Childbearing women in Canada are speaking out about their desire for respectful maternity care. The Vancouver Foundation funded Phase 1 of our provincial, community-led participatory action research project entitled "Changing Childbirth in BC: Women exploring access to high quality maternity care". A steering group of women from different cultural and socioeconomic backgrounds worked with researchers and community agencies to study access to preferred models of maternity care and experiences of autonomy, respect, discrimination, or coercion when participating in a decision-making process. Community leaders developed an online survey and focus group questions including items targeted for marginalized populations: street-entrenched, formerly incarcerated, and immigrant and refugee groups. The response from women from all communities was overwhelming: 4,082 respondents (392 from vulnerable populations) provided survey data, and 135 women in 20 focus groups.
Our preliminary analysis of this rich mixed-methods dataset suggests it will reveal detailed information on how model of care and patient-provider communication affect women's experience of care. Some women say they have a trusting relationship with a maternity provider who involves them in decision-making, but others report being treated in an impersonal, condescending manner; receiving fragmented care and false information; and feeling lonely, disregarded, and abandoned by care providers. Marginalized and immigrant women seem to experience higher rates of disrespect and lack access to maternity care options. Now we must confirm our findings, decide how best to tell these stories, and effect change.
We will work with community members to interpret and translate our findings into practice and policy. We will complete our analysis and examine differences in needs and preferences among women from varied regional and cultural contexts. We will hold town meetings to discuss the findings and decide how the community wants to tell the stories. To make an effective multimedia knowledge translation plan, we will link community members with health professional educators, public information specialists, and parents who have relevant technical expertise. Our partners will help us to create multilingual, culturally appropriate multimedia dissemination tools. Together we will lead implementation activities targeted at institutions, clinicians, and policymakers.