Culturally safe care & the Ontario midwifery model: exploring the challenges of serving uninsured immigrant clients

Immigrant women’s healthcare has been one of the major areas of research in the literature on settlement in Ontario, but little research exists on the relationship between immigrant women and their healthcare providers, and even less that is from the perspective of the healthcare provider. This study used semi-structured interviews with 10 midwives who serve uninsured immigrant clientele in order to understand how they navigate challenges to provide culturally safe care. Discourse analysis revealed that participants discussed barriers that were both logistical and conceptual in nature when providing care to uninsured immigrant clients. Midwives indicated that logistical barriers and fear of providing insufficient culturally safe care were factors that made practices more reluctant to take on uninsured immigrant clients. Their discussion of culturally safe care was informed by the Ontario midwifery model, but their strategies for delivering culturally safe care often involved a renegotiation of this model.