Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada.
Can J Nurs Res. 2023 Sep;55(3):333-344. doi: 10.1177/08445621221150620. Epub 2023 Jan 11.
The three-month health insurance waiting period in Ontario reinforces health inequities for newcomer women and their babies. Little is known about the systemic factors that shape newcomer women's experiences during the OHIP waiting period.
To examine the factors that shaped newcomer women's experiences with perinatal care during the three-month health insurance waiting period in Ontario, Canada.
This qualitative study was informed by an intersectional framework, and guided by a critical ethnographic method. Individual interviews were conducted with four newcomer women and three perinatal healthcare professionals. Participant observations at recruitment and interview sites were integral to the study design.
The key systemic factors that shaped newcomer women's experiences with perinatal care included social identity, migration, and the healthcare system. Social identities related to gender, race, and socio-economic status intersected to form a social location, which converged with newcomer women's experiences of social isolation and exclusion. These experiences, in turn, intersected with Ontario's problematic perinatal health services. Together, these factors form systems of oppression for newcomer women in the perinatal period.
Given the health inequities that can result from these systems of oppression, it is important to adopt an upstream approach that is informed by the Human Rights Code of Ontario to improve accessibility to and the experiences of perinatal care for newcomer women.
安大略省三个月的健康保险等待期加剧了新移民妇女及其婴儿的健康不平等。对于塑造新移民妇女在安大略省 OHIP 等待期内的围产期护理体验的系统性因素知之甚少。
研究在加拿大安大略省三个月健康保险等待期内,塑造新移民妇女围产期护理体验的因素。
本定性研究以交叉框架为指导,并以批判性人种学方法为指导。对四位新移民妇女和三位围产期保健专业人员进行了个人访谈。在招募和访谈地点的参与者观察是研究设计的重要组成部分。
塑造新移民妇女围产期护理体验的主要系统性因素包括社会身份、移民和医疗保健系统。与性别、种族和社会经济地位相关的社会身份相互交叉形成了一个社会位置,这与新移民妇女的社会孤立和排斥经历相吻合。这些经历反过来又与安大略省有问题的围产期保健服务交叉。这些因素共同构成了新移民妇女在围产期的压迫制度。
鉴于这些压迫制度可能导致的健康不平等,有必要采取一种源自安大略省人权法的上游方法,以提高新移民妇女获得围产期保健的机会,并改善她们的体验。