At What Cost to Health?: Tlicho women’s medical travel for childbirth
Pertice M Moffitt
PhD Candidate, Faculty of Nursing, Kinesiology & Medicine, University of Calgary, Calgary, Alberta, Canada
Ardene Robbinson Vollman
Adjunct Associate Professor, Faculty of Nursing, Kinesiology & Medicine, Dept of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
PP: 228 - 239
Abstract
Medical travel policies are instituted in all rural and remote areas of Canada as a means of providing universal health care services to residents. These policies are framed, developed and implemented from a colonial perspective and require re-examination through a more inclusive and collaborative postcolonial lens.
The purpose of this paper is to discuss the medical travel policy for childbirth in Canada's Northwest Territories from a postcolonial perspective and in consideration of the cultural safety of pregnant Tlicho women. The context within which Tlicho birthing and this policy thrives is reviewed along with the exploration of future possibilities. Personal, socioeconomic, political and legal factors surrounding birthing are highlighted. It is anticipated, that by illuminating the oppressive and paternalistic nature of this childbirth policy, there will be heightened awareness that fosters transitions within the system to transform current risk discourse creating new possibilities for Tlicho women in the birth of their babies.
Keywords
cultural safety, Tlicho First Nation, women’s health, colonialisation, health policy, childbirth, risk discourse
References
Anderson J, Perry J, Blue C, Browne A, Henderson A, Khan KB, Kirkham SR, Lynam J, Semeniuk P and Smye V (2003) 'Rewriting' cultural safety within the postcolonial and postnational feminist project: Toward new epistemologies of healing, Advances in Nursing Science 26(3): 196-214.
Binns B (1990) Obstetric care for northern women. In JD O'Neil and P Gilbert (eds) Childbirth in the Canadian North: Epidemiological clinical and cultural perspectives, pp.79-84, Northern Health Research Unit, University of Manitoba, Winnipeg MN.
Browne AJ and Fiske J (2001) First Nations women's encounters with mainstream health care services, Western Journal of Nursing Research 23(2): 126-147.
Carroll D and Benoit C (2001) Aboriginal midwifery in Canada: Blending traditional and modern forms, The Canadian Women's health Network 4(3), accessed at http://www.cwhn.ca/network-reseau/4-3/3pg2.html on 17 September 2005.
Chamberlain M, Nair R, Nimrod C, Moyer A and England J (1996) Evaluation of a midwifery birthing center in the Canadian North, Circumpolar Health 116-120.
Chamberlain M, Barclay K, Kariminia A and Moyer A (2001) Aboriginal birth psychosocial or physiological safety, Birth Issues 10(3/4): 81-86.
Clarkson G (1975) An assessment of hospital services in Yellowknife including observations on health services in the Northwest Territories, J Clarkson Consultants, Edmonton AB.
Cody WK (2003) Paternalism in nursing and healthcare: Central issues and their relation to theory, Nursing Science Quarterly 26(4): 288-296.
Cook E (2003) The NWT maternal and perinatal committee, EpiNorth 15: 17-18.
Cooney C (1994) A comparative analysis of transcultural nursing and cultural safety, Nursing Praxis New Zealand 9(1): 6-12.
Cuff G and Associates (2001) It's time to act: A report on the health and social services system, NWT Department of Health and Social Services, Yellowknife Canada.
Dacks G (1985 May) Consensus government in the NWT, Paper presented at the Annual meeting of the Canadian Political Science Association, Montreal, Canada.
Fox N (1999) Beyond health: Postmodernism and embodiment, Free Association Books, New York.
Funston B (1982) The Northwest Territories and its future constitutional and political development: An examination of the Drury report, Polar Record 21(131): 117-125.
Hagey R (2000) Cultural safety: Honouring traditional ways of life, Alternative and Complementary Therapies 6(4): 233-236.
Helm J (2000) The people of Denendeh: ethnohistory of the Indian's of Canada's Northwest Territories, McGill-Queen's University Press, Montreal.
Hooks B (2004) Choosing the margin as a space of radical openness. In S Harding (ed) The feminist standpoint theory reader: intellectual and political controversies, pp.153-159, Routledge, New York.
Irlbacher S (1997) The use of aboriginal traditional knowledge in public government programs and services in the NWT, Masters thesis. University of Alberta Department of Political Science, Alberta.
Kirkham SR, Smye V, Tang S, Anderson J, Blue C, Browne A, Coles R, Dyck I, Henderson A, Lynam MJ, Perry J, Semeniuk P and Shapera L (2002) Rethinking cultural safety while waiting to do fieldwork: Methodological implications for nursing research, Research in Nursing and Health 25: 222-232.
Leipert BD and Reutter L (2005) Developing resilience: How women maintain their health in northern geographically isolated settings, Qualitative Health Research 15(1): 49-65.
Lupton D (1999) Risk and the ontology of pregnant embodiment, on D Lupton (ed) Risk and sociocultural theory: New directions and perspectives, pp.59-85, Cambridge University Press, Cambridge UK.
Marshall H and Wollett A (2000) Fit to reproduce? The regulative role of pregnancy texts, Feminism and Psychology 10(3): 351-366.
McKinnon K (2005) The very LOUD discourse of risk in pregnancy! In P Godin (ed) Risk and nursing practice, London
National Aboriginal Health Organization (2004) Midwifery and Aboriginal midwifery in Canada. Ottawa, accessed at http://www.naho.ca/English/pdf/aboriginal_midwifery.pdf on 13 March 2005.
Northern News Service (March 2005) Sterilized woman wants $1.25 million, accessed at http://www.nnsl.com/frames/newspaper/2005-03/Mar905sue.html on 12 September 2005.
Northwest Territories Department of Health (1989) Report of the midwifery issue as it pertains to the Northwest Territories, Department of Health, Yellowknife Canada.
Northwest Territories Medical Association (1993) Medical travel policy, Department of Health, Yellowknife NT.
Nursing Council of New Zealand (2002) Guidelines for cultural safety. The treaty of Wataga and Maori health in nursing and midwifery practice, accessed at http://www.nursingcouncil.org.nz/Publications/culturalsafety.pdf on 1 April 2005.
NWT Bureau of Statistics (2003) Vital statistics, accessed at
http://www.stats.gov.nt.ca/Statinfo/Demographics/
VitalStats81-2003/birthsbycom.html on 12 September 2003.
O'Keefe K (1989) Northwest Territories accommodating the future. In G Levy and G White (eds) Provincial and territorial legislatures in Canada pp.207-220, University of Toronto Press, Toronto.
O'Neil JD, Kaufert PA, Brown P, Voisey E, Moffatt MM, Postl B, Brown R and Binns B (1988) Inuit concerns about policy in the Keewatin Region NWT. In H Linderholm, C Backman, N Broadbent and I Joelson (eds) Circumpolar Health 87: 485-489, The Nordic Council for Arctic Medical Research, Oulu Finland.
Paulette L (1990) The changing experience of childbirth in the Western NWT. In JD O'Neil and P Gilbert (eds) Childbirth in the Canadian North: Epidemiological clinical and cultural perspectives, pp.45-50, Northern Health Research Unit, University of Manitoba, Winnipeg:
Polaschek NR (1998) Cultural safety: a new concept in nursing people of different ethnicities, Journal of Advanced Nursing 27: 452-457.
Ramsden I (1993) Kawa Whakaruruhau. Cultural safety in nursing education in Aotearoa (New Zealand), Nursing Praxis in New Zealand 8(3): 4-10.
Ramsden I (2000) Cultural safety /Kawa Whakaruruhau ten years on: a personal overview, Nursing praxis in New Zealand 15(1): 4-12.
Rawlings L (1998) Traditional aboriginal birthing issues, Birth Gazette 14(1) accessed 24 March 2003 from EBSCO.
Reith G (2003) Living with uncertainty: the construction of 'risk' and the belief in luck, accessed at http://www.geocities.com/organti_revu/OQ6/Reith01.html on 3 October 2005.
Robinson E (1991) Maternal health and obstetrical services: measuring health status and quality of care in remote areas. In BD Postl, P Gilbert, J Goodwill, MEK Moffatt, JD O'Neil, PA Sarsfield and TK Young (eds) Circumpolar Health 90: 596-600 University of Manitoba Press for the Canadian Society for Circumpolar Health, Winnipeg, Canada.
Royal Commission on Aboriginal Peoples (1996) Report of the Royal Commission on Aboriginal Peoples, Ottawa.
Ryan J and Johnson M (1994) Traditional Dene medicine part one and part two Lac La Marte NWT, Dene Cultural Institute, Hay River, NT.
Smith D (2002) Comprehensive maternal child health care in First Nations and Inuit communities: A discussion paper, Office of Nursing Services First Nations and Inuit Health Branch Health Canada, Ottawa.
Smye V and Browne AJ (2002) Cultural safety and the analysis of health policy affecting Aboriginal people, Nurse Researcher. The International Journal of Research Methodology in Nursing and Health Care 9(3): 42-56.
Sutherland RW and Fulton MJ (1988) Health care in Canada: A description of Canadian health services, Health Group, Ottawa.
Wasikeesikaw FH (2003) Challenges in the new millenniums: Nursing in the First Nation Communities, in M McIntyre and E Thomlinson (eds) Realities of Canadian Nursing Professional practice and power issues, pp.447-458, Lippincott, New York NY.
White G (2001) And now for something completely Northern: Institutions of governance in the Territorial North, Journal of Canadian Studies 35(4): 80-99.
Wood P and Schwass M (1993) Cultural safety in nursing education in Aotearoa (New Zealand) Nursing Praxis in New Zealand 8(3): 4-15.

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