Birth-Issues in Perinatal Care最新文献

{"title":"Status of Horizontal Violence, Level of Psychological Empowerment, and Their Correlation Among Obstetric Nurses: A Cross-Sectional Survey.","authors":"Shan Huang, Ganxia Kong, Qiumei Li, Hamza Saidi Lilenga, Jinguo Zhai","doi":"10.1111/birt.12879","DOIUrl":"https://doi.org/10.1111/birt.12879","url":null,"abstract":"<p><strong>Background: </strong>China's maternity policy has led to an increase in work pressure, which has prompted horizontal violence among obstetric nurses. To understand this phenomenon better, we attempted to identify the factors that influence horizontal violence as well as the level of psychological empowerment among obstetric nurses.</p><p><strong>Methods: </strong>This cross-sectional survey was conducted among 522 obstetric nurses from December 2022 to February 2023.</p><p><strong>Results: </strong>The findings revealed that 40.42% (211) of the obstetric nurses had experienced horizontal violence in the past 3 months. The overall level of psychological empowerment of obstetric nurses was relatively low. Regression analysis indicated that being a formal worker, being from the area where one serves, the meaning attributed to work, and perceptions of autonomy, self-efficacy, and work impact acted as protective factors against the risk of horizontal violence among obstetric nurses. When compared with the 20-29-year-old age group, those in the 30-39-year-old age group showed a lower risk of experiencing horizontal violence (odds ratio [OR] = 0.369, p < 0.01). Compared with nurses who had worked in obstetrics for < 3 years, those who had worked for 3-5, 6-10, 11-20, and > 20 years showed lower risks of experiencing horizontal violence than the reference level (OR = 0.234, p < 0.05; OR = 0.182, p < 0.05; OR = 0.105, p < 0.05; and OR = 0.056, p < 0.05, respectively).</p><p><strong>Discussion: </strong>The incidence of horizontal violence among obstetric nurses is high, and the overall level of psychological empowerment is low. Nursing managers can alleviate the occurrence of horizontal violence by augmenting the psychological empowerment level of obstetric nurses.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wait, What? What's Going On?- Pregnancy Experiences of Deaf and Hard of Hearing Mothers Who Do Not Sign.","authors":"Sanjana Ratakonda, Tiffany L Panko, Sasha Albert, Lauren D Smith, Margarita M Cooley, Monika Mitra, Michael McKee","doi":"10.1111/birt.12881","DOIUrl":"https://doi.org/10.1111/birt.12881","url":null,"abstract":"<p><strong>Objective: </strong>Deaf and hard of hearing (DHH) women experience higher rates of reproductive healthcare barriers and adverse birth outcomes compared to their hearing peers. This study explores the pregnancy experiences of DHH women who do not sign to better understand their barriers and facilitators to optimal perinatal health care.</p><p><strong>Design: </strong>Qualitative study using thematic analysis.</p><p><strong>Setting: </strong>Semi-structured, individual remote, or in-person interviews in the United States.</p><p><strong>Sample: </strong>Twenty-two DHH English speakers (non-signers) who gave birth in the United States within the past 5 years.</p><p><strong>Methods: </strong>Semi-structured interviews explored how DHH women experienced pregnancy and birth, including access to perinatal information and resources, relationships with healthcare providers, communication access, and their involvement with the healthcare system throughout pregnancy. A thematic analysis was conducted.</p><p><strong>Main outcome measures: </strong>The barriers and facilitators related to a positive perinatal care experience among DHH women.</p><p><strong>Results: </strong>Five key themes emerged. For barriers, healthcare communication breakdowns and loss of patient autonomy highlighted DHH women's struggle with perinatal health care. In contrast, DHH participants outlined the importance of accessible health communication practices and accommodations, use of patient advocacy or self-advocacy, and assistive technologies for DHH parents for more positive perinatal care experiences.</p><p><strong>Conclusions: </strong>Perinatal healthcare providers and staff should routinely inquire about ways to ensure an inclusive and accessible healthcare experience for their DHH patients and provide communication accommodations for optimal care. Additionally, healthcare providers should be more aware of the unique parenting needs and resources of their DHH patients.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Social Support is Associated With Postpartum Depression Symptoms Among Illinois Postpartum Women.","authors":"Abigail Holicky, Ashley Horne, Amanda C Bennett","doi":"10.1111/birt.12889","DOIUrl":"https://doi.org/10.1111/birt.12889","url":null,"abstract":"<p><strong>Background: </strong>Postpartum depression (PPD) occurs after delivery, with severity and onset varying by individual. Women with low social support may be at higher risk for PPD. This study examined the association between social support and self-reported postpartum depression symptoms (PDS) among Illinois postpartum women.</p><p><strong>Methods: </strong>Using 2016-2020 data from the Illinois Pregnancy Risk Assessment Monitoring System (PRAMS) (n = 5886), instrumental support (physical, hands-on support) and partner emotional support were each categorized as high/low and were combined in a composite measure (high = high on both types, moderate = high on one type, and low = low on both types). PDS were self-reported. Crude and adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated using logistic regression.</p><p><strong>Results: </strong>Overall, 9.6% (95% CI = 8.8-10.4) of Illinois postpartum women experienced PDS. Of Illinois postpartum women, 63.5% (95% CI = 62.1-64.9) had high composite support, 29.3% (95% CI = 28.0-30.6) had moderate composite support, and 7.1% (95% CI = 6.4-7.9) had low composite support. After adjustment for maternal characteristics, instrumental support, partner emotional support, and a composite measure of support were each significantly associated with PDS. Compared to women with high composite support, women with low composite support had six times the odds of PDS (aOR = 6.1, 95% CI = 4.5-8.2), and women with moderate composite support had nearly three times the odds of PDS (aOR = 2.7, 95% CI = 2.2-3.4).</p><p><strong>Conclusion: </strong>PDS was associated with instrumental support, partner emotional support, and a composite measure of support in Illinois postpartum women. This suggests the importance of addressing social support for postpartum individuals.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum Women's Experiences of Postnatal Care in Sub-Saharan Africa: A Qualitative Evidence Synthesis.","authors":"Enos Moyo, Perseverance Moyo, Tafadzwa Dzinamarira, Andrew Ross","doi":"10.1111/birt.12872","DOIUrl":"https://doi.org/10.1111/birt.12872","url":null,"abstract":"<p><strong>Background: </strong>Postnatal care (PNC) is a critical service for the health and well-being of new mothers and newborns. However, in sub-Saharan Africa (SSA), most efforts to improve maternal and child health have been directed toward enhancing skilled birth attendance and urgent obstetric and neonatal care. This is despite the fact that more than half of maternal deaths globally occur in the postnatal period, with 65% of these occurring in the first week following birth. One of the health system factors influencing PNC utilization is the women's previous PNC experience at healthcare facilities. The aim of this review was to gain a better understanding of women's experiences of PNC in SSA.</p><p><strong>Methods: </strong>This study followed a qualitative evidence synthesis design. The phenomenon of interest was postpartum women's experiences of PNC in SSA. PubMed, CINAHL, EMBASE, Science Direct, Africa Journals Online (AJOL), SCOPUS, and Google Scholar were searched for peer-reviewed articles published in English between 2013 and 2023. To assess the quality of the included studies, we used an appraisal tool developed by the Evidence for Policy and Practice Information and Co-ordinating Centre. Two authors independently extracted relevant data from the included studies. Thomas and Harden's thematic synthesis framework was used to synthesize the data.</p><p><strong>Results: </strong>Eight articles were used in this review. Seven articles reported on qualitative studies, and one reported on a mixed-method study. All the included studies fully or partially met the 12 quality assessment criteria. Synthesis of the data resulted in the development of five analytical themes. The five themes were the adequacy of physical examination and communication of the findings, adequacy of PNC information, the quality of interactions with healthcare workers (HCWs), the availability of resources and adequacy of HCWs, and denial of care. The overall confidence in the review's findings was either moderate or high.</p><p><strong>Conclusion: </strong>Based on our findings, we recommend that countries in the region address staff shortages, implement task shifting, electronic medicine stock management systems, optimal supply chain policies, and train HCWs on PNC and interpersonal communication skills.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Advocacy Among Black Women During the Perinatal Period: Prevalence and Relationship to Patient Experiences.","authors":"Teresa Hagan Thomas, Savannah Vetterly, Elizabeth B Kaselitz, Willa Doswell, Betty Braxter","doi":"10.1111/birt.12885","DOIUrl":"https://doi.org/10.1111/birt.12885","url":null,"abstract":"<p><strong>Introduction: </strong>Black women experience many barriers to receiving high-quality maternal healthcare. The ability of Black women to self-advocate may mitigate these threats to their health. Limited research describes Black women's self-advocacy during the perinatal period and how self-advocacy related to other relevant concepts. The aim of this study was to describe the relationship between self-advocacy, patient-provider relationships, and mental health outcomes among Black women in the perinatal period.</p><p><strong>Methods: </strong>This cross-sectional descriptive pilot study recruited Black women who were either in their 3^rd trimester of pregnancy or within a year postpartum to complete surveys describing their self-advocacy (Female Self-Advocacy in Cancer Survivorship Scale adapted for perinatal period) and maternal health outcomes (trust and comfort with maternal healthcare providers-Patient-Provider Relationship Scale; abuse and disrespect during childbirth-Mothers of Respect Index; experiences of discrimination-Experiences of Discrimination scale; depression-Edinburgh Postnatal Depression Scale; and postpartum posttraumatic stress-City Birth Trauma Scale).</p><p><strong>Results: </strong>N = 40 participants were recruited between January and September 2022. Participants reported moderate levels of self-advocacy which were associated with trust and comfort with healthcare providers (r = 0.57-0.76, p < 0.001). Feeling respected by healthcare providers was positively associated with two self-advocacy subscales (r = 0.42-0.44, p < 0.01). Depression was inversely related to all self-advocacy subscales (r = -0.47-0.62, p < 0.001).</p><p><strong>Conclusion: </strong>Black women's self-advocacy during the perinatal period is associated with trust and comfort with healthcare providers, perceptions of respect from their providers, and perinatal depression. Future research should focus on promoting trusting, respectful relationships between Black women and their maternal health providers.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One Hundred Years of Seeking Respectful Maternity Care: History and Evolution.","authors":"Ellen L Tilden, Rebecca Jungbauer, Erica L Hart, Amy G Cantor","doi":"10.1111/birt.12876","DOIUrl":"https://doi.org/10.1111/birt.12876","url":null,"abstract":"<p><p>Growing awareness of poor maternal health outcomes and maternal health disparities in the United States has heightened urgency around the need to promote Respectful Maternity Care (RMC) as a fundamental tenet of obstetric/midwifery care and standardize efforts to improve safety, eliminate obstetric violence and racism, and optimize health outcomes for all birthing people. The historical context of prior and contemporary perspectives around childbirth influences our understanding of RMC and are shaped by varying scholarly, clinical, and community standards (e.g., religion, human rights, government, public health, midwifery, ethics, activism, and the law), which have changed significantly since the mid-19th century. In this commentary, we share results of a contextual question scoped as part of a larger systematic review of RMC to help inform consensus around a shared definition and development of a metric to standardize delivery and evaluation of RMC. Synthesis of this literature identified landmark historical influences on RMC over the past 100 years, highlighting the multidisciplinary scholarship and historical context influencing the progress toward RMC. Further understanding of this history may also inform policies and guidance for ongoing efforts to center respect and accountability in all aspects of maternity care, with particular attention to populations who are disproportionally impacted by disrespectful care.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Counseling About Cannabis Use During Pregnancy and Lactation: A Qualitative Study of Patient and Clinician Perspectives","authors":"Alexandra Cernat,&nbsp;Andrea Carruthers,&nbsp;Shipra Taneja,&nbsp;Anuoluwa Popoola,&nbsp;Devon Greyson,&nbsp;Janelle Panday,&nbsp;Elizabeth Darling,&nbsp;Sarah D. McDonald,&nbsp;Morgan Black,&nbsp;Beth Murray-Davis,&nbsp;Meredith Vanstone","doi":"10.1111/birt.12873","DOIUrl":"10.1111/birt.12873","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Legalization in many jurisdictions has increased the prevalence of cannabis use, including during pregnancy and lactation. Accordingly, clinicians providing perinatal and infant care are increasingly required to counsel about this topic, even if they do not feel comfortable or prepared for this conversation. The aim of this research was to explore how prenatal clinicians and pregnant and lactating women interact with cannabis consumption.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using qualitative description, we conducted semi-structured interviews with 75 individuals in Canada: 23 clinicians who provide pregnancy and lactation care, and 52 individuals who made cannabis consumption decisions during pregnancy and/or lactation. Data were analyzed using inductive content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three phases of the clinical encounter influenced decision-making about cannabis consumption: initiation of a discussion about cannabis, sense-making, and the outcome of the encounter. Patients and clinicians described similar ideals for a counseling encounter about cannabis consumption during pregnancy or lactation: open, patient-centered conversation grounded in an informed decision-making model to explore the benefits, risks, and alternatives to cannabis. While clinicians described these values as reflecting real clinical interactions, patients reported that in their experience, actual interactions did not live up to these ideals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Clinicians and pregnant and lactating people report desiring the same things from a counseling interaction about cannabis: sharing of information, identification of values, and facilitation of a decision. Both groups endorse an open, nonjudgemental counseling approach that explores the reasons why a patient is considering cannabis consumption and reflects these reasons against available evidence and alternatives known to be safe.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"51 4","pages":"867-877"},"PeriodicalIF":2.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12873","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return-on-Investment Analysis of an Enhanced Community Doula Program: Pre- and Post-COVID-19 Considerations.","authors":"Julie Mottl-Santiago, Dmitry Dukhovny, Emily Feinberg, Jennifer Moore, Victoria Parker, Howard Cabral, Diana Bowser, Gene Declercq","doi":"10.1111/birt.12886","DOIUrl":"https://doi.org/10.1111/birt.12886","url":null,"abstract":"<p><strong>Background: </strong>Community doulas are perinatal health workers who provide peer education, resource navigation, and support during pregnancy, childbirth, and the postpartum period. Evidence suggests that doulas improve the experience of care, reduce cesarean birth, and improve breastfeeding outcomes. However, people with low incomes cannot access affordable community doula support in most states due to lack of insurance reimbursement. To determine the affordability of Medicaid reimbursement for doula services, there is a need to fill a gap in research that employs real-world data and a return-on-investment (ROI) analysis approach.</p><p><strong>Methods: </strong>We conducted a ROI analysis from the healthcare perspective of an enhanced community doula intervention, Best Beginnings for Babies (BBB). Healthcare and program cost data were collected alongside clinical outcomes from a randomized controlled trial of routine maternity care at Boston Medical Center with and without BBB. ROI was calculated as the net healthcare savings divided by the investment costs. Post-COVID-19 program costing estimates were also performed.</p><p><strong>Results: </strong>Average healthcare costs per patient were $18,969 for the BBB group compared with $20,121 for routine care, a savings of $1,152. BBB program costs were an average of $971 per person. There was an 18% ROI. Lower costs for the birth hospitalization and NICU stays accounted for the largest areas of savings. Per-person program costs using proposed MassHealth fees produced a positive return on investment, although 2023 hospital doula program wages and salaries did not.</p><p><strong>Discussion: </strong>The BBB-enhanced community doula program was cost-saving to payers and increased access to doula support for low-income people. Even with post-COVID-19 increases in program costs, analysis demonstrated doula support was still financially feasible. This study should reassure budget-conscious Medicaid payers that doula services are affordable.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Birth Outcomes and Prenatal Care Use in the U.S. During the COVID-19 Pandemic in 2020 and 2021.","authors":"Wei Lyu, George L Wehby","doi":"10.1111/birt.12890","DOIUrl":"https://doi.org/10.1111/birt.12890","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has posed substantial social and economic disruptions that may have had adverse effects on maternal and infant health. This study examines the changes in birth outcomes and prenatal care use during the COVID-19 pandemic in 2020 and 2021 compared to pre-pandemic years.</p><p><strong>Methods: </strong>Data come from birth certificates from the U.S. Vital Statistics Natality Files. The analytical sample includes 18,678,327 births in the 50 states and Washington, DC between 2017 and 2021. An event study is employed to examine changes in multiple birth outcomes and prenatal care use over years adjusting for demographic/socioeconomic characteristics and state of residence.</p><p><strong>Results: </strong>There were very small changes in birth outcomes during pandemic years in 2020 and 2021. Specifically, low birth weight odds were lower in 2020 (OR = 0.99; 95 CI: 0.98-0.99) but higher in 2021 (OR = 1.03; 95% CI: 1.03-1.04) compared to 2019. C-section odds were higher in 2021 (OR = 1.01, 95% CI: 1.002-1.008) than in 2019. The mean number of prenatal visits in both 2020 and 2021 relative to 2019 was lower by about 0.3 visits (95% CI: -0.31 to -0.30 in 2021).</p><p><strong>Conclusion: </strong>Overall, there is no evidence of broad pandemic effects on low birth weight and preterm birth in 2020-2021.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Settler Midwifery: A Colonial Tool in Canada's Reproductive Healthcare System.","authors":"Melanie Murdock, Sarah Durant","doi":"10.1111/birt.12888","DOIUrl":"https://doi.org/10.1111/birt.12888","url":null,"abstract":"<p><strong>Introduction: </strong>The land we call Canada is a settler colonial country where reproductive healthcare is used as a mechanism to control, subjugate, and erase Indigenous people and to advance the White settler state. Healthcare providers play an integral role in the healthcare system and contribute to Canada's colonization. In this piece, we critically analyze how settler midwifery is complicit with colonialism in reproductive healthcare by exploring the history of midwifery in Canada, midwifery education, and contemporary settler midwifery.</p><p><strong>Discussion: </strong>European settlers omitted the history of Indigenous midwifery in Canada and to justify their erasure, they conceptualized Indigenous Peoples as uncivilized and their birthing practices as substandard. To establish a colonial healthcare system, settler midwives replaced traditional Indigenous birth attendants. When midwifery became regulated, midwives were required to train in formal post-secondary institutions that sustain colonial logics, systems, and practices. Midwifery education programs maintain colonialism by reinforcing medicalized Western practices and sustaining barriers to the growth of Indigenous midwifery. As a result, Western birthing practices are widespread among settler midwives and Indigenous Peoples face barriers to comprehensive and culturally sensitive care. To decolonize Canadian midwifery, we must dismantle stereotypes about Indigenous Peoples and their birthing practices in historical narratives, implement an anti-colonial approach to midwifery education, support Indigenous midwives in returning birth home, and improve the provision of culturally sensitive care.</p><p><strong>Conclusion: </strong>Settler midwifery in Canada is complicit in colonialism; building anti-colonial alliances can help support Indigenous midwives in leading a decolonial future for reproduction and birthing.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}