title: Delivering away from home: the perinatal experiences of First Nations women in northwestern Ontario.
abstract: BACKGROUND
  Our objective was to understand the perinatal knowledge and experiences of First Nations women from northwestern Ontario who travel away from their remote communities to give birth.
  
  
  METHODS
  A systematic review of MEDLINE, HealthSTAR, HAPI, Embase, AMED, PsycINFO and CINAHL was undertaken using Medical Subject Headings and keywords focusing on Canadian Aboriginal (First Nations, Metis and Inuit) prenatal education and care, and maternal health literacy. This qualitative study using semistructured interviews was conducted in a rural hospital and prenatal clinic that serves First Nations women. Thirteen women from remote communities who had travelled to Sioux Lookout, Ont., to give birth participated in the study.
  
  
  RESULTS
  We identified 5 other qualitative studies that explored the birthing experiences of Aboriginal women. The studies documented a negative experience for women who travelled to access intrapartum maternity care. While in Sioux Lookout to give birth, our participants also experienced loneliness and missed their families. They were open to the idea of a culturally appropriate doula program and visits in hospital by First Nations elders, but they were less interested in access to tele-visitation with family members back in their communities. We found that our participants received most of their prenatal information from family members.
  
  
  CONCLUSIONS
  First Nations women who travel away from home to give birth often travel great cultural and geographic distances. Hospital-based maternity care programs for these women need to achieve a balance of clinical and cultural safety. Programs should be developed to lessen some of the negative consequences these women experience.
authors.affiliation: Division of Clinical Sciences, Northern Ontario School of Medicine, Sioux Lookout, Ont.
authors.forename: Terry
authors.initials: T
authors.lastname: O'Driscoll
authors.forename: Len
authors.initials: L
authors.lastname: Kelly
authors.forename: Lauren
authors.initials: L
authors.lastname: Payne
authors.forename: Natalie
authors.initials: N
authors.lastname: St Pierre-Hansen
authors.forename: Helen
authors.initials: H
authors.lastname: Cromarty
authors.forename: Bryanne
authors.initials: B
authors.lastname: Minty
authors.forename: Barb
authors.initials: B
authors.lastname: Linkewich
mesh_terms: D036861:Delivery, Obstetric; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007198:Indians, North American; D009864:Ontario / Q000208:ethnology; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D036301:Qualitative Research; D012424:Rural Population; D014195:Travel