Background: Globally, there are disparities in access to maternal health care services and equity in maternal health outcomes between Indigenous and non-Indigenous populations. While the literature is growing, it has not been systematically synthesized. This review addresses this gap by synthesizing the existing literature on the organizational structure of maternity care, accessibility and delivery of services, and clinical disparities impacting Indigenous maternal health within Canada. It also identifies current knowledge gaps in research on these topics.Methods: A scoping review was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines and the extension for scoping reviews. The search for relevant papers was performed in PubMed, CINAHL, and SCOPUS electronic databases and included any empirical literature written in English and published during 2006 – 2021. The research team inductively coded 5 articles to develop a coding scheme, which was then applied to the remaining articles.Results: A total of 89 articles were included in the review, of which 32 were qualitative papers, 40 quantitative, 8 were mixed-methods publications, and 9 were review papers. The analysis of the articles resulted in identifying a range of overarching themes pertaining to the maternal health of Indigenous women within Canada including provision of services, clinical issues, education, health disparities, organization, spatial context, and impact of informal support. The results suggest that physical, psychological, organizational, and systemic barriers inhibit the quality-of-care pregnant Indigenous women receive, and that maternal health services are not consistently provided in a culturally safe manner. Results also suggest that, compared to non-Indigenous pregnant women, Indigenous women are more likely to develop clinical complications during pregnancy, reflecting the structural impacts of colonization that continue to negatively influence Indigenous maternal health and well-being.Conclusions: There are many complex barriers that prevent Indigenous women from receiving high quality and culturally appropriate maternal care. Possible areas that could address the service gaps illuminated through this review include the implementation of cultural considerations across health care jurisdictions within Canada.

Traditional foods contribute to the health and well-being of Indigenous Peoples. Many Indigenous Peoples within Canada have expressed a desire to consume more traditional foods; however, there are a number of barriers to doing so. Southern and urban communities face unique challenges associated with traditional food consumption. To address these concerns and build on community interests in a Haudenosaunee community in Southern Ontario, a participatory research project was initiated. This community-based study utilized Photovoice methodology to explore the perceptions of and experiences with traditional foods among local youth. Participants ranging in age from 15–22 (n = 5) took photos of their local food environments, including locations where foods were acquired, consumed, prepared, or shared during two seasons of the year. Semi-structured interviews were conducted to collect participants’ stories behind 8–10 self-selected images. A thematic analysis was subsequently utilized to identify patterns and themes illustrated by the photos and interview content. The youth conveyed contextual understandings of traditional foods and a preference for these items, despite their limited consumption, preparation or harvesting of these foods. The youth also identified the important influence of families and communities on their individual perceptions and experiences with traditional foods. Recommendations to reduce barriers to traditional food choices among youth are made.

There are collective movements of Indigenous food sovereignty (IFS) initiatives taking up place and space within urban environments across the Grand River Territory, within southern Ontario, Canada. Indigenous Peoples living within urban centres are often displaced from their home territories and are seeking opportunities to reconnect with culture and identity through Land and food. This research was guided by Indigenous research methodologies and applied community-based participatory research to highlight experiences from seven Indigenous community members engaged in IFS programming and practice. Thematic analysis revealed four inter-related themes illustrated by a conceptual model: Land-based knowledge and relationships; Land and food-based practices; relational principles; and place. Participants engaged in five Land and food-based practices (seed saving; growing and gathering food; hunting and fishing; processing and preserving food; and sharing and distributing), guided by three relational principles (responsibility, relationality, and reciprocity), framed by the social and physical environments of the place. Key findings revealed that employing self-determined processes to grow, harvest, and share food among the Indigenous community provide pathways towards IFS. This study is the first to explore urban IFS initiatives within this region, offering a novel understanding of how these initiatives are taking shape within urban environments.

Indigenous families are overrepresented among those within Canada who experience food insecurity. Studies have largely focused on northern populations, with less attention paid to southern and urban communities, including the social, cultural, and geographic processes that challenge food security. In this study, we present findings from a decade‐long community‐based study with the Southwest Ontario Aboriginal Health Access Centre (London, Ontario) to examine family perspectives related to the social determinants of food security. These topics were explored through qualitative interviews (n = 25) and focus groups (n = 2) with First Nation mothers with young children from the city of London, and a nearby reserve community. Interviewees from both geographies identified a number of socio‐economic challenges including household income and transportation. However, some interviewees also shed light on barriers to healthy eating unique to these Indigenous contexts including access issues such as a lack of grocery stores on‐reserve; loss of knowledge related to the utilization of traditional foods; and the erosion of community, familial, and social supports. Resolving these unique determinants of food security for urban and reserve‐based First Nation families will require a range of economic and culturally specific interventions, particularly those that support development and uptake of Indigenous foodways.

The ongoing negative health effects of colonization have disproportionately affected Indigenous women, who are disproportionately affected by diabetes, food insecurity, and undernutrition. Indigenous women also perceive their health less positively than men do. This article draws theoretically from the socio-ecological model to explore health inequalities experienced by Indigenous women associated with the intergenerational effects of the residential school legacy, specifically related to food practices. Study objectives were to describe and compare the historical context of present-day urban and rural food environments, and explore the hypothesis that food insecurity may be associated with cultural loss resulting from the intergenerational trauma of residential schools in this region of southwestern Ontario, Canada. Framed by a larger community-based participatory study, life history interviews took place with 18 Elder women living on- and off-reserve in southwestern Ontario, Canada. Women discussed painful circumstances of displacement from the land and social disconnection from families and communities. The 10 participants who were residential school survivors conveyed the intergenerational effects of loss, responsibility, lack of support, and an altered sense of identity as narratives of survival. Six women had moved away from their home communities, which created challenges to fully engage in local food procurement and sharing practices. These altered geographies present practical limitations, along with apparent mechanisms of social and cultural exclusion. Research on Indigenous Peoples’ food systems requires further analysis of the root causes of disparities in the context of societal and gender relations. Food sovereignty has been the domain of women, who have led movements aimed at both social and environmental justice. Unraveling the historical, social, and environmental determinants of Indigenous food knowledge will support and guide community and policy recommendations, highlighting the ongoing effects of residential schooling and other indirect examples of environmental dispossession that have disproportionately affected Indigenous women.

Background: The objective of this study was to describe women’s processes for finding pregnancy-related nutrition information, their experiences seeking this information online and their ideas for improving internet sources of this information. Methods: In total, 97 pregnant women completed an online quantitative questionnaire and 10 primiparous pregnant women completed semi-structured telephone interviews. Questionnaires and interviews asked participants to describe sources of pregnancy-related nutrition information; time of seeking; processes of searching online; experiences searching online; ideas for improving information found online. Survey data were analyzed using descriptive statistics and Chi square tests; interview data were analyzed using thematic analysis. Results: Nearly all (96%) survey participants sought nutrition information online. Information was most commonly sought during the first trimester of pregnancy. Motivators for using the internet included convenience and lack of support from health care providers. Barriers to using online information included lack of trust, difficulty finding information and worry. Women adapted the information they found online to meet their needs and reported making positive changes to their diets. Conclusions: The internet is a key source of prenatal nutrition information that women report using to make positive dietary changes. Women would benefit from improved access to trustworthy internet sources, increased availability of information on different diets and health conditions, and increased support from health care providers.