Please note, this is not an open access database or repository. We have focused on creating simple summaries of reports and articles that we have accessed through websites and academic journals, with a focus on key findings, so that even if a full report is not free to access you can reference it. When possible, we include a link to wherever the original document is hosted (which may or may not be open-access). If you come across a link that is no longer active, please let us know and we can update it. There are also some reports that will have been submitted directly to the project. In this case, these reports are uploaded directly with permission from the author or publisher. Any original documents found on this site are stored in Canada on our secure servers

Vulnerable Women’s Perceptions of Individual Versus Group Prenatal Care: Results of a Cross-Sectional Survey

Vulnerable pregnant women (e.g. women with low socio-economic status or recent immigrants) are less likely to receive adequate prenatal care or to attend perinatal education classes. CenteringPregnancy (CP) is a model of group prenatal care which combines assessment, education and support. This study aimed to assess patient experience among vulnerable women in group prenatal care compared to individual care. Results: Women in CP were younger, more likely to be single and having their first baby than women in individual care. Women in CP were significantly more likely to report having received enough information on exercise during pregnancy, breastfeeding and baby care. Women in CP were more likely to report that they felt their prenatal care providers were interested in how the pregnancy was affecting their life. Hence, group prenatal care provides a positive experience and improves information exchange among vulnerable populations. Programs interested in engaging, educating and empowering vulnerable pregnant women may benefit from implementation of group care. Vulnerable pregnant women (e.g. women with low socio-economic status or recent immigrants) are less likely to receive adequate prenatal care or to attend perinatal education classes. CenteringPregnancy (CP) is a model of group prenatal care which combines assessment, education and support. This study aimed to assess patient experience among vulnerable women in group prenatal care compared to individual care. Results: Women in CP were younger, more likely to be single and having their first baby than women in individual care. Women in CP were significantly more likely to report having received enough information on exercise during pregnancy, breastfeeding and baby care. Women in CP were more likely to report that they felt their prenatal care providers were interested in how the pregnancy was affecting their life. Hence, group prenatal care provides a positive experience and improves information exchange among vulnerable populations. Programs interested in engaging, educating and empowering vulnerable pregnant women may benefit from implementation of group care.
This publication has no Abstract to dispaly

Nurturing maternal health in the midst of difficult life circumstances: a qualitative study of women and providers connected to a community-based perinatal program

Many socioecological and structural factors affect women’s diets, physical activity, and her access and receptivity to perinatal care. We sought to explore women’s and providers’ perceptions and experiences of health in the pre- and post-natal period while facing difficult life circumstances, and accessing a community-based program partially funded by Canada Prenatal Nutrition Program (CPNP) in Alberta, Canada. Women perceived eating healthy foods, taking prenatal vitamins, and being physically active as key health behaviours during pregnancy and postpartum. However, they were commonly coping with many difficult life circumstances, and faced health barriers for themselves and their babies. These barriers included pregnancy or birth complications, family and spousal issues, financial difficulties, and living rurally. On the other hand, women and providers identified many aspects of the community-based program that addressed the burden of adversities as enablers to better health during pregnancy and postpartum. Community-based programs have an important role in alleviating some of the burden of coping with difficult life circumstances for women. With such potential, community-based programs need to be well supported through policies. Policies supporting these programs, and ensuring adequate funding, can enable more equitable services to rural women and truly promote maternal health during pregnancy and postpartum. Many socioecological and structural factors affect women’s diets, physical activity, and her access and receptivity to perinatal care. We sought to explore women’s and providers’ perceptions and experiences of health in the pre- and post-natal period while facing difficult life circumstances, and accessing a community-based program partially funded by Canada Prenatal Nutrition Program (CPNP) in Alberta, Canada. Women perceived eating healthy foods, taking prenatal vitamins, and being physically active as key health behaviours during pregnancy and postpartum. However, they were commonly coping with many difficult life circumstances, and faced health barriers for themselves and their babies. These barriers included pregnancy or birth complications, family and spousal issues, financial difficulties, and living rurally. On the other hand, women and providers identified many aspects of the community-based program that addressed the burden of adversities as enablers to better health during pregnancy and postpartum. Community-based programs have an important role in alleviating some of the burden of coping with difficult life circumstances for women. With such potential, community-based programs need to be well supported through policies. Policies supporting these programs, and ensuring adequate funding, can enable more equitable services to rural women and truly promote maternal health during pregnancy and postpartum.
This publication has no Abstract to dispaly

Caring for pregnant refugee women in a turbulent policy landscape: perspectives of health care professionals in Calgary, Alberta

Female refugees can be a vulnerable population, often having suffered through traumatic events that pose risks to their health, especially during pregnancy. Pregnancy can be an entry point into the health care system, providing health care professionals the opportunity to gain women’s trust, connect refugees with resources, and optimize the health of mother and child. Policies surrounding the provision and funding of health care services to refugees can impact access to and quality of care. The aim of our study was to understand the experiences of health care professionals caring for pregnant refugee women in Calgary, AB. Health care providers described several barriers when caring for pregnant refugees, including language barriers, difficulty navigating the health care system, and cultural barriers such as managing traditional gender dynamics, only wanting a female provider and differences in medical practices. Providers managed these barriers through using a team-based approach to care, coordinating the patient’s care with other services, and addressing both the medical and social needs of the patient. The federal funding cuts added additional challenges, as many refugees were left without adequate health coverage and the system was complicated to understand. Health care providers developed creative strategies to maximize coverage for their patients including paying out of pocket or relying on donations to care for uninsured refugees. Finally, the recent Syrian refugee influx has increased the demand on service providers and further strained already limited resources. Female refugees can be a vulnerable population, often having suffered through traumatic events that pose risks to their health, especially during pregnancy. Pregnancy can be an entry point into the health care system, providing health care professionals the opportunity to gain women’s trust, connect refugees with resources, and optimize the health of mother and child. Policies surrounding the provision and funding of health care services to refugees can impact access to and quality of care. The aim of our study was to understand the experiences of health care professionals caring for pregnant refugee women in Calgary, AB. Health care providers described several barriers when caring for pregnant refugees, including language barriers, difficulty navigating the health care system, and cultural barriers such as managing traditional gender dynamics, only wanting a female provider and differences in medical practices. Providers managed these barriers through using a team-based approach to care, coordinating the patient’s care with other services, and addressing both the medical and social needs of the patient. The federal funding cuts added additional challenges, as many refugees were left without adequate health coverage and the system was complicated to understand. Health care providers developed creative strategies to maximize coverage for their patients including paying out of pocket or relying on donations to care for uninsured refugees. Finally, the recent Syrian refugee influx has increased the demand on service providers and further strained already limited resources.
This publication has no Abstract to dispaly

Perspectives of Immigrant Women on the Gender of Provider During Childbirth

We studied how the gender of a medical provider affects the experience of immigrant women with obstetrical care. We interviewed 38 immigrant women from one hospital in Edmonton, Alberta. These women came from varied educational and ethnic backgrounds (predominately North/East African, Middle Eastern, and South Asian), but most were Muslim and married. Their average age was 27 years old. All of the women stated that they preferred a female provider. They explained their preference because they placed a high value on modesty, often as part of the Muslim faith. At the same time, the women deemed provider competency and having safe childbirth more important. Many said that they would accept care from a male provider if necessary. A small minority of the women reported experiencing psychological stress as a consequence of having received care from a male provider. Overall, women who participated in our study stated that they accepted care from male providers. But for some of them this compromise came at a price, and a small minority of women perceived it as hurtful. With this in mind, we see a need to identify those women for whom gender of provider is important. It will help with providing them with optimal care. We studied how the gender of a medical provider affects the experience of immigrant women with obstetrical care. We interviewed 38 immigrant women from one hospital in Edmonton, Alberta. These women came from varied educational and ethnic backgrounds (predominately North/East African, Middle Eastern, and South Asian), but most were Muslim and married. Their average age was 27 years old. All of the women stated that they preferred a female provider. They explained their preference because they placed a high value on modesty, often as part of the Muslim faith. At the same time, the women deemed provider competency and having safe childbirth more important. Many said that they would accept care from a male provider if necessary. A small minority of the women reported experiencing psychological stress as a consequence of having received care from a male provider. Overall, women who participated in our study stated that they accepted care from male providers. But for some of them this compromise came at a price, and a small minority of women perceived it as hurtful. With this in mind, we see a need to identify those women for whom gender of provider is important. It will help with providing them with optimal care.
This publication has no Abstract to dispaly

Men Become Baby Dolls and Women Become Lions: African Immigrant Men’s Challenges with Transition and Integration

Over the past decade, scholars have begun to explore neglected aspects of immigrant family life such as gender relations, domestic violence, parenting, and relationships with service providers. Many of these studies, however, are based on women’s experiences. As an equally crucial starting point in building sustainable and resilient immigrant communities, our study focuses on the experiences of African immigrant men in a Canadian context. It reveals African immigrant men’s frustration with their search for a better life. Our thematic analysis of participants’ responses identified three main stressors among this group: challenges with economic integration, changing ideals about masculinities and gender relations across transnational spaces, and tensions in the parent-child relationship. These findings suggest that despite the vulnerabilities they face in Canada, African men could play a strategic role as critical agents of change in families’ transitions and integration. Overall, our study calls for the active engagement of both African immigrant men and women in developing policies and practices that impact their everyday lives. Over the past decade, scholars have begun to explore neglected aspects of immigrant family life such as gender relations, domestic violence, parenting, and relationships with service providers. Many of these studies, however, are based on women’s experiences. As an equally crucial starting point in building sustainable and resilient immigrant communities, our study focuses on the experiences of African immigrant men in a Canadian context. It reveals African immigrant men’s frustration with their search for a better life. Our thematic analysis of participants’ responses identified three main stressors among this group: challenges with economic integration, changing ideals about masculinities and gender relations across transnational spaces, and tensions in the parent-child relationship. These findings suggest that despite the vulnerabilities they face in Canada, African men could play a strategic role as critical agents of change in families’ transitions and integration. Overall, our study calls for the active engagement of both African immigrant men and women in developing policies and practices that impact their everyday lives.
This publication has no Abstract to dispaly

Racialized Women, the Law and the Violence of White Settler Colonialism

In 2001, Rie Fujii, a 23-year-old Japanese national living without legal status in Calgary, Alberta, Canada left her two infant children alone in her apartment for 10 days while visiting her out-of-town boyfriend. The children, Domenic and Gemini, died of dehydration and starvation. Charged with two counts of second-degree homicide, Fujii plead guilty to manslaughter and received an 8-year sentence. Through an analysis of the publicly available judicial documents relating to the crimes of Rie Fujii, this paper explores how the law’s individualization and medicalization of crime and violence may obscure the multiple forms of everyday and structural violence that racialized women in white settler states such as Canada experience and may perpetrate. I argue that the law’s conceptualization of crime and violence conceals and thus advances the violence endemic to white settler colonialism. In 2001, Rie Fujii, a 23-year-old Japanese national living without legal status in Calgary, Alberta, Canada left her two infant children alone in her apartment for 10 days while visiting her out-of-town boyfriend. The children, Domenic and Gemini, died of dehydration and starvation. Charged with two counts of second-degree homicide, Fujii plead guilty to manslaughter and received an 8-year sentence. Through an analysis of the publicly available judicial documents relating to the crimes of Rie Fujii, this paper explores how the law’s individualization and medicalization of crime and violence may obscure the multiple forms of everyday and structural violence that racialized women in white settler states such as Canada experience and may perpetrate. I argue that the law’s conceptualization of crime and violence conceals and thus advances the violence endemic to white settler colonialism.
This publication has no Abstract to dispaly

Uninsured Maternity Patients in Calgary: Local Trends and Survey of Health Care Workers

Uninsured maternity patients comprise a small but complex group of patients and include marginalized Canadians, undocumented immigrants, visitors, and non-Canadians seeking health care and/ or citizenship for their newborn. This study found a trend of uninsured deliveries in Calgary that is accounted for by non-Canadian patients. Midwives and physicians agree on provision of emergency care but not preventive care. Across medical specialties, fewer caregivers felt obliged to care for non-Canadian patients seeking citizenship for their newborn. Among physicians, 61% were aware of the Canadian Medical Protective Association’s guidelines on liability coverage for non-Canadian patients, and only 28% consistently protected themselves legally. There is large variation regarding whether physicians bill for services when the patient is uninsured. In Calgary, the study observed an increase in numbers of uninsured maternity patients. Differing ethical perspectives on the care of these patients may lead to conflict within health care teams because of differences on ethical perspectives of care among team members. Health care providers require education to understand the implications and challenges of obstetrical care of non-Canadians. Uninsured maternity patients comprise a small but complex group of patients and include marginalized Canadians, undocumented immigrants, visitors, and non-Canadians seeking health care and/ or citizenship for their newborn. This study found a trend of uninsured deliveries in Calgary that is accounted for by non-Canadian patients. Midwives and physicians agree on provision of emergency care but not preventive care. Across medical specialties, fewer caregivers felt obliged to care for non-Canadian patients seeking citizenship for their newborn. Among physicians, 61% were aware of the Canadian Medical Protective Association’s guidelines on liability coverage for non-Canadian patients, and only 28% consistently protected themselves legally. There is large variation regarding whether physicians bill for services when the patient is uninsured. In Calgary, the study observed an increase in numbers of uninsured maternity patients. Differing ethical perspectives on the care of these patients may lead to conflict within health care teams because of differences on ethical perspectives of care among team members. Health care providers require education to understand the implications and challenges of obstetrical care of non-Canadians.
This publication has no Abstract to dispaly

Sociodemographic Correlates of Clinical Laboratory Test Expenditures in a Major Canadian City

Objectives: The increasing cost of clinical laboratory testing is a challenge in our health care system. This study calculates the annual clinical laboratory test costs. Results: While more women received laboratory testing (58.4%), men had slightly higher testing costs per capita. Except for Chinese, visible minority and Aboriginal populations had higher testing costs. There was an inverse correlation between testing cost and household income. Higher costs were found in those without postsecondary education and the unemployed. Furthermore, another factor that affect the costs is where patients live and access healthcare. Conclusions: Laboratory costs are different depending on social and economic background of patients. Objectives: The increasing cost of clinical laboratory testing is a challenge in our health care system. This study calculates the annual clinical laboratory test costs. Results: While more women received laboratory testing (58.4%), men had slightly higher testing costs per capita. Except for Chinese, visible minority and Aboriginal populations had higher testing costs. There was an inverse correlation between testing cost and household income. Higher costs were found in those without postsecondary education and the unemployed. Furthermore, another factor that affect the costs is where patients live and access healthcare. Conclusions: Laboratory costs are different depending on social and economic background of patients.
This publication has no Abstract to dispaly

Social support needs of Sudanese and Zimbabwean refugee new parents in Canada

The purpose of this paper is to examine support needs of African refugee new parents in Canada. Separated from their traditional family and cultural supports, refugee new parents reported isolation and loneliness. They lacked support during pregnancy, birth, and postpartum and had limited interactions with people from similar cultural backgrounds. Refugees required support to access services and overcome barriers such as language, complex systems, and limited financial resources. Support preferences included emotional and information support from peers from their cultural community and culturally sensitive service providers. The purpose of this paper is to examine support needs of African refugee new parents in Canada. Separated from their traditional family and cultural supports, refugee new parents reported isolation and loneliness. They lacked support during pregnancy, birth, and postpartum and had limited interactions with people from similar cultural backgrounds. Refugees required support to access services and overcome barriers such as language, complex systems, and limited financial resources. Support preferences included emotional and information support from peers from their cultural community and culturally sensitive service providers.
This publication has no Abstract to dispaly

Accommodating Immigrant Women’s Preferences for Female Health Care Providers

In this study we investigate how a request for a female obstetrician can affect and challenges of providing intrapartum care to immigrant women. To answer these questions, we interviewed service providers in one of the large Edmonton hospitals. We interviewed 13 female and 7 male physicians. Physicians recognized the validity of immigrant women’s preference and requests for female health care providers and expressed sympathy for them. However, they were also resistant and expressed several concerns about accommodating these requests. These concerns included (1) a fear of perpetuating and exacerbating gender inequalities in medicine, (2) the ability of the health system to meet the demands, and (3) implications of these requests for training and quality of care. Although physicians were sympathetic to immigrant women’s requests for female obstetricians, they placed greater value on maintaining gender equity both within the medical profession and in wider society. In other words, they resisted accommodating gender-of-health-care-provider requests. We then see a need for greater research to shape policy that meets the professional and personal values of both physicians and patients. In this study we investigate how a request for a female obstetrician can affect and challenges of providing intrapartum care to immigrant women. To answer these questions, we interviewed service providers in one of the large Edmonton hospitals. We interviewed 13 female and 7 male physicians. Physicians recognized the validity of immigrant women’s preference and requests for female health care providers and expressed sympathy for them. However, they were also resistant and expressed several concerns about accommodating these requests. These concerns included (1) a fear of perpetuating and exacerbating gender inequalities in medicine, (2) the ability of the health system to meet the demands, and (3) implications of these requests for training and quality of care. Although physicians were sympathetic to immigrant women’s requests for female obstetricians, they placed greater value on maintaining gender equity both within the medical profession and in wider society. In other words, they resisted accommodating gender-of-health-care-provider requests. We then see a need for greater research to shape policy that meets the professional and personal values of both physicians and patients.
This publication has no Abstract to dispaly