The cultural safety of publicly available maternity services in New Brunswick, Canada
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University of New Brunswick, Canada
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1358
Background: Pregnant Indigenous women in Canada suffer from a lack of access to culturally safe prenatal care. For prenatal care to become accessible, areas of inaccessibility and opportunities for improvement must be identified. This study was designed to explore how publicly available maternity services could be more culturally safe to Indigenous women in the province of New Brunswick. Objectives: 1) Explore the experiences of Indigenous women who have accessed publicly available prenatal care in New Brunswick in the last 5 years 2) Consult with Elders and other Knowledge Holders about traditional maternity practices and the future of maternity care 3) Use Findings to create a model of culturally safe care Methods: The research employed a community-based participatory action approach. Eight Indigenous mothers and three Elders shared knowledge (i.e., provided data) through community engagement sessions, group sharing circles, and individual conversations. Collaborative thematic analysis was used to examine the stories told by participants and to group these into themes. Preliminary findings were presented to Elders, whose reactions and commentaries added context to findings. Results: Three overarching themes were identified. This included relationality (relationships with self, body, baby, partner, friends, family, the environment, and care providers); heath systems (existing systems of medical care, including national and provincial health networks, hospitals, clinics, and the practices and policies within them); and Indigenous ways of knowing (recognizing that Indigenous people have always known and continue to know best-practice for ourselves and our people). These together with subthemes provide a preliminary model to improve culturally safe care for Indigenous mothers in New Brunswick. Conclusions: Indigenous-specific, community-based prenatal care that is guided by Indigenous nurses, doulas, midwives, Elders, Knowledge Holders, and mothers is needed. Traditional maternity practices should be maintained, revitalized, and available to all Indigenous mothers in New Brunswick.