Exploring Equitable Maternal-Newborn Care With Sub-Saharan Black African Migrant Women in Ontario, Canada

To explore the lived experiences of sub-Saharan Black African migrant women (SBAMW) in accessing and receiving equitable maternal-newborn health care in Ontario, Canada, and to examine how intersecting identities and structural determinants shape these experiences.

Interpretive descriptive qualitative design, guided by intersectionality and structural determinants of health frameworks.

Ontario, Canada, where persistent inequities in maternal-newborn care are reported for SBAMW, particularly related to temporary immigration status, navigation barriers, and experiences of discrimination and lack of culturally safe care.

Ten SBAMW residing in Ontario who had accessed maternal-newborn care within the past 5 years; most held temporary visas, including student and work permit holders.

Semistructured interviews were conducted with field notes and audio-recorded for transcription. Data were analyzed using an iterative, inductive thematic analysis approach to generate codes, categories, and themes.

Three major practice-oriented insights emerged: (a) This (Canadian health care system) is not a health-care-for-all system. Women described discrimination tied to temporary visa status, barriers in navigating the system, poorly coordinated referrals and follow-ups, and limited postpartum support. (b) We are relying on Google: lack of information and compassionate care. Participants frequently reported rushed appointments, inadequate communication, insufficient information, and feeling unheard. (c) Felt less of a person: racialization, stereotypes, and cultural unsafety. Participants noted experiences of stereotyping, dismissal of pain, covert racism, lack of culturally safe care, and distrust in provider relationships.

Findings highlight how intersecting identities (e.g., race, sex, and immigration status) produce overlapping disadvantages that exacerbate inequitable maternal-newborn care. Key strategies to mitigate these inequities include inclusive health insurance policies, enhanced provider communication, cultural safety training, and antiracism initiatives across health care organizations. Addressing these systemic barriers is critical to rebuilding trust, reducing disparities, and ensuring high-quality care.