Nurturing the future : exploring maternal health knowledge, attitudes and behaviors among Mi’kmaq women

Abstract

Much of the maternal health care literature on Aboriginal women is biomedical in its focus, covering topics such as gestational diabetes, abnormal birth weight, and infant morality. There has also been some exploration of First Nations women’s relationships with health professionals. There is a dearth of literature that addresses First Nations women’s choices, experiences, knowledges (traditional and medical), attitudes, beliefs and values surrounding their pregnancies and prenatal health care. This qualitative study conducted by a Mi’kmaw woman explores Mi’kmaw women’s perceptions of their maternal health, the relationships that support or serve Mi’kmaw women during their pregnancy, birthing, and postpartum delivery in two First Nations communities in Nova Scotia. The stories of fourteen Mi’kmaw female participants, ranging from young women to Elders, were explored using a narrative inquiry approach that is consistent with First Nations oral traditions of storytelling. Stories were told in a focus group and individual interviews. Data collection, analysis, and interpretation was guided by an Indigenous framework of two superimposed medicine wheels: (1) holistic model of health (mental, physical, emotional and spiritual), and; (2) maternal health life cycle (becoming a woman, teachings during pregnancy, experiences during birth, motherhood and the fourth trimester: after birthing). This study found that the colonization of birthing has significantly impacted Mi’kmaw maternal health experiences, and is characterized by a tension between western medical knowledge and Mi’kmaq traditional knowledge systems that plays out very strongly during this critical period in the life of a woman and her child. In addition, recognition of the socio-cultural context of Mi’kmaq women is critical to understanding their decision making in regards to maternal health. The results suggest there is a need to create culturally sensitive models of maternal health that incorporate First Nations traditional knowledge of maternity and Western medical knowledge.