ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2021
Long-distance travel for birthing among Indigenous and non-Indigenous pregnant people in Canada.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 38 citations in OpenAlex.
- Reclaiming Indigenous birth: research framework to assess the economic costs and outcomes of obstetric evacuation and experiences of Indigenous midwifery in Canada.BMC pregnancy and childbirth · 2026Article
- Effect of midwife-led planned education on psychosocial health and obstetric outcomes among pregnant women in rural areas during the COVID-19 pandemic: a quasi-experimental study.BMC pregnancy and childbirth · 2026Article
- Birthing injustice: unmasking structural racism and the illusion of reconciliation in indigenous perinatal care in Canada, insights from the RESPCCT study.Frontiers in global women's health · 2026Article
- What makes Inuulitsivik midwifery successful and sustainable? How an Inuit-led care model brought birth back to our remote arctic communities.International journal of circumpolar health · 2025Review
- Understanding the experiences of young, urban, Indigenous mothers-to-be in British Columbia, Canada.BMC pregnancy and childbirth · 2025Observational
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- Structural racism and violence: Routine healthcare access in a cohort of marginalized Indigenous women and Two-Spirit Peoples during the COVID-19 Pandemic.Research square · 2023Article
- The pandemic experiences of Ontario perinatal providers: a qualitative study.BMC health services research · 2023Article
- Disparities in primary and emergency health care among "off-reserve" Indigenous females compared with non-Indigenous females aged 15-55 years in Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
- Article
- Integration of midwifery care in Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
- No community left behind: advancing rural anesthesia, surgery, and obstetric care in Canada.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2022Article
- Enhancing health and wellness by, for and with Indigenous youth in Canada: a scoping review.BMC public health · 2022Article
- Public health perinatal promotion during COVID-19 pandemic: a social media analysis.BMC public health · 2022Article
- Addiction in the family: Two Indigenous families overcoming barriers to opioid agonist therapy.Canadian family physician Medecin de famille canadien · 2022Article
- Article
- Addressing racial disparities: Time for action.Obstetric medicine · 2022Article
- Experiences of Canadian perinatal care during the COVID-19 pandemic: Analysis of open-ended survey responses.Women's health (London, England)Article
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Authors and funding
8 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundFor Indigenous Peoples in Canada, birthing on or near traditional territories in the presence of family and community is of foundational cultural and social importance. We aimed to evaluate the association between Indigenous identity and distance travelled for birth in Canada.
methodsWe obtained data from the Maternity Experiences Survey, a national population-based sample of new Canadian people aged 15 years or older who gave birth (defined as mothers) and were interviewed in 2006-2007. We compared Indigenous with non-Indigenous Canadian-born mothers and adjusted for geographic and sociodemographic factors and medical complications of pregnancy using multivariable logistic regression. We categorized the primary outcome, distance travelled for birth, as 0 to 49, 50 to 199 or 200 km or more.
resultsWe included 3100 mothers living in rural or small urban areas, weighted to represent 31 100 (1800 Indigenous and 29 300 non-Indigenous Canadian-born mothers). We found that travelling 200 km or more for birth was more common among Indigenous compared with non-Indigenous mothers (9.8% v. 2.0%, odds ratio [OR] 5.45, 95% confidence interval [CI] 3.52-8.48). In adjusted analyses, the association between Indigenous identity and travelling more than 200 km for birth was even stronger (adjusted OR 16.44, 95% CI 8.07-33.50) in rural regions; however, this was not observed in small urban regions (adjusted OR 1.04, 95% CI 0.37-2.91).
interpretationIndigenous people in Canada experience striking inequities in access to birth close to home compared with non-Indigenous people, primarily in rural areas and independently of medical complications of pregnancy. This suggests inequities are rooted in the geographic distribution of and proximal access to birthing facilities and providers for Indigenous people.
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