Interactions Between Indigenous Women Awaiting Childbirth Away From Home and Their Southern, Non-Indigenous Health Care Providers

Qual Health Res. 2018 Oct;28(12):1858-1870. doi: 10.1177/1049732318792500. Epub 2018 Aug 10.

Abstract

We examine patient-provider interactions for Indigenous childbirth evacuees. Our analysis draws on in-depth interviews with 25 Inuit and First Nations women with medically high-risk pregnancies who were transferred or medevacked from northern Quebec to receive maternity care at a tertiary hospital in a southern city in the province. We supplemented the patient data with interviews from eight health care providers. Three themes related to patient-provider interactions are discussed: evacuation-related stress, hospital bureaucracy, and stereotypes. Findings show that the quality of the patient-provider interaction is contingent on individual health care providers' ability to connect with Indigenous patients and overcome cultural and institutional barriers to communication and trust-building. The findings point to the need for further training of medical professionals in the delivery of culturally safe care and addressing bureaucratic constraints in the health care system to improve patient-provider communication and overall relationship quality.

Keywords: North America; childbirth; communication; distress; doctor–patient; gender; marginalized or vulnerable populations; nurse–patient; participatory research; pregnancy; qualitative; reproduction; stress; women’s health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Attitude of Health Personnel*
  • Birth Setting
  • Communication
  • Culturally Competent Care*
  • Delivery, Obstetric / psychology*
  • Female
  • Health Services Accessibility
  • Humans
  • Indians, North American / psychology*
  • Interviews as Topic
  • Pregnancy
  • Pregnancy Complications / ethnology
  • Professional-Patient Relations
  • Qualitative Research
  • Quebec
  • Socioeconomic Factors
  • Stereotyping
  • Tertiary Care Centers / organization & administration*
  • Trust
  • Women's Health
  • Young Adult