CIET-PRAM, Department of Family Medicine, McGill University, 5858 Chemin de la Côte des Neiges, Montreal, Quebec, H3S 1Z1, Canada.
CIET-PRAM, Department of Family Medicine, McGill University, 5858 Chemin de la Côte des Neiges, Montreal, Quebec, H3S 1Z1, Canada; Grupo de Estudios en Sistemas Tradicionales de Salud, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota, Colombia.
Women Birth. 2022 Feb;35(1):11-22. doi: 10.1016/j.wombi.2021.03.003. Epub 2021 Mar 11.
Routine evacuation of pregnant Indigenous women from remote regions to urban centres for childbirth is a central strategy for addressing maternal health disparities in Canada. Maternal evacuation continues despite mounting evidence of its negative impacts on Indigenous women and families.
Since the 1960s, pregnant Indigenous women living in remote regions in Canada have been transferred to urban hospitals for childbirth. In the following decades, evidence emerged linking maternal evacuation with negative impacts on Indigenous women, their families, and communities. In some communities, resistance to evacuation and the creation of local birthing facilities has resulted in highly diverse experiences of childbirth and evacuation.
A scoping review mapped the evidence on maternal evacuation of Indigenous women in Canada and its associated factors and outcomes from 1978 to 2019.
We searched MEDLINE, Embase, and CINAHL, and grey literature from governmental and Indigenous organizations. We collated the evidence on maternal evacuation into 12 themes.
Factors related to evacuation include (a) evacuation policies (b) institutional coercion (c) remoteness and (d) maternal-fetal health status. Evacuation-related outcomes include (e) maternal-child health impacts (f) women's experience of evacuation (g) financial hardships (h) family disruption (i) cultural continuity and community wellness (ij) engagement with health services (k) self-determination, and (l) quality of health services.
Numerous emotional, social and cultural harms are associated with evacuation of Indigenous women in Canada. Little is known about the long-term impacts of evacuation on Indigenous maternal-infant health. Evidence on evacuation from remote Métis communities remains a critical knowledge gap.
将偏远地区的孕妇常规转移到城市中心分娩，是解决加拿大母婴健康差距的核心策略。尽管有越来越多的证据表明这种做法对原住民妇女和家庭有负面影响，但孕产妇转移仍在继续。
自 20 世纪 60 年代以来，生活在加拿大偏远地区的原住民孕妇被转移到城市医院分娩。在接下来的几十年里，有证据表明，孕产妇转移与原住民妇女、她们的家庭和社区的负面影响有关。在一些社区，对转移的抵制和创建当地生育设施导致了生育和转移方面非常多样化的体验。
本研究通过范围综述，绘制了 1978 年至 2019 年间加拿大原住民妇女孕产妇转移及其相关因素和结果的证据图。
我们检索了 MEDLINE、Embase 和 CINAHL，并从政府和原住民组织中收集了灰色文献。我们将孕产妇转移的证据整理成 12 个主题。
与转移相关的因素包括（a）转移政策、（b）机构强制、（c）偏远地区和（d）母婴健康状况。与转移相关的结果包括（e）母婴健康影响、（f）妇女对转移的体验、（g）经济困难、（h）家庭破裂、（i）文化连续性和社区健康、（ij）与卫生服务的互动、（k）自决以及（l）卫生服务质量。
在加拿大，大量的情感、社会和文化伤害与原住民妇女的转移有关。对于转移对原住民母婴健康的长期影响知之甚少。关于偏远梅蒂斯社区转移的证据仍然是一个关键的知识空白。
