Grant: Project Grant

BACKGROUND Inuit women in Canada carry a disproportionate burden of poor health, with higher rates of maternal mortality and negative birth outcomes. Some 14% of Inuit women in Nunavik (Inuit territory in Quebec) travel to tertiary southern hospitals for specialized obstetric care (a process known as fly-out births). Fly-out births are linked to adverse health outcomes for Inuit women, their families and communities. This participatory research supports culturally safe Inuit childbirth, and will co-design pilot interventions with Inuit stakeholders and their care providers, to inform the decolonization of obstetric care in Quebec tertiary hospitals. METHODS The study engages Nunavik-based Inuit women, their families and community members, as well as perinatal healthcare providers and policy makers in Nunavik and Montreal. With each group, a series of group fuzzy cognitive mapping sessions will explore experiences with fly-out childbirth and perspectives of decolonization in obstetric care. Individual and household questionnaires will document the frequency of these findings. Stakeholders will co-design an intervention through deliberative dialogue and community meetings. Recommendations will be shared with obstetrical staff of a Montreal tertiary hospital. A follow-up survey will measure quantitative changes in birth outcomes, patient satisfaction, and decolonizing care practices. An integrated knowledge translation and exchange strategy engages stakeholders in cognitive mapping sessions, and co-design interventions in deliberative dialogue. DISCUSSION Evacuation for childbirth aims to reduce health disparities faced by Inuit women, yet it is inadvertently associated with adverse health outcomes. Affirming Inuit values of childbirth and engaging Inuit voices in service delivery improvement can support culturally safe care. The protocol and instruments developed may have wider relevance for rural Inuit across Canada.