A Canadian policy requires the routine evacuation of pregnant First Nations women who live on-reserve in rural and remote regions to larger centres to gain access to perinatal services. Despite this access, First Nations women's health remains poor and the First Nations infant mortality rate remains high. In this paper, we employ First Nations feminist theory to understand why the evacuation policy does not result in good health, especially for First Nations women. Four themes emerge: decolonization, self-determination, land, and community. Based on these results, we argue that First Nations’ concepts of health are largely incongruent with the Euro-Canadian bio-medical model, a model that is foundational to the evacuation policy. Until health policies incorporate and are congruent with First Nations’ epistemologies and related health practices, their health will continue to suffer. Policy recommendations are offered to promote First Nations health in a way that is consistent with First Nations’ epistemologies.