Gaining Insight: A Community-Based Approach to Understanding Physical Activity and Weight Gain in Pregnancy with First Nations and Métis Women

Abstract

Weight-gain and physical inactivity in pregnancy have important implications for First Nations and Métis women, populations that experience a disproportionate burden of poor health outcomes in pregnancy. Utilizing a postcolonial feminist theoretical lens in conjunction with a social determinants of health framework and tenets of cultural safety, the purpose of my doctoral research, which was written in the publishable paper format, was to address four questions: a) Are First Nations women marginalized through current physical activity pregnancy guidelines?; b) How do pregnant First Nations and Métis women understand weight-gain and physical activity during pregnancy?; c) What are the factors that influence excessive weight-gain during pregnancy in urban First Nations and Métis women?; and d) How can obesity prevention programs with pregnant First Nations and Métis women who live in urban centres be reflective of and sensitive to their cultural practices? To answer these questions, I conducted community-based qualitative research, which included 15 semi-structured interviews with key informants who are health/service providers for Aboriginal women in Ottawa and focus groups and semi-structured interviews with 25 pregnant/postpartum First Nations and Métis women. I also conducted two focus groups with both health/service providers and pregnant/postpartum women to determine what type of resource would benefit pregnant, urban First Nations and Métis women. Ultimately, I used this information to develop this resource. My research results revealed a complex interaction between the social determinants of health underlined by current manifestations of colonialism, which impact urban First Nations and Métis women’s physical activity and weight-gain during pregnancy. These findings emphasize the need for culturally safe physical activity and weight-gain resources for First Nations and Métis women during pregnancy. Ultimately, this study identified the importance of community consultation to develop culturally safe, community-driven, and useful health interventions for urban, pregnant First Nations and Métis women.