Open Collections

Abstract

Iitsimákaatsita: Enhancing Relations between Indigenous Women and Registered Nurses was a four-phase, Indigenous-led mixed-methods study that investigated how nursing contributes to and/or mitigates perinatal health inequities experienced by Blackfoot women in southern Alberta. Grounded in Siksikaitsitapi (Blackfoot ways of knowing), Indigenous Research Methodologies (IRM), and guided by Critical Indigenous Feminism (CIF) and Red Intersectionality (RI), this dissertation centers Indigenous women’s voices, knowledge systems, and sovereignty to disrupt colonial framings of health and care. In Phase 1, a culturally specific survey tool was co-developed in partnership with a Blackfoot Advisory Circle to reflect community priorities, relational ethics, and Blackfoot understandings of health and wellbeing. The survey was used to capture Blackfoot women’s perinatal experiences and serve as a foundation for later phases. Phase 2 involved administering the survey with 107 Blackfoot women, whose responses revealed widespread experiences of racism, surveillance, and cultural exclusion in nursing care, alongside expressions of strength, resistance, and the women’s ongoing engagement with Blackfoot perinatal traditions. These findings challenge deficit-based narratives and offer a sovereignty-affirming framework for understanding Indigenous women’s health experiences. Phase 3 engaged 27 perinatal nurses across five focus groups to reflect on the survey findings and explore their roles in reinforcing or disrupting systemic harm. Nurses identified the limitations of cultural competency frameworks and described both institutional constraints and moments of relational care rooted in kinship (understood here not simply as familial ties, but as relational accountability and ethical responsibilities to others), advocacy, and anti-colonial intent. Across community and hospital settings, nurses enacted—and at times resisted—the systemic structures that shape care for Indigenous families. Phase 4 returned findings to Blackfoot communities through knowledge-sharing gatherings to support accountability, relational repair, and community-led action. Overall, the study offers an Indigenous-led, community-engaged model for health research and nursing practice. It demonstrates how equity-oriented, culturally grounded care must be rooted in Indigenous sovereignty and relational responsibility. This dissertation contributes to nursing scholarship and Indigenous Peoples’ health by illuminating pathways to transform perinatal care in ways that uphold the voices, values, and well-being of Indigenous women.