Indigenous Reproductive & Sexual Health
"The right to sexual and reproductive health means that people are able to enjoy a mutually satisfying and safe relationship, free from coercion and violence, without fear of infection or unintended pregnancy, and that they have the ability to regulate their fertility without adverse or dangerous consequences."
From "Sexual and Reproductive Health, Rights, and Realities and Access to Services for First Nations, Inuit, and Métis in Canada." Joint policy statement from the Society of Obstetricians and Gynaecologists of Canada.
For more information on medical colonialism and reproductive health, see the Forced/Coerced Sterilization section of this guide.
Reproductive Health
- Decolonization in Sexual and Reproductive Health Research Methods: Protocol for a Scoping ReviewThe aim of this scoping review is to review decolonized research methodologies through the lens of sexual health as a step in creating a shared understanding of best practices.
- Relationships to land as a determinant of wellness for Indigenous women, two-spirit, trans, and gender diverse people of reproductive age in Toronto, CanadaReproductive justice scholars and activists advocate for intersectional approaches to enhancing Indigenous health equity that recognize land as a central determinant of wellness.
- FNHA Sacred and StrongSacred and Strong is a report about the health and wellness of First Nations women and girls living in BC.
- First Nations Sexual Health Toolkit - NYSHNNYSHN partnered with the First Nations Centre at the National Aboriginal Health Organization to create a two-part sexual health toolkit.
- 'Snag bags': Adapting condoms to community values in Native American communitiesInnovations in culturally integrating condoms and safe sex messages into Native cultural ideals are proving beneficial. One such innovation is the snag bag, which incorporates popular Native sexual ideology while working within local ideals of shame to distribute condoms and safe sex materials to sexually active young people and adults.
- S08.1 ‘Elders teach and youth reach’: indigenous conversations on sexual healthSexual health has been a part of Indigenous communities since time immemorial. Prior to colonization, Indigenous peoples used teachings, traditions and ceremony to pass knowledge about sexuality, including sexual health, from Elders to youth for generations. People were revered for who they were, be it woman, man, child, Two-Spirit, or Elder. These traditions and ways of knowing were disrupted with the arrival of settlers in what is now called Canada, who used deliberate strategies including residential schools to separate Indigenous peoples from family and culture.
- A rapid review of Indigenous boys' and men's sexual health in CanadaIndigenous boys and men in Canada face adverse social and structural circumstances that affect their ability to achieve and maintain sexual health. Research about Indigenous sexual health, however, is largely limited to matters relating to women and statistics on sexually transmitted infections. A rapid review of research was conducted to determine what is currently known about Indigenous boys' and men's sexual health in Canada.
- Abuse of power in relationships and sexual healthSTI rates are high for First Nations in Canada and the United States. Our objective was to understand the context, issues, and beliefs around high STI rates from a nêhiyaw (Cree) perspective.
- Inuit women's stories of strength: informing Inuit community-based HIV and STI prevention and sexual health promotion programmingThe aim of this study was to create a dialogue with Inuit women to address the lack of information available to inform programming to improve the sexual health of Inuit women, their families, and their communities in the Canadian Arctic.
- "Do something with them!": developing "comfortable" engagement with Elders participating in an arts-based sexual health promotion and STBBI prevention workshop for Indigenous Youth in Labrador, CanadaAlthough Indigenous Elders were traditionally involved in cross-generational health promotion and education, colonisation disrupted this role. Little research examines the role of Elders in contemporary health promotion for Indigenous youth and few strategies have been identified to engage Elders in health promotion or sexual health education. We explored engagement of Elders through participatory filmmaking in a sexual health and HIV education workshop for youth.
Aboriginal women, for example, have expressed concern that epidemiological risk profiles for cervical cancer used in public health campaigns could further stigmatize aboriginal women as lascivious and irresponsible. Instead, analyses are needed that recognize that high rate of cervical cancer (among other illnesses) can no longer be blamed on women’s high-risk status, nor can low rates of participation in screening programmes be attributed to cultural issues. Rather, these rates are perhaps equally indicative of women’s avoidance of a health system that is not culturally safe and that does little to acknowledge or counter patterns of individual or institutional discrimination.
Annette J. Browne and Jo-Anne Fiske, First Nations women’s encounters with mainstream health care services.
- Colonial legacy and the experience of First Nations women in cervical cancer screening: a Canadian multi-community study(2016). Indigenous women’s rates of cervical cancer remain disproportionately high, a factor which is not acknowledged in national media or in educational materials reporting Canada’s new cervical cancer screening guidelines. Here, we present findings from a cervical cancer screening initiative in Northwestern Ontario.
- SOGC Policy Statement on Returning Birth to Aboriginal, Rural, and Remote Communities.Eighteen percent of all the women in Canada - many of them indigenous - live in rural or remote communities. With routine birthing evacuations, indigenous women are regularly forced to experience birth alone, far from their homes, families and support systems. For many healthy pregnant women, this has resulted in stressful, lonely and costly births with negative health outcomes. The SOGC strongly supports returning birth to rural and remote communities for low-risk pregnancies.
- Sexual and Reproductive Health, Rights, and Realities and Access to Services for First Nations, Inuit, and Métis in Canada.In 2010, the SOGC teamed with the Assembly of First Nations (AFN), the Native Youth Sexual Health Network (NYSHN), Pauktuutit Inuit Women of Canada, and the Canadian Federation of Sexual Health (CFSH) to create a joint policy statement, affirming the sexual and reproductive health (SRH) rights of First Nations, Inuit and Métis (FNIM) women and youth.
- Sexual and Reproductive Health, Rights, and Realities and Access to Services for First Nations, Inuit, and Métis in CanadaThe Society of Obstetricians and Gynaecologists of Canada.
- Native Youth Sexual Health Network (NYSHN)The Native Youth Sexual Health Network (NYSHN) is an organization by and for Indigenous youth that works across issues of sexual and reproductive health, rights and justice throughout the United States and Canada.
- Native Women's Association of CanadaFounded to enhance, promote, and foster the social, economic, cultural and political well-being of First Nations and Métis women.
Pregnancy, birthing, and parenthood
Indigenous experiences of pregnancy and birth by Call Number: PWH T35 N35 2017ISBN: 9781772581355Publication Date: 2017The editors have put together a powerful collection that honours the spirit of pregnancy and birth, and the strength and resilience of Indigenous women and families. By acknowledging the ceremony of birth in relation to contemporary Indigenous issues, such as forced evacuation and water protection, the editors contextualize the layers of meaning embedded in returning birth to Indigenous communities.
Mothers of the Nations by Call Number: Koerner Library, & Okanagan Library - HQ759 .M928 2014ISBN: 9781927335451Publication Date: 2014-10-01This book addresses diverse subjects, including child welfare, Indigenous mothering in curriculum, mothers and traditional foods, intergenerational mothering in the wake of residential schooling, mothering and HIV, urban Indigenous mothering, mothers working the sex trade, adoptive and other mothers, Indigenous midwifery, and more from peoples living in North America, Central America, Sub-Saharan Africa, the Philippines and Oceania.
Red medicine : traditional indigenous rites of birthing and healing by Call Number: PWH G66 R43 2012ISBN: 0816529566Publication Date: 2012The book explores how Indigenous knowledge has endured and persisted among peoples with a legacy to Mexico. Gonzales shows how this knowledge is now being reclaimed by Chicanos, Mexican Americans and Mexican Indigenous peoples.- Indigenous women's health book, within the sacred circle : reproductive rights, environmental health, traditional herbs and remedies byCall Number: PWH N38 N35 2003Publication Date: 2003
Intimate integration : a history of the Sixties Scoop and the colonization of Indigenous kinship by Call Number: KX S74 N85 2020ISBN: 9781487500641Publication Date: 2020Intimate Integration utilizes an Indigenous gender analysis to identify the gendered operation of the federal Indian Act and its contribution to Indigenous child removal, over-representation in provincial child welfare systems, and transracial adoption. Specifically, women and children's involuntary enfranchisement through marriage, as laid out in the Indian Act, undermined Indigenous gender and kinship relationships.
- Indigenous maternal health and health services within Canada: a scoping reviewGlobally, 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.
Birth Evacuations
- Canada’s evacuation policy for pregnant First Nations women: Resignation, resilience, and resistanceOne Health Canada policy, the evacuation policy, requires all First Nations women living on rural and remote reserves to leave their communities between 36 and 38 weeks gestational age and travel to urban centres to await labour and birth. The theme of resignation was epitomized by the quote, "Nobody has a choice." The ability to withstand and endure the evacuation policy despite poor or absent communication and loneliness informed of resilience. Resistance was demonstrated by women who questioned the necessity and requirement of evacuation for labour and birth.
Abortion
- The Fireweed Project
Through a community-led approach, the goal of the Fireweed Project is to build on existing community knowledge and strengths, advance knowledge around, and remove barriers to abortion services for Indigenous Women, Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual, plus (LGBTQIA+) People in Canada. - A qualitative study exploring access barriers to abortion services among Indigenous Peoples in CanadaOur study demonstrates that Indigenous Peoples experience abortion access barriers that are different than non-Indigenous Canadians, and that these barriers are closely linked to colonialism. Indigenous knowledges and practices that honor reproductive choice that pre-dates settler colonialism, must be brought forward into today to enhance the quality of abortion care.
- Experiences of access to contraception and abortion care among Indigenous clients: A systematic reviewThis paper summarizes the literature describing Indigenous clients’ experiences accessing contraception and abortion services in Canada, and identifies opportunities for health service improvement.
See also the section of the guide on forced/coerced sterilization.
HIV/AIDS
Organizations
- CAAN (Canadian Aboriginal AIDS Network)CAAN is committed to addressing the issues of HIV within an Indigenous context. CAAN provides a national forum for First Nations, Métis and Inuit Peoples to wholistically address HIV/AIDS, HCV, STBBI, TB, mental health, aging and related co-morbidities.
Books
Collective care: Indigenous motherhood, family, and HIV/AIDS by Call Number: SCH D68 C65 2021ISBN: 9781487587642Publication Date: 2021Collective Care provides an ethnographic representation of urban Indigenous life and caregiving practices in the face of Saskatchewan's HIV epidemic. Based on a five-year study conducted in partnership with AIDS Saskatoon, the book focuses on the contrast between Indigenous values of collective kin care and non-Indigenous models of intensive maternal care.- Residential schools, prisons, and HIV/AIDS among aboriginal people in Canada: exploring the connections byCall Number: ERB B37 R47 2009Publication Date: 2009
- My people's blood : indigenous sexual health recovery byCall Number: SCH A94 M9 2014Publication Date: 2014Colonization has impacted the gender roles and sexuality of Indigenous peoples. Through unhealed molestation and abuse First Nations communities are seeing the impact of HIV/AIDS. A series of three plays were developed with a group of First Nation youth and Elders to address the impacts of the virus that causes AIDS in an Indigenous community. My People's Blood: Indigenous Sexual Health Recovery is about giving voice to those stories that hurt, blame, and shame.
Articles
- Experiences of the HIV Cascade of Care Among Indigenous Peoples: A Systematic ReviewIndigenous leaders remain concerned that systemic oppression and culturally unsafe care impede Indigenous peoples living with HIV from accessing health services that make up the HIV cascade of care. We conducted a systematic review to assess the evidence related to experiences of the HIV care cascade among Indigenous peoples in Australia, Canada, New Zealand, and United States.
- Research Done in "A Good Way": The Importance of Indigenous Elder Involvement in HIV Community-Based ResearchCulturally appropriate Elder engagement in HIV CBR with Indigenous communities is vital for promoting positive relationships and culturally safe research that respects ceremony and Indigenous ways of knowing.
- “Stay Strong, Stay Sexy, Stay Native”: Storying Indigenous youth HIV prevention activismEighteen diverse Indigenous youth leaders produced digital stories about Indigenizing HIV prevention during the summer of 2012 at a week-long retreat. In contrast to conventional public health messaging, youth produced stories rarely focused on individual harm reduction strategies. Instead, ideas of Indigeneity and decolonization were foregrounded as key strategies for health promotion work.