Indigenous-led birth research project exposes colonial barriers inside academia

A five-year effort to put Indigenous communities in charge of research on pregnancy and childbirth has documented, in unusual detail, how university systems themselves can become the biggest obstacle to that goal. The Decolonizing Birth Research project, run from fall 2019 to spring 2022 with six Indigenous communities in British Columbia and Manitoba, was designed to identify community-defined indicators of respect, disrespect, racism and mistreatment during pregnancy and childbirth. But according to a new paper in Frontiers in Global Women’s Health, the most persistent barriers the team faced came not from communities but from the funding, ethics and administrative machinery of the academic institution that held the grant.

The project was co-led by two Indigenous researchers: Dr. Rachel Olson of Tr’ondëk Hwëch’in First Nation, president and director of the research consultancy Firelight, and Dr. Wanda Phillips-Beck of Hollow Water First Nation, Seven Generations Scholar at the First Nations Health and Social Secretariat of Manitoba. They were supported by Elder Roberta Price of the Snuneymuxw and Cowichan Nations and Dr. Saraswathi Vedam, principal of the Birth Place Lab at the University of British Columbia. Funding came through the Support for Patient Oriented Research Support Unit in British Columbia, and ethics approval was granted by the UBC Behavioural Ethics Board.

The team convened a multi-stakeholder Steering Council with ceremony and Elder leadership at the outset, and the co-leads met monthly over two years to oversee strategy, troubleshoot obstacles and allocate work between Firelight and the Birth Place Lab. In each participating community, a local person was designated Community Lead and directed the definition of research priorities, the choice of culturally appropriate data collection methods such as storytelling, body mapping, birth journals and talking circles, and community engagement. Ethical protocols were adapted in consultation with local Elders, Knowledge Keepers and community members, and each Nation signed a community agreement setting out the terms of participation.

The communities involved were Haida Gwaii, Seabird Island, Port Hardy, two Nations in the Vancouver urban and rural Okanagan regions, and Pimicikamak Cree Nation in Manitoba, where the team had established relationships. The work was repeatedly disrupted by the COVID-19 pandemic, devastating fires, and the discovery of unmarked graves of Indigenous children at a residential school site in the participating Okanagan community. One community experienced a serious COVID outbreak that pulled its Community Lead into clinical support services. The team followed the communities’ direction on when they had capacity to re-engage. Despite these disruptions, all six communities eventually selected data collection methods and five designed community engagement plans.

Four communities completed data collection. Haida Gwaii drew on thematic analysis of existing written birth journals. Seabird Island adapted person-centred measures from the national RESPCCT study for internal interviews with prompts from the Snuneymuxw and Cowichan Nations. The Vancouver community held a community meeting and worked with an Indigenous storyteller. Cross Lake, the site associated with Pimicikamak Cree Nation, held a gathering circle and focus groups and supported online completion of the RESPCCT survey. Two communities, Kamloops and Port Hardy, identified preferred methods, likely focus groups or body mapping, for future data collection. Under agreements aligned with OCAP principles of ownership, control, access and possession, each community retained authority over its data: some shared only high-level summaries with the DBR team, while two shared no data at all.

The paper’s central findings concern what happened when this community-anchored design collided with university structures. UBC released the project’s funding only after ethics approval, and the ethics process initially required signed research agreements from five communities before any money was confirmed. The team argued it was unreasonable to ask communities with deep and real mistrust of universities to undertake that work without compensation. After negotiation, the project was permitted to proceed with only two of the six communities having signed research agreements. The team describes one meeting in which the chair of the ethics board took time to explain ethical Indigenous research to an Indigenous co-principal investigator who holds a PhD and has twenty years of community-based research experience.

Money became a second arena of conflict. Once funding arrived, the Birth Place Lab had to manage it under university policies, including human resources rules. The team identified a highly qualified candidate with experience in Indigenous birth work as project coordinator, but because the candidate lacked a master’s degree, UBC policy prevented paying them appropriately, a rule the authors say excludes expertise gained through experiential community and cultural knowledge. Payment processes for community participants were slow, with one team member noting that honorariums could take three months to arrive. The team’s proposed solution was to route honoraria and payments through Firelight, which was not bound by institutional restrictions. UBC’s position was that the Birth Place Lab should hold the funds and subcontract to the two Indigenous principal investigators. The team held firm, and after extensive negotiation with UBC’s Office of Research Services and University Industry Liaison Office, an advance on roughly $90,000 was transferred to the Indigenous organization. Team members describe the transfer as both practically important, enabling reimbursement of community coordinators within about 24 hours of an invoice, and symbolically significant, as putting the majority of the funding in the hands of an Indigenous organization removed institutional barriers.

The authors frame these frictions as examples of epistemic violence, which they define as violence exercised in the production, circulation and recognition of knowledge, including denial of epistemic agency and unacknowledged exploitation of epistemic resources. They argue that rigid funding and ethics processes prioritize bureaucratic requirements and institutional control over the needs and priorities of Indigenous researchers and communities, replicate colonial dynamics by placing control in institutional hands, and position Indigenous peoples as subjects of research rather than agents of knowledge creation. They note that UBC’s own 2020 Indigenous Strategic Plan, including Action 13, calls for co-developing research protocols with community partners and honoring free, prior and informed consent and Indigenous data sovereignty, yet their experience was that implementation at the structural level lagged behind these commitments.

Not everything in the account is conflict. The team credits the Birth Place Lab’s willingness to challenge institutional barriers, made possible in part by Vedam’s established academic record, as pivotal in building trust with community collaborators. Community Leads, some of them midwives, birth workers or parents, were given flexibility in how they organized work, including sharing the lead role and funds in one community and reallocating budget lines in another. The project also produced practical outputs: research training materials, adaptable templates for ethics and project governance, and community-specific knowledge mobilization tools such as policy briefs, storytelling dramatizations and health professional training modules. The team co-developed what it calls a roadmap for Indigenous and other historically marginalized communities to lead or meaningfully participate in maternity care research.

The paper’s conclusion is direct: university systems remained embedded in colonial logics through restrictive ethics protocols, inflexible funding mechanisms and hierarchies of knowledge that devalued Indigenous expertise and governance, and these barriers were central, not peripheral, challenges. The authors argue that meaningful, ethical and methodologically rigorous research does not depend on academic affiliation, and that Indigenous communities and organizations are leading some of the most innovative and accountable research practices, often more effectively than institutions bound by colonial structures. They call on academic institutions to redistribute power and resources, remove structural barriers, recognize birth and bodily sovereignty, and support Indigenous leadership of health equity research without co-optation or control. The paper focuses on methodological and structural aspects of the process rather than primary research outcomes on respectful care, which the team reports separately. As one Indigenous co-principal investigator put it in the paper, the hope is that in seven generations birthing will have returned to communities, with control of childbirth practices, their own stories, and their traditions and ceremonies threaded through the generations.

Subject of Research: Indigenous-led community research on respectful maternity care and the institutional barriers it encountered within academic systems in Canada

Article Title: Start with the truth: lessons from the decolonizing birth research project

Article References: Olson, R., Phillips-Beck, W., Tomkins, E., Price, E. R., & Vedam, S. (2026). Start with the truth: lessons from the decolonizing birth research project. Frontiers in Global Women's Health, 7, 1780730. https://doi.org/10.3389/fgwh.2026.1780730

Image Credits: AI Generated

DOI: 10.3389/fgwh.2026.1780730

Keywords: Indigenous research, decolonizing research, maternity care, birth, UBC, ethics, funding barriers, data sovereignty, community-based research, Firelight, epistemic violence, health equity