Start with the truth: lessons from the decolonizing birth research project

Indigenous families in Canada have long endured colonial violence in birthing spaces, including systemic racism, forced evacuations, and child welfare interventions. Parallel to these harms, academic research has often functioned as a tool of colonialism. The Decolonizing Birth Research (DBR) project, conducted between 2019 and 2022 across six Indigenous communities in British Columbia and Manitoba, sought to challenge these legacies by centering Indigenous leadership, knowledge systems, and governance through a community-based, participatory model. Two Indigenous scholars, with lived experience, anthropologic, and clinical research expertise in perinatal health services, as well as community-specific knowledge, were supported by an Elder and an academic midwife to co-lead this project. Having an Indigenous research organization as an integral part of the research team allowed the project to navigate and, in some cases, circumvent the colonial constraints of academic institutions, highlighting the capacity of Indigenous organizations to support communities in conducting rigorous, ethical, and culturally grounded research. This article explores both the innovations and structural barriers encountered throughout the project, offering a critical reflection on how academia continues to perpetuate epistemic and structural violence despite commitments to reconciliation. It calls for a reimagining of perinatal and health equity research as a practice that can and must be led by Indigenous communities, both within and beyond the academy.