Disrupting Racism in Ontario Midwifery

INTRODUCTION

There are a limited number of Canadian studies that explore the experiences of racism among health care providers who are Black, Indigenous, or people of color (BIPOC), and specifically within the context of midwifery in Ontario. More information is needed to better understand how to achieve racial equity and justice at all levels of the midwifery profession.

METHODS

Semistructured key informant interviews were conducted with racialized midwives in Ontario to understand how racism manifests in the midwifery profession and to conduct a needs assessment of interventions required. The researchers used thematic analysis to identify patterns and themes within the data and to develop a better understanding of participants' experiences and perspectives.

RESULTS

Ten racialized midwives participated in key informant interviews. The vast majority of participants reported experiences of racism in their work as a midwife, including being subject to or witnessing racism from clients and colleagues, tokenism, and exclusionary hiring practices. More than half of participants also emphasized their commitment to providing culturally concordant care for BIPOC clients. Participants relayed that access to BIPOC-centered gatherings, workshops, peer reviews, conferences, support groups, and mentorship opportunities constitute important supports for improving diversity and equity in midwifery. They also expressed a need for midwives and midwifery organizations to actively work to disrupt racism and the power structures in midwifery that enable racial inequity to proliferate.

DISCUSSION

The manifestations of racism in midwifery have negative impacts on the career trajectory, career satisfaction, interpersonal relationships, and well-being of BIPOC midwives. It is crucial to understand the role of racism in midwifery and make meaningful changes toward dismantling interpersonal and systemic racism in the profession. These progressive changes will serve to create a more diverse and equitable profession, where all midwives can belong and thrive.

Exploring Somali women's reproductive health knowledge and experiences: results from focus group discussions in Mogadishu

With a total fertility ratio of 6.7 children per woman, a maternal mortality ratio over 1,000 deaths per 100,000 live births, high rates of sexual and gender-based violence, and the lowest contraceptive prevalence rate in the world, women's reproductive health indices in Somalia prove alarming. The voices of women living in Somalia have long been neglected and we undertook this qualitative study to explore women's reproductive health knowledge and experiences. In 2014, we conducted four focus group discussions with 21 married and unmarried women of reproductive age living in Mogadishu, Somalia. Discussions took place in Somali and we used a constant comparative approach to analyse the discussions for content and themes. Our findings reveal that misinformation, restrictive policies, mistrust of clinicians, and prohibitively expensive services shape women's experiences and health-seeking behaviours. Women identified the need for culturally resonant reproductive health information and services as a significant priority. As Somalia begins to emerge from over two decades of civil war, it is imperative that comprehensive reproductive health issues are included on the national agenda and that women's perspectives are incorporated into future policies and interventions.