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- Page navigation anchor for RE: Response to commentary: Addressing barriers to Indigenous maternity careRE: Response to commentary: Addressing barriers to Indigenous maternity care
I would like to thank Smylie and Phillips-Beck for their thoughtful commentary.1 I agree with the authors that the low uptake of prenatal care among mothers who had a child placed in care goes well beyond what we discussed in our study, including ongoing colonialism, anti-Indigenous racism and gaps in cultural safety competencies, and that there are Indigenous community-led models of maternity care that are addressing these issues. As the authors point out, an Indigenous-specific analysis of this research question would lead to a better understanding the drivers of inadequate prenatal care among mothers who had a child place in out-of-home care.
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Smylie and Phillips-Beck identify ethical concerns regarding this research, primarily around the absence of Indigenous engagement and input on a study where the affected group primarily comprised of Indigenous mothers. Our study was conducted using data from families involved with child protection services in Manitoba, and although we did not include an Indigenous identifier, it is known that during the study years, between 80 and 87% of children in care in Manitoba were Indigenous.2,3 I take Smylie and Phillips-Beck’s concerns seriously and acknowledge that the exclusion of Indigenous involvement in this study was an oversight on my part; I apologize for my role in the harms this causes and will work to ensure that Indigenous representation and engagement is present in relevant research using routinely collected data.Competing Interests: None declared. - Page navigation anchor for RE: Truth, respect and recognition: addressing barriers to Indigenous maternity careRE: Truth, respect and recognition: addressing barriers to Indigenous maternity care
Smylie and Phillips-Beck (1) raise a number of valid issues in their commentary on Indigenous maternity care. We would like to highlight two of these. Firstly, the challenges that Indigenous peoples face need to be understood in the context of the harms of residential schools, the Sixties scoop, and the ongoing inequities and systemic racism they continue to experience. Secondly, that in the era of Reconciliation, research exploring the health and well-being of Indigenous peoples should include those peoples in all phases of the research. This fundamental requirement should ensure the ethical conduct of the research and appropriate interpretation of the findings. As leaders at the Manitoba Centre for Health Policy we fully endorse this approach.
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While we have as yet been unable to recruit Indigenous scientists to lead research studies focused on Indigenous populations, we partner with Nanaandawewigamig (the First Nations Health and Social Secretariat of Manitoba), other First Nations groups (e.g., Swampy Cree Tribal Council) and the Manitoba Metis Federation in respectful partnerships. We have personally found these relationships to be opportunities for growth and new understanding. They have without question enhanced the quality of our research.
All research at MCHP is subject to review by the Health Research Ethics Board at the University of Manitoba, the Health Information Privacy Committee of the Manitoba government and the custodians of the data included i...Competing Interests: None declared.