The Fireweed Project: Recommendations for Improving Abortion Access and Experiences by and for Indigenous Peoples in Canada

Background Indigenous Peoples in Canada face significant barriers to accessing abortion services, attributed to colonial policies, systemic racism, and geographic isolation. Despite the presence of intergenerational reproductive knowledge, barriers persist. The Fireweed Project seeks to address barriers by gathering recommendations from Indigenous abortion seekers to improve access and experiences. Methods Forty-one-on-one conversations were conducted with Indigenous abortion seekers across Canada. Data was analyzed using the DEPICT participatory qualitative analysis model, ensuring that the voices of Indigenous communities were central to the process. The Indigenous Gender-Based Analysis Plus (IGBA+) framework further informed analysis, considering intersections of race, gender, and socio-economic status. Results Six key themes emerged from the data, including the need for Indigenous-led reproductive health services, ongoing cultural safety training for healthcare providers, enhanced follow-up and support services, and dismantling abortion stigma within Indigenous communities. Participants also recommended expanding abortion education in schools and improving maternal-child health supports through policy change. Conclusion This study highlights the importance of centering Indigenous voices in the improvement of abortion services. Implementing the recommendations from Indigenous abortion seekers can help dismantle systemic barriers and improve cultural safety and accessibility of care. These findings contribute to ongoing efforts to ensure equitable reproductive health services for Indigenous communities in Canada.