BACKGROUND:
Indigenous families in Canada continue to face inequities in maternal health, including higher rates of preterm birth, gestational diabetes, and infant mortality. In New Brunswick, prenatal services are largely biomedical and often experienced as culturally unsafe, leading to mistrust and disengagement. Public health nurses are well-positioned to co-create models that address these gaps. Building on the lead presenter's 2023 masters thesis and community recommendations, Under One Sky Friendship Centre partnered with a nurse scientist, Elders, doulas, families, and other experts to design a 10-week prenatal program. Guided by Etuaptmumk (Two-eyed seeing), the model integrates ceremony and Indigenous teachings with evidence-based education.

METHODS:
The program was co-created using community-based participatory research methods. Each weekly gathering combines biomedical content with ceremony, kinship, and circle dialogue. Practical supports such as meals, transportation, and childcare reduce barriers. Evaluation combines surveys, storytelling, reflections, and long-term outcome tracking (i.e. maternal knowledge, birth experiences, healthcare use), along with chart reviews and NB-IRDT data linkages.

RESULTS:
The pilot is being delivered in two rounds: first in Fall 2025 (complete), and second in Winter 2026 (underway). Data analysis is currently underway. Expected outcomes include increased knowledge, confidence, cultural connection, and earlier engagement in perinatal care. System-level impacts include evidence on access, outcomes, and lived experiences to guide policy and funding models.

CONCLUSIONS:
This is one of the first urban Indigenous prenatal programs in the region to integrate Indigenous and biomedical systems. Innovations include embedding ceremony in prenatal education, reducing barriers, and pioneering evaluation that values clinical and cultural outcomes. Future directions include scaling to other communities and informing sustainable nurse-led practice models.