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
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
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.
“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
“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
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
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
Strategies and tools on using, collecting, and evaluating data through an indigenous lens.
ACEs, Historical Trauma and Emotional Wellness information and strategies.
Maternal health information on perinatal and postpartum care.
Holistic and indigenized approaches to birthwork.
Resources meant for all birthing people and community members with accompanying toolkits/workbooks.
Understand how epigenetics affects indigenous communities and maternal health outcomes.
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
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
Governmental and large-scale health and policy organizations addressing maternal and child health (MHI) broadly.
• Arizona Department of Health Services (ADHS)
• Arizona Center for Rural Health
• 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
• From Barriers to Bridges: Implementing Access Solutions to Improve American Indian, Alaska Native and Native Hawaiian Maternal Health
• Strengthening Maternal Health Data to Improve Health and Wellbeing in American Indian and Alaska Native Communities
• Preventing Maternal Mortality and Morbidity among American Indian, Alaska Native and Native Hawaiian People
• Building Systems of Care: Investment in Native Maternal Health Infrastructure
• Workforce Equity in Maternal Health: Tribal and Native Community-Led Solutions
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)
• Reclaiming Native Truth
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
• Nutrition Guide for Postpartum and Breastfeeding Mothers
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
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
Interviews, shorts, and videos on maternal health.
• Know When to Seek Help for Depression After Giving Birth
• Know the Warning Signs: Being Informed Saves Lives
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.
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:
At the end of this Introduction to Cultural Safety course, learners will be able to:
https://ceu.catalog.instructure.com/courses/introduction2cultural-safety
March 29, 2023
Topic: Standardized Prenatal & Postpartum Care at Whiteriver Indian Hospital Birthing Center
Presenter: Laura Close, DNP, FNP-BC
Link to Resource:
Presentation Slides
March 22, 2023
Topic: Navigating Maternal Health Care
Presenter: Nicolle L. Gonzales, BSN, RN, MSN, CNM
Links to Resources:
Presentation Slides
Road Map through Pregnancy Care
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
Pediatric Primary Care Toolkit
Implementing a Tribal Maternal Health Task Force Toolkit
Two-Spirit People: Sex, Gender & Sexuality in Historic and Contemporary Native America
Tribal Equity Toolkit 3.0: Tribal Resolutions and Codes to Support Two Spirit & LGTBQ Justice in Indian Country
Indigenizing Love: A Toolkit for Native Youth to Build Inclusion
Youth Support: Connecting Native youth with valuable resources to support them in all walks of life.
Elements of a Healthy Tribal Community
Tribal toolkit for Navigating Federal Grant Terminations
Maternal Mortality and Trauma-Informed Care
Understanding Maternal Mortality
Why is Postpartum Care Important?
February 27, 2023
Topic: The Power of Prenatal Care during Pregnancy
Presenter: Jacqueline Badine, RDN
Links to Resources:
Presentation Slide
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
January 10, 2023
Topic: Adverse Childhood Experiences (ACEs) and Trauma Informed Perinatal Care
Presenter: Valerie M. Kading, DNP, MBA, MSN, PMHNP-BC
Link to Recording
Links to Resources:
ACE Questionnaire
Preventing ACEs
ACEs in AI/AN Population Article
ACEs Aware
ACEs Resource Basket
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