPD including anxiety, experiencing stressful life events during pregnancy, having low levels of social support, and a previous history of depression were consistent among non-Aboriginal women. However, with the exception of the number of stressful events among First Nations offreserve, these were not associated with PPD among Aboriginal women. This information can be used to further increase awareness of mental health indicators among Aboriginal women.
On dispose de peu de recherches sur la santé mentale chez les femmes autochtones enceintes, ce qui nous a conduit à examiner dans cette étude la prévalence de la dépression post-partum (DPP) et ses déterminants, en tenant compte des antécédents de dépression chez les femmes non autochtones et autochtones du Canada.
L’Enquête sur l’expérience de la maternité (EEM) est une enquête nationale portant sur l’expérience et les pratiques des femmes canadiennes préalablement à la conception et jusqu’aux premiers mois de la maternité. On a calculé, à l’aide de la méthode de correction Mantel-Haenszel, les estimations du risque pour les facteurs de prédiction de la DPP en se basant sur les rapport de cotes de l’analyse de régression ajustée. L’analyse a été menée auprès de femmes s'étant auto-identifiées comme autochtones (Inuites, Métisses ou membres des Premières Nations vivant hors réserve) ou comme non autochtones.
La prévalence d'antécédents dépression était plus élevée chez les femmes s'étant auto-identifiée comme membre des Premières Nations vivant hors réserve ou métisses que chez les femmes non autochtones, les femmes inuites offraient la plus faible prévalence d'antécédents de dépression autodéclarée. Les femmes autochtones avaient une prévalence plus élevée de DPP que les femmes non autochtones. La présence d'antécédents de dépression n'était pas un facteur de prédiction de DPP chez les femmes inuites et métisses, mais s'est révélée en être un chez les femmes des Premières Nations vivant hors réserve et chez les femmes non autochtones. Un nombre disproportionnellement plus élevé de femmes autochtones que de femmes non autochtones ont déclaré avoir été victimes de violence.
Notre étude a montré que les facteurs usuels de prédiction de DPP que sont l’anxiété, les événements stressants de la vie pendant la grossesse, un faible niveau de soutien social et des antécédents de dépression étaient bien présents chez les femmes non autochtones mais que, à l’exception du nombre d’événements stressants chez les femmes des Premières Nations vivant hors réserve, ces facteurs n'étaient pas associés à la DPP chez les femmes autochtones. Ces résultats incitent à développer la sensibilité des indicateurs de santé mentale pour les femmes autochtones.
PubMed ID
30129714 View in PubMed
Less detail

8 records – page 1 of 1.