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. • In Canadian health systems risk is conceptualized through the biomedical model. • Literature was reviewed to understand Indigenous People’s perspective of wholistic risk when evacuated from community. • Three main sources of risk were identified within the literature: racism, colonialism, and leaving the community. • To mitigate these risks, we support the calls to bring birth home.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.026 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".