Introduction
Maternal healthcare and education are essential for a healthy pregnancy (1). Unfortunately, maternal health inequities persist for several vulnerable groups, including Indigenous communities (1). According to the World Health Organization (WHO), proper prenatal care involves a minimum of eight visits with a health professional (2). This level of care significantly reduces the risk of perinatal complications and mortality by detecting abnormalities and addressing lifestyle factors that may affect pregnancy outcomes (1, 2). Many Indigenous women face challenges in accessing prenatal care, leading to higher risks for adverse health outcomes for both themselves and their newborns (2). Recent research also highlights that Indigenous women from low socioeconomic backgrounds are less likely to attend prenatal classes (3). These disparities significantly increase the risk of maternal complications for Indigenous women compared to non-Indigenous women (2). Identifying barriers to accessing prenatal care is crucial for developing actionable plans to address these adverse outcomes.
Maternal Care Challenges
Accessing quality healthcare and education remains an uphill battle for Indigenous women (2). Due to their rural locations, many Indigenous women lack adequate transportation to reach the obstetric services available in their area (1, 4). Coupled with low socioeconomic status, this contributes to adverse health outcomes like preterm birth and low birth weight (4). Moreover, in rural regions dominated by male-driven resource extraction industries, rates of violence against Indigenous women and girls soar, severely affecting various aspects of their well-being (5). This pervasive violence may force these women and girls into survival mode, prioritizing immediate safety over their long-term health needs. Intergenerational trauma, which stems from colonization and residential schools, further complicates matters as distrust in the healthcare system and stigma deter Indigenous women from seeking care (1, 4). Systemic barriers to care such as these are reflected in alarming statistics, including the high rates of alcohol consumption during pregnancy. It is estimated that 37% of Indigenous women consume alcohol while pregnant (6). This results in Fetal Alcohol Spectrum Disorder (FASD), a condition which causes physical and cognitive abnormalities in developing fetuses and infants (7). The societal tendency to shame mothers for this behaviour further complicates the challenges of maternal care, discouraging mothers from attaining the healthcare they need and deserve (8). In light of the above factors, and many more, there is an urgent need for culturally safe and competent care approaches.
A Comprehensive & Collaborative Approach
Addressing barriers in Indigenous maternal health is a necessity and presents an opportunity for transformative change. To truly make a difference, a comprehensive approach is needed. This approach must respect traditions, recognize the weight of historical and socio-economic realities, and embrace evidence-based practices to navigate challenges effectively while reducing the prevalence of substance use and FASD (9). It is crucial to challenge misconceptions about substance use among mothers and advocate for policies that address the root causes of health disparities rather than perpetuate harmful stereotypes (8). In addition, gaining a deeper understanding of the cultural values and beliefs of this marginalized group is vital to providing culturally-appropriate prenatal care (1). Often, Indigenous communities feel that their needs are neglected by research efforts that are meant to assist them (10). Decolonizing research, a process which amplifies Indigenous voices and perspectives, can bridge this gap (10). By actively involving Indigenous representatives and practitioners in research, decision-making, and maternal care, inclusivity and improved research effectiveness will be ensured (9, 11). Overall, action items like these will not only elevate research quality but also empower Indigenous communities, foster trust, lead to improved interventions, and ultimately, result in better health outcomes for both mothers and infants within this population.
References
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