The Relationship Between Colonialism and Public Health in Canada: The Effects of the Evacuation Policy on the Rates of Postpartum Depression for Indigenous Women

Abstract

The purpose of this research is to illustrate the effects of colonialism on the maternal health of Indigenous women, and to highlight the importance of their agency in the incorporation of Indigenous epistemologies in healthcare contexts. Indigenous people in Canada experience significant social, political, and economic disadvantages as a direct outcome of colonialism. This research investigates the effects of the evacuation policy on the rates of postpartum depression in Indigenous women living on-reserve or in rural areas. The evacuation policy is a federally enforced health policy that requires the medical evacuation of Indigenous women from their communities into urban areas/hospitals in order to create accessibility to maternal health services. Existing research shows that the evacuation policy is typically unfavoured among Indigenous women in Canada, as they have reported negative experiences and sentiments towards the policy and expressed preference to local birthing centers instead. In addition, existing research proposes that this policy is not effective in promoting the health of Indigenous mothers; rather, it creates adverse health outcomes as medical evacuation is associated with increased rates of stress as a result of a variety of factors, including mistrust in the healthcare system. This study’s research is significant because of the limited amount of literature about the perpetuation of colonialism in Canada through Westernized health policies. The findings indicate that the evacuation policy increases the rates of stress in pregnant Indigenous women, which may contribute to the increasing rates of postpartum depression (PPD). The findings also highlight the opinions of the evacuation policy being unfavorable for Indigenous women and their preference in incorporating Indigenous traditions.