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Bringing Safety and Responsiveness Into the Forefront of Care for Pregnant and Parenting Aboriginal People

Smith, Dawn PhD, RN; Edwards, Nancy PhD, RN; Varcoe, Colleen PhD, RN; Martens, Patricia J. PhD, IBCLC; Davies, Barbara PhD, RN

Original Article

Poor access to prenatal care for Aboriginal people is well documented, and is explicated as an unethical barrier to care resulting from colonial and neocolonial values, attitudes, and practices. A postcolonial standpoint, participatory research principles, and a case study design were used to investigate 2 Aboriginal organizations' experiences improving care for pregnant and parenting Aboriginal people. Data were collected through exploratory interviews and small-group discussions with purposefully selected community leaders, providers, and community members. The study found that safety in healthcare relationships and settings, and responsiveness to individuals' and families' unique experiences and capacities must be brought into the forefront of care. Results suggest that the intention of care must be situated within a broader view of colonizing relations to improve early access to, and relevance of, care during pregnancy and parenting for Aboriginal people.

An investigation of 2 Aboriginal organizations' experiences improving care for pregnant and parenting Aboriginal people. Results suggest that the intention of care must be situated within a broader view of colonizing relations to improve early access to, and relevance of, care during pregnancy and parenting for Aboriginal people. www.advancesinnursingscience.com

School of Nursing (Drs Smith, Edwards, and Davies) and the Department of Community Health and Epidemiology (Dr Edwards), University of Ottawa; University of British Columbia School of Nursing, Vancouver (Dr Varcoe); and the Department of Community Health Sciences, Faculty of Medicine, University of Manitoba (Dr Martens), Canada.

Corresponding author: Dawn Smith, PhD, RN, Room 3245B, 451 Smyth Rd, University of Ottawa, Ottawa, Canada K1H 8M5 (e-mail: dsmith@uottawa.ca).

Dawn Smith, PhD, RN, gratefully acknowledges the contributions of individuals and organizations who participated in this study. Dr Smith received a doctoral fellowship from the Anisnawbe Kekendazone ACADRE center (Aboriginal Capacity and Development Research Environments) funded by the Canadian Institutes for Health Research, and a Strategic Areas of Development Award from the University of Ottawa. Dr Smith also has financial support from the Ontario Training Center in Health Services and Policy Research, a regional training center funded by the Canadian Health Services Research Foundation, Canadian Institutes of Health Research, and Ontario Ministry of Health and Long-term Care. Dr Smith received pilot funding from the Nursing Chair award held by Dr Edwards. This award is funded by Canadian Health Services Research Foundation, Canadian Institutes of Health Research, and Ontario Ministry of Health and Long-term Care.

© 2006 Lippincott Williams & Wilkins, Inc.