Strengthening support: service providers’ insights on addressing the complex needs of birthing people facing insecure housing in Winnipeg, Manitoba
Bibliographic record
Abstract
Background: Pregnant people experiencing housing instability often have complex needs. Urban Indigenous doulas can benefit from the expertise of social service and healthcare providers to learn best practises for supporting this population in the urban centre of Winnipeg, Manitoba. Purpose: The purpose of the study was to gather the experiential knowledge of healthcare and social service providers in inner-city Winnipeg, focusing on their perceptions of essential care practises to support unsheltered Indigenous clients throughout their reproductive experiences. Findings will inform the training curriculum for the She Walks with Me: Supporting Urban Indigenous Expectant Mothers through Culturally Based Doulas project. Methods: A two-phase mixed methods design was used: Phase 1 used a questionnaire as an informal needs assessment scan of current supports available for pregnant people experiencing housing instability and served as a recruitment tool (n=58); Phase 2 involved exploratory qualitative semi-structured interviews with social service and healthcare providers to explore their approaches and challenges in supporting pregnant people facing housing insecurity or unsafe housing (n=16). Thematic analysis was conducted to identify key themes. Results: The questionnaire responses noted various reasons why pregnant people experiencing housing instability seek services at service providers’ workplaces, including accessing mental health services, housing support, and harm reduction supplies. Interviews revealed best practises and approaches to care that emphasise cultural safety, compassion, and interprofessional collaboration. Participants shared nuanced approaches for supporting pregnant people with housing instability, highlighting that care should be nonjudgmental, provide resources and referrals, foster trust, incorporate harm reduction practises, and be client-led. They also identified critical gaps, such as the need for a supportive housing shelter for families that offers onsite support for mental health and substance use through an interprofessional wrap around model of care as a best practise. Further, providers offered practical strategies for self-care to avoid burnout when supporting birthing folks with complex circumstances. Conclusion: The study highlights the importance of trauma-informed, anti-racist, and client-led care practises in supporting pregnant people facing housing instability in Winnipeg, while recognising urban Indigenous doulas need to foster relationships, provide anti-racist and trauma informed care, and advocate for this population's unique needs.
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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 | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.015 | 0.005 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 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".