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Addressing Maternal Health Disparities in American Indian and Alaska Native Communities

American Indian and Alaska Native women face maternal mortality rates two to three times higher than white women, driven by systemic inequities and under-resourced care. Over 90% of these deaths—often linked to mental health and hemorrhage—were preventable, underscoring the urgent need for culturally competent, data-informed solutions.

Addressing Maternal Health Disparities in American Indian and Alaska Native Communities

The Need to Do More Than Screen

A Mother’s Story: Beyond the Checklist
Emily Johnson’s story sheds light on Postpartum Anxiety and suicidal thoughts and how screening alone isn’t alone isn’t enough. Her experience highlights the urgent need for invlusive, culturally responsive mental health care that truly supports all birthing people. Read her story.

A Mother’s Story: Postpartum Anxiety and Suicidal Thoughts and the Need to Do More Than Screen

Indian Health Service access and health insurance coverage associated with higher quality perinatal care among American Indian and Alaska Native people

A new School of Public Health study finds that perinatal care among AI/AN people is insufficient for many, but access to Indian Health Service care and health insurance coverage may help.

click here to learn more

Dismantling Disparities: Rejecting DEI Comes at a Cost We Cannot Afford

Prioritizing DEI in maternal healthcare helps create a fairer system where all women receive quality care, leading to better health outcomes and a stronger, more equitable society.

click here to learn more

12th Annual Tribal Summit 2025

PSI

Walking In Sacred Harmony

PSI

2026 Midwifery Summit Save the Date

PSI

Food Insecurity in Pregnancy, Receipt of Food Assistance, and Perinatal Complications

“In this cohort study, food insecurity in pregnancy was associated with a higher risk of perinatal complications, and these associations were overall attenuated to the null among individuals who received food assistance in pregnancy. These findings support clinical guidelines of screening for food insecurity in pregnancy and provide evidence to expand food assistance programs that may help improve maternal and neonatal outcomes.” See link for more information.

Food Insecurity in Pregnancy, Receipt of Food Assistance, and Perinatal Complications

Find Birthing Resources

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      Indigenous doulas helping Native moms take back their health after centuries of discrimination

      “Now, organizations across North America are resuscitating the practice of Indigenous doulas. They’re training them to offer culturally safe, emotional and physical care, relying on traditional knowledge and reestablishing their place in the health care system: by the sides of Indigenous birthing women, where today’s doulas say they were always meant to be.” Read more below!
      Indigenous doulas are helping Native moms take back their health after centuries of discrimination

      National Indian Health Board Tribal Prenatal-to-Three Policy Agenda

      The National Indian Health Board developed the Tribal Prenatal-to-Three Policy Agenda to raise
      awareness regarding the most impactful and culturally appropriate policy levers and strategies
      to support American Indian and Alaska Native (AI/AN) health and wellbeing in the earliest years
      of life, from the prenatal period through age 3. These recommendations chart a path forward to
      health equity and improved outcomes for AI/AN families, infants, and toddlers.
      2024 Tribal Prenatal-To-Three Policy Agenda

      Online Session Tools

      RoadMap EmpoweredBodies BestPractices ICARE PatientInfo PatientInfo PatientInfo

      MHI Tribal Maternal Health Strategic Plan

      ITCA_MaternalHealth_Secondary Logo_Black

      In 2020, the Inter Tribal Council of Arizona, Inc. (ITCA), was contracted by the Arizona Department of Health Services (ADHS) to develop a strategic plan in collaboration with tribal maternal health professionals. The Maternal Health Innovation program is funded nationally by HRSA and is designed to assist states in collaborating with maternal health experts and optimizing resources to implement state-specific actions that address disparities in maternal health and improve maternal health outcomes.

      Program Purpose:

      The purpose of the Maternal Health Innovation Program is to reduce maternal mortality and morbidity in American Indian communities in Arizona.

      MHI Program Goals

      1. Improve maternal mortality and morbidity in Tribal communities
      2. Improve access to maternal health data surveillance
      3. Improve maternal health partnerships between tribal communities and the state

      Strategic Plan Image

      Recorded Webinars

      Missed a webinar? Check them out below.

      Lactation Part 1: Social & Emotional Wellness for the workplace Part 2: Social & Emotional Wellness for the workplace Perinatal Harm Reduction Training Advancing Health Equity Advancing Health Equity Advancing Health Equity Advancing Health Equity CongenitalSyphilis Syphilis101 EmpoweredBodies EmpoweredBodies NurturingConnections NurturingConnections IndigenousPeople&Epigenetics Epigenetics DataSovereignty Severe Maternal Morbidity
      HistoricalTraumaProviders HistoricalTraumaProviders PostpartumCare ACES

      Syphilis 101: Understanding an Emerging Infection in AI/AN Communities

      July 23, 2024 

      12:00-1:30pm MST/PHX

      Topic: Syphilis 101: Understanding an Emerging Infection in AI/AN Communities

      Presenter: Mayra Mollo, ADHS, STI/HIV DIS Coordinator

      Nurturing Connections

      Nurturing Connections: The Social-Ecological Model, ACES and Maternal Health

      July 17, 2024 and July 31, 2024 

      12:00-1:30pm

      Topic: Nurturing Connections: The Social-Ecological Model, ACES and Maternal Health

      Presenters:
      Stephanie Noriega, University of Arizona
      Lakisa Muhammad, AZ Birthworkers of Color

      Nurturing Connections

      Maternal Health Resources

      ITCA_MaternalHealth_Secondary Logo_BlackPublic Health and Policy Resources
      Governmental and large-scale health and policy organizations addressing maternal and child health (MHI) broadly.

      • Arizona Department of Health Services (ADHS)
      • ADHS Women’s and Children’s Health
      • CDC: Maternal Mortality
      • CDC: Hear Her Campaign
      • Health Resources and Services Administration (HRSA)
      • HRSA Tribal Affairs
      • Indian Health Service (IHS)
      • Medicaid Innovation Collaborative
      • Arizona Health Care Cost Containment System (AHCCCS)
      • National Indian Health Board (NIHB)
      • Public Health Shift (Maricopa)
      • American Public Health Association (APHA)
      • Doula Medicaid Project
      • Doula Medicaid Resource Library
      • Best Practices for Medicaid Coverage for Doula Care
      • Pregnancy Related Deaths: Data from Maternal Mortality Review Committees
      • American Indian/Alaska Native Pregnancy Related Deaths: Data from Maternal Mortality Review Committees
      ________________________________________
      Indigenous and Tribal Maternal Health Resources
      Organizations and initiatives supporting Indigenous and tribal maternal health needs.

      • Native Health
      • Native Birthworkers
      • Cihuapactli Collective
      • Seattle Urban Natives
      • Native American Women’s Dialogue on Infant Mortality (NAWDIM)
      • Family Spirit Program
      • Indigenous Midwifery
      • Paths Remembered
      • Arizona Birthworkers of Color
      • Indigenous Birth
      • Navajo Nation Institute (NNI)
      • Labriola National American Indian Data Center
      • Indian Country ECHO
      • Native Reach
      • Albuquerque Area Southwest Tribal Epidemiology Center (AASTEC)
      • National Council of Urban Indian Health (NCUIH)
      • Arizona Advisory Council on Indian Health Care (AACIHC)
      ________________________________________
      Maternal Support, Education, and Community Initiatives
      Community-focused organizations, advocacy groups, and educational resources for maternal health.

      • Spinning Babies
      • Evidence-Based Birth
      • Doula Match
      • Candelen.org
      • Healthy Families Arizona
      • March of Dimes
      • Maternal Health Learning and Innovation Center
      • Support Birth
      • PSI Arizona
      • Spiritual Garden Healing
      • CityMatCH
      • Brazelton Touchpoints: Indigenous Early Learning
      • CARE Principles for Indigenous Data Governance – NNI Database
      ________________________________________
      Research, Data, and Specialized Maternal Programs
      Research organizations and specialized initiatives for advancing maternal health and well-being.

      • Seven Directions Indigenous Public Health Institute
      • Johns Hopkins Center for Indigenous Health (CIH)
      • Maternal and Child Health Bureau
      • Reproductive Grief Care
      • Brazelton Touchpoints Center
      • Safe to Sleep Campaign (NICHD)
      • First Things First
      • Arizona Perinatal Trust
      • Rural Development (USDA)
      • Fatherhood Initiative
      ________________________________________
      Substance Use Resources
      Research and resources to support recovery and well-being.

      • Opioid Service Locator
      • Arizona Pregnant and Parenting Women Resource Guide
      • Supporting Recovery with Pregnant, Birthing and Parenting People Living with Substance Use Disorder
      • AZ Mental Health Map

      Breastfeeding Training for Healthcare Providers- Together for the Duration

      The Together for the Duration is a program developed by the Arizona Department of Health Services, AZ Health Zone, and the Arizona WIC Program to support health care professionals in their lactation education and build stronger community partnerships while working with maternal and infant populations. The Together for the Duration series contains 15 online learning courses. Each course is 60 minutes long, including the review of external resources and completion of all items within the course.

      More information is available here.

      Introduction to Cultural Safety

      This course is available free on line through Frontier Nursing University.

      The purpose of this course is to:

      Introduce the concept of cultural safety and to explore the three main aspects of it, which include:

      • Learning about the history and impacts of colonization on Indigenous people in the U.S.
      • Being self-reflective on our identities as health providers who may care for Indigenous people
      • Centering the Indigenous patient experience and listening as the patient defines what safe care is

      At the end of this Introduction to Cultural Safety course, learners will be able to:

      1. Define cultural safety
      2. Identify the three key tenets of cultural safety
      3. Explain the impacts of colonization on Indigenous people in the U.S.
      4. Describe what culturally safe vs. culturally unsafe care may look like (give examples)
      5. Discuss personal and systems change strategies for improving the cultural safety of care

      https://ceu.catalog.instructure.com/courses/introduction2cultural-safety

       

      Standardized Prenatal & Postpartum Care at Whiteriver Indian Hospital Birthing Center

      March 29, 2023

      Topic: Standardized Prenatal & Postpartum Care at Whiteriver Indian Hospital Birthing Center
      Presenter: Laura Close, DNP, FNP-BC

      Link to Recording

      Link to Resource:
      Presentation Slides

      Navigating Maternal Health Care

       March 22, 2023

      Topic: Navigating Maternal Health Care
      Presenter: Nicolle L. Gonzales, BSN, RN, MSN, CNM

      Link to Recording

      Links to Resources:
      Presentation Slides
      Road Map through Pregnancy Care

      Toolkits

      Social Media Toolkit
      ITCA is pleased to provide a social media toolkit for tribal health programs to promote perinatal health in their communities. This is a living document that will be updated periodically as we add new information so check back often! There are also links to presentations on how to share maternal health research findings using social media.

      Click here to access the social media toolkit

      Disseminating Maternal Health Research Findings on Social Media

      Practical Steps for Using Social Media to Improve Maternal Health Outcomes

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      Implementing a Tribal Maternal Health Task Force Toolkit

      PatientInfo

      The Power of Prenatal Care During Pregnancy

      February 27, 2023

      Topic: The Power of Prenatal Care during Pregnancy
      Presenter: Jacqueline Badine, RDN

      Link to Recording

      Links to Resources:
      Presentation Slide

      Reproductive Grief Care: Sensitivity to Pregnancy Loss

      February 24, 2023

      Topic: Reproductive Grief Care: Sensitivity to Pregnancy Loss
      Presenter: Sara West, MSHS-PH
      Link to Recording

      Links to Resources:
      Presentation Slides
      Best Practices
      Misconceptions about Miscarriages
      I Care- What to do if someone shares their story
      Patient Information Sheet- Grief and Loss after Miscarriage
      Patient Information Sheet- Grief and Loss after Abortion
      abortionchangesyou.com