Open Access Open Badges Research article

Help bring back the celebration of life: A community-based participatory study of rural Aboriginal women’s maternity experiences and outcomes

Colleen Varcoe1*, Helen Brown1, Betty Calam2, Thelma Harvey3 and Miranda Tallio4

Author Affiliations

1 University of British Columbia School of Nursing, T149 - 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada

2 Department of Family Practice, University of British Columbia, British Columbia, Canada

3 Community Health Representative, Box 463, Bella Coola, BC VOT 1CO, Canada

4 Family Support Worker, Box 132, Bella Coola, BC VOT 1CO, Canada

For all author emails, please log on.

BMC Pregnancy and Childbirth 2013, 13:26  doi:10.1186/1471-2393-13-26

Published: 29 January 2013



Despite clear evidence regarding how social determinants of health and structural inequities shape health, Aboriginal women’s birth outcomes are not adequately understood as arising from the historical, economic and social circumstances of their lives. The purpose of this study was to understand rural Aboriginal women’s experiences of maternity care and factors shaping those experiences.


Aboriginal women from the Nuxalk, Haida and 'N

is First Nations and academics from the University of British Columbia in nursing, medicine and counselling psychology used ethnographic methods within a participatory action research framework. We interviewed over 100 women, and involved additional community members through interviews and community meetings. Data were analyzed within each community and across communities.


Most participants described distressing experiences during pregnancy and birthing as they grappled with diminishing local maternity care choices, racism and challenging economic circumstances. Rural Aboriginal women’s birthing experiences are shaped by the intersections among rural circumstances, the effects of historical and ongoing colonization, and concurrent efforts toward self-determination and more vibrant cultures and communities.


Women’s experiences and birth outcomes could be significantly improved if health care providers learned about and accounted for Aboriginal people’s varied encounters with historical and ongoing colonization that unequivocally shapes health and health care. Practitioners who better understand Aboriginal women’s birth outcomes in context can better care in every interaction, particularly by enhancing women’s power, choice, and control over their experiences. Efforts to improve maternity care that account for the social and historical production of health inequities are crucial.

Aboriginal; Rural; Maternity care; Outcomes; Colonialism; Critical ethnography