Conceptualizing risk for pregnant Indigenous Peoples accessing maternity care in Canada: A critical interpretive synthesis
Bibliographic record
Abstract
In Canada, Indigenous Peoples living in northern, rural, and/or remote communities are evacuated for birth to hospitals based on beliefs within the Euro-Canadian biomedical model, which does not consider risk in a wholistic manner and overemphasizes biomedical risks like preeclampsia, hypertension, and diabetes. To understand risk wholistically, we conducted a critical interpretative synthesis to generate three concepts of risk: colonialism, racism, and leaving community. We call upon all health systems in Canada to end mandatory evacuation for birth to mitigate the outlined risks. We urge health systems and its workforces to adopt the Calls to Action from the Truth and Reconciliation Commission of Canada (2015) and the Calls for Justice from Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls (2019) to bring birth back to Indigenous communities through an Indigenous midwifery-led approach.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.070 | 0.072 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.011 | 0.013 |
| Science and technology studies | 0.038 | 0.046 |
| Scholarly communication | 0.025 | 0.008 |
| Open science | 0.006 | 0.011 |
| Research integrity | 0.003 | 0.009 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".