We Don’t Bear The Burden Equally
In Australia, an initiative titled Close the Gap is meant to draw attention to a disturbing truth: Aboriginal and Torres Strait Islander people do not enjoy the same good health as other Australians. Indigenous women are 1.5 times more likely to have a stillborn child than white women (Ibiebele et al., 2016).
Australia isn’t alone in this (Shah et al., 2011). In the United States, Indigenous women are 1.25 times more likely to have a stillborn child and 1.3 times more likely to lose a child in the first 30 days of life (Wingate, Barfield, Smith, & Petrini, 2015). In Canada, Inuit women are nearly twice as likely to have a stillborn child and First Nations women are close behind, with 1.6 times the likelihood of having a stillborn child (Auger, Park, Zoungrana, McHugh, & Luo, 2013).
This is appalling.
While many excuses are made for why this is the case, the reality is that we still bear the scars of colonialism. Access to health care isn’t equal in practice, even if it is in theory. When indigenous women complain about reduced fetal movements, or other concerns about their care, their care providers may make racist assumptions. Our shameful history of segregated hospitals, also makes indigenous women reluctant to share their concerns in the first place. Reserves (Canada) and reservations (United States) may have health care providers that are overstretched and underfunded. Did you know that in Canada, many indigenous women have to leave their homes when they are 36 weeks pregnant and wait in hotels in the city, away from their family, jobs, and friends until they go into labour?
What can you do?
Let your government representatives know that no one should face a worse life expectancy because of their race. In Australia, you can let them know you support the Close the Gap initiative. In Canada and the United States, we can also let our representatives know that indigenous health is important. The Truth and Reconciliation Report explicitly states: “Reconciliation must create a more equitable and inclusive society by closing the gaps in social, health, and economic outcomes that exist between Aboriginal and non-Aboriginal Canadians.”
Stillbirth is just one measure of a poor health outcome. But it is one near and dear to many of our hearts. We don’t want another woman to endure what we’ve had to endure. Let’s have the courage to take action to prevent it.
Auger, N., Park, A. L., Zoungrana, H., McHugh, N. G., & Luo, Z. C. (2013). Rates of stillbirth by gestational age and cause in Inuit and First Nations populations in Quebec. CMAJ Canadian Medical Association Journal, 185(6), E256-262. doi:https://dx.doi.org/10.1503/cmaj.120945
Ibiebele, I., Coory, M., Smith, G. C., Boyle, F. M., Vlack, S., Middleton, P., . . . Flenady, V. (2016). Gestational age specific stillbirth risk among Indigenous and non-Indigenous women in Queensland, Australia: a population based study. BMC Pregnancy & Childbirth, 16(1), 159. doi:https://dx.doi.org/10.1186/s12884-016-0943-7
Shah, P. S., Zao, J., Al-Wassia, H., Shah, V., & Knowledge Synthesis Group on Determinants of Preterm, L. B. W. B. (2011). Pregnancy and neonatal outcomes of aboriginal women: a systematic review and meta-analysis. Womens Health Issues, 21(1), 28-39. doi:https://dx.doi.org/10.1016/j.whi.2010.08.005
Wingate, M. S., Barfield, W. D., Smith, R. A., & Petrini, J. (2015). Perinatal Disparities Between American Indians and Alaska Natives and Other US Populations: Comparative Changes in Fetal and First Day Mortality, 1995-2008. Maternal & Child Health Journal, 19(8), 1802-1812. doi:https://dx.doi.org/10.1007/s10995-015-1694-1
Image credit: Nick Russill on Flickr.com, used under Creative Commons Licence