Indigenous mothers’ perspectives on improving maternal healthcare in Northwest Territories, Canada: Results from the Maternal and Infant Health Project

BackgroundImproving global maternal health is a key goal within the United Nations' Sustainable Development Goals. In Northwest Territories, Indigenous mothers face significant disparities in maternal healthcare, with higher risks of maternal mortality and healthcare access challenges.ObjectiveTo explore Indigenous mothers' perspectives on opportunities to improve maternal healthcare services in Northwest Territories, Canada, using qualitative data from the Maternal and Infant Health study.DesignQualitative design.MethodsSelf-identifying Indigenous women of childbearing age (17-49 years) who were pregnant at the time of the interview or had given birth within the last three years were invited to participate. A culturally appropriate, interviewer-administered, semi-structured questionnaire was utilized for quantitative and qualitative data collection. Qualitative data were analyzed using reflexive thematic analysis.ResultsIn total, 156 Indigenous women participated (mean age =29.7 years, SD=6; age range 17-47 years). 93% gave birth in the past three years, and 18% were pregnant. Three themes emerged regarding areas in which to improve maternal healthcare: experiences and challenges with service delivery, support networks, including more connections with Elders, and cultural sensitivity. Specifically, participants reported a preference for childbirth to take place within home communities, aided by midwives and family members and utilizing Indigenous maternal care practices. Participants also voiced the necessity of increasing the provision of mental healthcare, postpartum care, and support group services that incorporate traditional local languages.ConclusionTo improve maternal healthcare services within Indigenous communities, building trusting relationships with healthcare professionals that honour Indigenous practices, improving healthcare accessibility, and increasing the delivery of local healthcare services and support are of priority. This paper contributes to the sparse literature currently available, providing Indigenous-informed evidence to guide the conceptualization, practice, and policy of maternal healthcare in Northwest Territories.