University of British Columbia School of Nursing, T149 - 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.
BMC Pregnancy Childbirth. 2013 Jan 29;13:26. doi: 10.1186/1471-2393-13-26.
Despite clear evidence regarding how social determinants of health and structural inequities shape health, Aboriginal women's birth outcomes are not adequately understood as arising from the historical, economic and social circumstances of their lives. The purpose of this study was to understand rural Aboriginal women's experiences of maternity care and factors shaping those experiences.
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.
尽管有明确的证据表明健康的社会决定因素和结构性不平等如何塑造健康，但原住民妇女的生育结果并没有充分认识到是由她们生活的历史、经济和社会环境所导致的。本研究的目的是了解农村原住民妇女的孕产护理体验，以及影响这些体验的因素。
努克萨尔、海达和纳奈莫第一民族的原住民妇女和英属哥伦比亚大学护理、医学和咨询心理学专业的学者在参与式行动研究框架内使用了民族志方法。我们采访了 100 多名妇女，并通过访谈和社区会议让更多的社区成员参与进来。数据在每个社区内和社区之间进行分析。
大多数参与者描述了在怀孕和分娩期间的痛苦经历，因为她们不得不应对当地产妇护理选择的减少、种族主义和艰难的经济环境。农村原住民妇女的分娩经历受到农村环境、历史和持续殖民化的影响以及自我决定和更有活力的文化和社区的努力的交叉影响。
如果医疗保健提供者了解并考虑到原住民在历史和持续殖民化方面的不同遭遇，这些遭遇无疑会影响健康和医疗保健，那么妇女的体验和生育结果可以得到显著改善。更了解原住民妇女在背景下的生育结果的从业者可以在每次互动中更好地护理，特别是通过增强妇女对其体验的权力、选择和控制。努力改善考虑到社会和历史上健康不平等的产生的孕产妇护理至关重要。
