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

IF 2.6 3区医学 Q1 NURSING

Midwifery Pub Date : 2025-05-22 DOI:10.1016/j.midw.2025.104466

Fariba Kolahdooz , Se Lim Jang , Priya Patel , Claire Manning , Sarah Deck , Anahat Juneja , Debbie DeLancey , André Corriveau , Stephanie Irlbacher-Fox , Marie Tarrant , Sarah Cook , Adrian Wagg , Sangita Sharma

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引用次数: 0

Abstract

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.

查看原文本刊更多论文

“在这个过程中我感到很孤独：”加拿大北极地区土著妇女产妇医疗旅行的经历和改进的机会

由于体制障碍、文化差异和地理隔离，土著妇女在与怀孕/分娩有关的医疗旅行中面临独特的挑战。在加拿大，土著妇女经常为了怀孕护理和分娩而长途跋涉。西北地区的许多孕妇被要求在怀孕36 - 38周期间前往有二级/三级医院的城市中心。问题/假设/目的西北西北地区土著妇女在怀孕和与分娩有关的医疗旅行方面的经历是什么？文化和社区特有的、了解文化的和可获得的保健做法如何影响土著妇女在与怀孕有关的医疗旅行期间的经历？方法在西北地区的三个社区中，156名自认为怀孕或在过去三年内分娩的土著妇女完成了一份半结构化的访谈问卷。定性数据采用NVivo自反主题分析进行分析。调查结果：在55名因孕期护理而旅行的女性中，68.5%的人对医疗旅行做好了准备，57.4%的人有积极的体验。在为分娩而旅行的52名妇女中，分娩后的平均停留时间为11天（1至90天不等），其中63.5%的停留时间≤一周。与会者强调了三个主题：旅行经历、产前护理和分娩经历以及改进建议。这些经历包括孤独、紧张、后勤挑战、沟通和资源问题。讨论建议包括提高文化竞争力，扩大社区医疗保健，并纳入老年人知识共享。结论：虽然许多妇女报告了积极的经历，但需要改善医疗旅行和获得护理的机会，以指导土著孕产妇保健政策和规划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Midwifery 医学-护理

CiteScore

4.50

自引率

7.40%

发文量

221

审稿时长

13.4 weeks

期刊介绍： Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.