BACKGROUND:
Currently, pregnant First Nations peoples living in remote, northern reserve communities in Ontario are subjected to evacuation for birth by the First Nations and Inuit Health Branch (FNIHB). People are evacuated out of their communities by plane to give birth at healthcare centres in urban cities.

OBJECTIVES:
Describe the referral patterns for First Nations peoples evacuated in Ontario to give birth and to name the specific organizations where births are taking place.

METHODS:
I collected documentary data from FNIHB, as well as survey and interview data from 15 perinatal care providers working within the province of Ontario and provide care to evacuees for birth.

RESULTS:
Referral patterns from reserve communities to healthcare centres were determined at an institutional level. When possible, care providers tried to transfer people to the healthcare centres of their choice. First Nations peoples were referred automatically to an OBGYN. People who chose to birth with a midwife needed to arrange and pay for their transportation and accommodation, as midwives were not part of institutional referral patterns. Birth is not the only time during pregnancy that First Nation peoples were transported out of the community to access healthcare. Pregnant people also needed to leave their community if they wanted abortions, ultrasounds, or required other specialized testing, meaning that many people forgo care.

CONCLUSIONS:
First Nations peoples evacuated for birth lack choice over where and who they birth with, because of a lack of perinatal care options within and close to their communities.

KEY MESSAGE:
To bring birth closer to home, midwives, specifically Indigenous midwives need to be included in FNIHB’s referral pathways for First Nations peoples. Globally, midwifery must be an accessible care option within health systems. Poster session 4 (Group B)