PT  - JOURNAL ARTICLE
AU  - Rice, Kathleen
AU  - Shenker, Hannah
AU  - Jimenez, Vania
TI  - What Does Culturally Competent and Safe Perinatal Care Look Like? Lessons from an Ethnographic Study at the Maison Bleue
AID  - 10.1370/afm.22.s1.6227
DP  - 2024 Nov 20
TA  - The Annals of Family Medicine
PG  - 6227
VI  - 22
IP  - Supplement 1
4099  - http://www.annfammed.org/content/22/Supplement_1/6227.short
4100  - http://www.annfammed.org/content/22/Supplement_1/6227.full
SO  - Ann Fam Med2024 Nov 20; 22
AB  - Context: The Maison Bleue is an organization in Montreal whose mission is to reduce social inequalities by helping a vulnerable pregnant woman, and by fostering optimal development of their children. They use prevention-based approach termed “social perinatal care.” Data shows that their approach is effective in achieving key benchmarks (e.g., better birth outcomes; cost effectiveness). However, the content of the work that primary healthcare providers do at the Maison Bleue remains poorly understood, limiting capacity to transpose and/or scale up the model.Objective: To explore how primary care providers at the Maison Bleue understand and implement culturally safe and competent care, and to identify challenges to providing such care.Study Design and Analysis: Ethnographic methodology, using interviews and ethnographic observations; thematic analysis component.Setting or Dataset: 18 in-depth interviews with healthcare providers (physicians, nurses, social workers, child psychologists, midwives; translators, administrators); 40 hours of observations of team meetings.Population Studied: Primary care providers.Intervention/Instrument: N/AOutcome Measures: N/AResults: Care providers identified the Maison Bleue’s interdisciplinary model, shared values among providers, and efforts to foster two-way exchange with clients as being integral to providing culturally competent and safe care. Tensions were apparent between a notion of “culture” as an asset to be mobilized (e.g., connecting isolated women from similar backgrounds), and as a threat to clients’ wellbeing. Topic areas that were challenging for providers to navigate included corporal punishment of children, infant feeding practices, contraception, domestic violence, and patriarchal gender norms in families.Conclusions: Interdisciplinary, non-hierarchical care may be crucial for providing holistic care to vulnerable perinatal care patients. Efforts to teach and provide culturally competent and safe care should have a clear idea of what is meant by culture. Care providers need support in navigating cross-cultural differences in parenting practices, and cross-cultural gender norms.