Help bring back the celebration of life: A community-based participatory study of rural Aboriginal women’s maternity experiences and outcomes

Aboriginal women from the Nuxalk, Haida and 'Namgis First Nations and academics from the University of British Columbia in nursing, medicine and counselling psychology used ethnographic methods within a participatory action research framework. We interviewed over 100 women, and involved additional community members through interviews and community meetings. Data were analyzed within each community and across communities.Most participants described distressing experiences during pregnancy and birthing as they grappled with diminishing local maternity care choices, racism and challenging economic circumstances. Rural Aboriginal women’s birthing experiences are shaped by the intersections among rural circumstances, the effects of historical and ongoing colonization, and concurrent efforts toward self-determination and more vibrant cultures and communities.Women’s experiences and birth outcomes could be significantly improved if health care providers learned about and accounted for Aboriginal people’s varied encounters with historical and ongoing colonization that unequivocally shapes health and health care. Practitioners who better understand Aboriginal women’s birth outcomes in context can better care in every interaction, particularly by enhancing women’s power, choice, and control over their experiences. Efforts to improve maternity care that account for the social and historical production of health inequities are crucial.Despite clear evidence indicating that social determinants of health and structural inequities shape health, Aboriginala women’s birth outcomes may be presented without accounting for historical and current economic and social circumstances. For every indicator of healthy pregnancy and infancy (e. g. teen pregnancy, preterm birth, low and high birth weight, infant and neonatal mortality), outcomes are 2 to 5 times worse for Aboriginal people in Canada, with low birth weight and preterm birth rates worsening [1]. Although research confirms that mul