EXAMINING EVACUATION FOR BIRTH & CARE FOR FIRST NATIONS IN ONTARIO
Bibliographic record
Abstract
Introduction: First Nations peoples are subjected to evacuation birth policy, through the First Nation Inuit Health Branch (FNIHB), whereby federally employed nursing personnel at FNIHB nursing stations arrange transport at 36 weeks’ gestation or sooner, resulting in the relocation of birth outside of their communities. Objectives: 1) Describe where First Nations peoples are being evacuated within the province of Ontario based on referral patterns. 2) Describe the influence of the dominant western culture within the federal and Ontario healthcare systems related to the provision of perinatal care provided to First Nations peoples who are evacuated out of their communities to give birth. Methods: Guided by focused ethnography and anti-oppression theory, I collected documentary data from FNIHB about evacuation for birth, as well as survey and interview data from 15 perinatal care providers working within the province of Ontario who have cared for evacuees. Results: Utilizing reflexive thematic analysis, I outlined overarching referral patterns established through institutional agreements that dictate where evacuees are sent for birth. I explain different facets of structural oppression present in perinatal care culture and its influence of provision of care, including lack of continuity of care; hyper-medicalization of care; centering of whiteness in policy and practice, and; a lack of knowledge about First Nations health and culture amongst providers. I share anti-oppressive practices implemented by care providers, health organizations, and systems which supported the return of birth back to First Nations communities. Discussion: Ending mandatory evacuation for birth is dependent on the growth of Indigenous midwifery in communities where evacuation for birth policy is implemented. I call upon and provide recommendations to health systems to redress structural oppression by uplifting Indigenous midwifery and creating anti-oppressive perinatal care cultures across Turtle Island.
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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 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.010 | 0.004 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.000 | 0.001 |
| 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".