Celina G. Solís Becerra, David Uribe Villavicencio, Saraswathi Vedam
Background: Respectful and inclusive health services are globally acknowledged as a key indicator of maternal-newborn optimal outcomes. However, social factors such as cultural background, immigration status, and racism are core barriers to equitable access to high-quality care. Among these social factors, language is identified as a significant barrier to respectful perinatal care, particularly among immigrants. Canada is a country with a long tradition of welcoming immigrants and promoting the arrival of newcomers from all over the world. However, this positive attitude is not always consistent with immigrants’ experiences navigating the health system. Thus, we present the design of an ongoing analysis that aims to examine how allophone languages limit or expand access to respectful perinatal care for birthing people in Canada.
Methods: The Research Examining the Stories of Pregnancy and Childbearing in Canada Today (RESPCCT) is a Canada-wide study on the experiences of perinatal care. Using validated person-centered measures, more than 6,000 participants from diverse identities, backgrounds, and circumstances reported on respect, autonomy, and mistreatment during pregnancy. Through thematic analysis inspired by constructivist social theories, we are reviewing participants’ open-ended responses. In this paper, we present our innovative approach to qualitative analysis of a large number of open-ended responses to a cross-sectional survey that goes beyond the limits of quantitative content analysis to achieve deeper meaning-making.
Results: To contextualize the responses of Arabic, traditional and simplified Chinese, Spanish, and Punjabi-speaking immigrant participants, we considered their scores on the Mothers on Respect (MOR), My Autonomy in Decision Making (MADM), and Mistreatment Index (MIST-7) tools. These patient-reported outcome measures allowed us to connect lived experiences with language as a cultural marker. This explanatory process unveiled and unpacked the role that language played during their perinatal care experience, revealing how mother tongues interplay with (I) cultural safety, (II) informed consent access, (III) non-verbal communication, (IV) verbal communication from care providers, and (V) supportive behaviors and conditions of treatment.
Conclusions: We outlined the methodology for a qualitative data analysis focusing on language contributions to respectful perinatal healthcare. Expected final results will uncover insights into culturally sensitive healthcare practices that reduce discrimination and enhance cultural safety.
