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.
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.
“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
Public 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
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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)
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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
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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
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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
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
The steering committee is composed of health care, community health, traditional healers, and other maternal health professionals who work with pregnant women and those of childbearing age in tribal communities across Arizona. Meetings are designed to share data, best practices, and new ideas to support pregnant people and their families. The Steering Committee also informs ITCA’s work on implementation of the Tribal Maternal Health Strategic Plan.
If you would like to participate in steering committee meetings, contact Wendell Honanie, Jr. at wendell.honanie@itcaonline.com.
Funding for this was made possible (in part) by the Centers for Disease Control and Prevention. The views expressed in written materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services, nor does the mention of trade names, commercial practices, or organizations imply endorsement by the U.S. government.
The ITCA Health and Human Services (HHS) has developed and distributed the infographics below to support tribal communities in responding to GHWIC tobacco topics. Tribes are welcome to download, print, and distribute these materials. Please contact ITCA HHS staff if you have any questions about the materials, if you’d like to add your Tribe seal to the infographic, if you want to request development of a infographic related to the GHWIC Strategy Areas, or experience any difficulty in downloading the files.
Funding for this was made possible (in part) by the Centers for Disease Control and Prevention. The views expressed in written materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services, nor does the mention of trade names, commercial practices, or organizations imply endorsement by the U.S. government.
Note: All meeting times are listed in Mountain Standard Time (MST).
A Cultural Approach to Good Health and Wellness in Indian Country (GHWIC) Funding Opportunity
Resources:
Arizona Department of Health Services
https://www.azdhs.gov
Association of American Indian Physicians
https://www.aaip.org
Indian Health Service
https://www.ihs.gov
National Indian Health Board
https://www.nihb.org
Northwest Portland Area Indian Health Board
http://www.npaihb.org
Centers for Disease Control and Prevention
https://www.cdc.gov
National Library of Medicine on American Indian Health
https://americanindianhealth.nlm.nih.gov
It’s Your (Sex) Life
http://www.itsyoursexlife.com
HIV.gov
https://www.hiv.gov
We R NATIVE
https://www.wernative.org
