TPHW 2024: Protecting Native Mothers

American Indian/Alaska Native (AI/AN) women are pillars in Tribal communities as life givers, culture bearers, and caretakers of homelands. Holding the power to bring life into this world is a highly valued and sacred tradition in Indian Country that is surrounded by cultural importance, knowledge, and good medicine. As keepers of traditions and customs in many Tribes, mothers hold distinct roles of nourishing, teaching, and leading their families as matriarchs. Native women, across all Tribal nations, have the fundamental and equal right to have healthy birth experiences and the right to quality care before, during, and after pregnancy and childbirth. 

Losing a woman during or after their pregnancy is traumatizing for families and communities, and AI/AN populations face a disproportionate maternal morbidity and mortality burden. For every 100,000 live births to AI/AN women, there were 32 deaths related to pregnancy from 2017 to 2019. AI/AN women were nearly 2.3 times more likely to die from a pregnancy-related cause than non-Hispanic White women. Research has shown that approximately 60% of maternal deaths in the U.S. are preventable, and AI/AN maternal morbidity and mortality rates highlight the larger health risks that people of color and rural residents face compared to their non-Hispanic white and urban counterparts. 



Gathering accurate data also presents a substantial challenge: Racial misclassification and the relatively small sample size of AI/AN women has prevented the issue of maternal mortality in Indian Country from gaining national attention. Protecting AI/AN mothers, their families, and Tribal communities in ways that uphold Tribal values and practices is essential for preventing maternal mortality in Indian Country.  

Adverse maternal health outcomes like this are due, in part, to the ongoing trauma of inequitable access to healthcare including discrimination, racism, and OBGYN deserts, as well as the historical trauma of systemic racism, colonization, genocide, forced migration, reproductive coercion, and cultural erasure. Despite these challenges, Native women and communities continue to draw strength and resiliency from our cultures and traditions – we’ve seen incredible growth and development of birth workers, doulas, and traditional birth attendants, as well as in the realms of traditional birthing practices, and even the development of traditional birthing centers! 

Addressing maternal health disparities and inequities in Indian Country requires collective action and meaningful collaboration and consultation directly with Tribal communities to eliminate the systemic and structural barriers that hinder efforts to achieve maternal health and well-being now and for future generations. 

The high maternal mortality rates for AI/AN women reflect the U.S. policies on maternal and reproductive health. Failure to address the social determinants of health, combined with a lack of comprehensive healthcare access, prenatal and postpartum support, and cultural humility, has led to the adverse maternal health outcomes we see today. Failing to recognize and address the health inequities in our current healthcare system stops us from achieving equitable health for AI/AN women and children. 

Since 1972, the National Indian Health Board (NIHB) has not stopped working to address this health burden. Keep reading to learn more!

NIHB supports Tribally Led Maternal Mortality Review Committees 

NIHB is proud to partner with the Centers for Disease Control and Prevention (CDC) to assist Tribes and Tribal organizations in exploring the feasibility and building capacity to implement Tribal-led Maternal Mortality Review Committees (MMRCs) as a potential model for maternal mortality prevention. Currently, there are no tribally led MMRCs, and many states lack Tribal representation or have in their MMRCs. It is critical to establish a committee that deeply understands our people's cultural and historical context to develop equitable solutions for maternal health in Indian Country. 

Hear Her Campaign

Our Partnership with CDC also includes our work on the Hear Her Campaign to amplify the voices of AI/AN people and to raise awareness about urgent maternal warning signs during and after pregnancy that could indicate potentially serious complications. Families and communities deserve access to culturally appropriate care rooted in their traditional practices. Through this partnership, we have offered funding opportunities, supported by the U.S. Department of Health and Human Services, Office of Minority Health, and the Centers for Disease Control and Prevention, for Tribes and Tribal organizations to support and advance their efforts in maternal health promotion that meet the needs of their communities and speak to their perspectives of maternal mortality prevention capacity locally while utilizing the CDC Hear Her campaign materials. 

NIHB Hosts Community Events

2023 Convening on Tribal Maternal Mortality Review

From November 2-3, NIHB's Maternal Health Team, in collaboration with the CDC Maternal Mortality Prevention Team, hosted the "2023 Convening on Tribal Maternal Mortality Review" that was held on the sacred lands of the Santa Ana Pueblo at the Hyatt Regency Tamaya Resort. This gathering successfully brought together 60+ maternal health experts, Tribal partners, birth workers, and advocates from across the nation, including our partners from Area Health Boards and Tribal epidemiology centers, who are dedicated to improving the healthcare and well-being of Native communities. During this in-person convening, participants across Indian Country engaged in peer-to-peer learning to shape the future of this work. 

Maternal Health Webinars

The Maternal Health Tribal Learning Community Series is a virtual series dedicated to learning together about maternal health work in Indian Country, sharing knowledge to inform efforts going forward, and engaging with others in the field. Some of the topics covered included sovereignty from first breath, cultural competency and responsive healthcare practices, mental health and wellbeing, and advancing health equity. 

Annual Maternal Health Promotion Institute

Each year, in partnership with CDC, NIHB hosts a virtual Maternal Health Promotion Institute. The goal of these institutes are to share culturally centered practices, strength-based approaches, and equitable solutions that are making a positive impact on the health and well-being of Tribal communities. Some of the topics covered in previous institutes include home visiting and the Family Spirit Program, affirming LGBTQ2S+ clients in perinatal care, Tribally-led Maternal Mortality Review Committees, and midwifery work in Indian Country. Stay tuned for details on 2024's institute!

Maternal Health at National Tribal

Health Conference 2024

Join us in May as we passionately advocate for eliminating maternal health disparities and upholding the sacred role of AI/AN women in Tribal communities. We will host several Maternal health-focused sessions at the 2024 NTHC, including workshops highlighting doula program initiatives, decolonizing lactation education efforts, and reducing health inequities for birth givers. A plenary session will be held to discuss the future directions for maternal health and what efforts are needed to drive innovative policy and systemic solutions to improve maternal health and well-being now and for future generations.

 

Additionally, we are honored to be hosting a free Tribal Maternal Health Institute on Monday, May 20, to create a space for participants to engage in these critical conversations, including addressing maternity care gaps, reclaiming birthing practices, and improving access and support for our Native mothers, babies, and communities locally and nationally. 

NIHB will continue to advocate and emphasize the critical need for direct funding to Tribes and Tribal organizations to advance sustainable capacity to develop and lead solutions for positive maternal health outcomes. Our goal is to ensure that AI/ANs receive the health care and public health services necessary to achieve the best possible health outcomes.