"I felt so alone in the process:" Experiences of Indigenous women with maternal medical travel in the Canadian Arctic and opportunities for improvement.

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.