1. Objectifs

Intentions :
The «aims of this scoping review are threefold: […] to map the existing knowledge of maternal evacuation among rural and remote First Nation, Inuit and Métis communities in Canada; […] to identify and analyze the gaps in the knowledge base and […] to identify and evaluate the key factors and outcomes associated with maternal evacuation.» (p. 12)

2. Méthode

Échantillon/Matériau :
The authors «examined 61 studies including 43 published papers, 6 book chapters, 7 reports and 5 dissertations covering more than 10,000 births between 1978 and 2019 (see Table 1). Studies reviewed employed qualitative, quantitative and mixed methodologies. Thirty-one percent of the studies were authored by at least one scholar who publicly identified as Indigenous. Among the three officially recognized Indigenous groups in Canada most studies examined maternal evacuation among the Inuit (54.8%) followed by First Nations (38.4%) and Métis (6.8%).» (p. 14)

Type de traitement des données :
Analyse théorique

3. Résumé

«Three insights emerge from mapping the documented and mostly published evidence on maternal evacuation of Indigenous women in Canada. First, the emotional, social and cultural harms associated with evacuation are persistent and pervasive, with surprisingly little variation across time, place, or Indigenous group. Evacuation sets up childbirth as an experience punctuated by loneliness, anxiety and sadness for women who must leave their families and supportive networks behind, instead of being a pivotal moment for healing and breaking the cycle of intergenerational trauma. […] Evacuating women also leaves family management gaps that must be held together by family members who remain in the community.» (p. 19) «The second insight relates to the stated objective of evacuation improving maternal and infant health. With the weight of its adverse impacts on women, families and communities, paradoxically evacuation seems to defeat this goal. Examining the colonial origins of evacuation highlights the legacy of dispossession of Indigenous bodies, knowledge and land, and the consequences of this dispossession. Evacuation repeatedly assaults Indigenous women’s embodiment and sovereignty, depriving them of fundamental rights in childbirth. Those who are willing to assert their desires in childbirth must stand against governmental and medical authorities, risking coercion and policing.» (p. 19) «Finally, evacuation continues in the face of decades of evidence on its associated emotional, social and cultural harms, with little examination of its consequences to Indigenous maternal-infant health.» (p. 19)