Midwifery · 2025
"I felt so alone in the process:" Experiences of Indigenous women with maternal medical travel in the Canadian Arctic and opportunities for improvement.
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Kolahdooz Fariba, Jang Se Lim, Patel Priya, Manning Claire, Deck Sarah, Juneja Anahat, DeLancey Debbie, Corriveau André, Irlbacher-Fox Stephanie, Tarrant Marie, Cook Sarah, Wagg Adrian, Sharma Sangita
Аннотация
PROBLEM: Indigenous women face unique challenges during pregnancy/birth-related medical travel due to systemic barriers, cultural differences, and geographic isolation.
BACKGROUND: In Canada, Indigenous women frequently travel substantial distances for pregnancy care and birth. Many pregnant women in Northwest Territories (NWT) are mandated to travel to urban centres with secondary/tertiary hospitals between 36-38-weeks gestation.
QUESTION/HYPOTHESIS/AIM: What are the experiences of Indigenous women in NWT regarding pregnancy and birth-related medical travel? How do cultural and community-specific, culturally informed, and accessible healthcare practices influence the experiences of Indigenous women during pregnancy-related medical travel?
METHODS: Across three NWT communities, 156 self-identifying Indigenous women who were pregnant or who had given birth in the previous three years completed a semi-structured interviewer-administered questionnaire. Qualitative data were analyzed using reflexive thematic analysis in NVivo.
FINDINGS: Of the 55 women who travelled for pregnancy care, 68.5 % felt prepared for medical travel and 57.4 % had a positive experience. Of the 52 women who travelled for birth, the mean length of stay after birth was 11 days (ranges from 1 to 90 days), with 63.5 % staying ≤ one week.
PARTICIPANTS HIGHLIGHTED THREE THEMES: Travel experiences, experiences with prenatal care and childbirth, and suggestions for improvement. The experiences involved loneliness, nervousness, logistical challenges, and communication and resource issues.
DISCUSSION: Suggestions included improving cultural competency, expanding community healthcare, and incorporating Elder knowledge sharing.
CONCLUSION: While many women reported positive experiences, improvements in medical travel and care access are needed to guide Indigenous maternal healthcare policy and planning.
BACKGROUND: In Canada, Indigenous women frequently travel substantial distances for pregnancy care and birth. Many pregnant women in Northwest Territories (NWT) are mandated to travel to urban centres with secondary/tertiary hospitals between 36-38-weeks gestation.
QUESTION/HYPOTHESIS/AIM: What are the experiences of Indigenous women in NWT regarding pregnancy and birth-related medical travel? How do cultural and community-specific, culturally informed, and accessible healthcare practices influence the experiences of Indigenous women during pregnancy-related medical travel?
METHODS: Across three NWT communities, 156 self-identifying Indigenous women who were pregnant or who had given birth in the previous three years completed a semi-structured interviewer-administered questionnaire. Qualitative data were analyzed using reflexive thematic analysis in NVivo.
FINDINGS: Of the 55 women who travelled for pregnancy care, 68.5 % felt prepared for medical travel and 57.4 % had a positive experience. Of the 52 women who travelled for birth, the mean length of stay after birth was 11 days (ranges from 1 to 90 days), with 63.5 % staying ≤ one week.
PARTICIPANTS HIGHLIGHTED THREE THEMES: Travel experiences, experiences with prenatal care and childbirth, and suggestions for improvement. The experiences involved loneliness, nervousness, logistical challenges, and communication and resource issues.
DISCUSSION: Suggestions included improving cultural competency, expanding community healthcare, and incorporating Elder knowledge sharing.
CONCLUSION: While many women reported positive experiences, improvements in medical travel and care access are needed to guide Indigenous maternal healthcare policy and planning.