Indigenous Maternal Health: Understanding the Crisis

The Numbers Tell a Scary Story:

According to a 2021 study, Indigenous women are almost 5 times more likely to die from pregnancy than white women.

Think about that. If you're Native American and pregnant, you're 5 times more likely to die.

These rates are very similar to what we see in the Black maternal mortality crisis. But the oppression that these populations face was created differently and works differently. For Native American Heritage Month, we're talking about what birthing people in Indigenous communities are dealing with.

The Root of the Problem: Genocide and Poverty

Native women experience many different forms of oppression at the same time. This is the result of active genocide being committed against Native people.

Let's be clear about what genocide means: It's the intentional destruction of a group of people. And it's still happening.

This genocide has left Indigenous communities with extreme levels of poverty. And poverty has a terrible impact on health during pregnancy.

How Poverty Hurts Pregnant People:

When you're living in poverty during pregnancy, you're more likely to have:

• Gestational diabetes (high blood sugar during pregnancy)

• High blood pressure

• Premature birth (baby born too early)

• Low birth weight babies

• Complications that can kill you or your baby

There's also a lack of healthcare access, no insurance to cover care, and no way to manage these health problems even when you know you have them.

On top of all that, Indigenous people face a disgusting amount of racism from healthcare providers. Doctors and nurses might not take their pain seriously, ignore their symptoms, give them lower quality care, or treat them with disrespect.

Violence and Addiction: The Impact of Trauma

More than 4 in 5 Native women experience violence in their lifetime. Domestic violence during pregnancy increases the risk of death. Indigenous women already have the highest maternal mortality rates—add domestic violence on top of that, and the danger multiplies.

Addiction rates are also particularly high in Indigenous communities. This isn't because Native people are "more prone" to addiction. It's because poverty and trauma drive people to cope however they can, and there's limited access to mental health care or addiction treatment.

When pregnant people struggle with addiction, they face criminalization instead of treatment, lose access to prenatal care out of fear, and are more likely to have their babies taken away. All of this makes pregnancy more dangerous.

Maternal Health Deserts: No Care Where You Need It

A "maternal health desert" means there are no hospitals, clinics, or birth centers nearby. Many Indigenous communities live in these deserts.

What This Means:

• You might drive 2-3 hours just to see a doctor

• You might not be able to afford gas to get to appointments

• If something goes wrong, you're hours away from help

• If you go into labor, you might not make it to a hospital in time

Many Indigenous women have to leave their communities weeks before their due date to be close to a hospital. This means being away from family support, spending money on housing, being alone during pregnancy, and missing cultural practices around birth.

Attacks on Healthcare Are Making Things Worse

Across the U.S., attacks on healthcare are getting worse:

Attacks on Abortion Clinics:When you shut down abortion clinics, you're not just taking away abortion access. You're also closing clinics that provide prenatal care, birth control, miscarriage treatment, and cancer screenings.

Attacks on Healthcare Workers:Healthcare providers face death threats, legal threats, and harassment. When providers are scared or leave, entire communities lose access to care.

Indigenous communities already have the least access to healthcare. When clinics close or providers leave, the closest care gets even farther away, maternal health deserts get bigger, and more people die.

How Culture Can Heal: Access to Traditional Practices

Here's something important that often gets left out of these conversations: culture saves lives.

When Indigenous people have access to their cultural institutions and traditional practices, it can lessen the impact of all this structural oppression.

What This Looks Like:

Traditional Birth Practices:

• Midwives who understand Indigenous birthing traditions

• Birth in community with cultural ceremonies

• Traditional medicines and healing practices

• Elders present to guide and support

Cultural Connection:

• Strong ties to community reduce isolation

• Cultural identity provides resilience against racism

• Traditional knowledge offers alternatives to Western medicine

• Language and ceremony create healing spaces

Why Culture Matters for Maternal Health:

Research shows that when Indigenous people have access to cultural practices and institutions:

• Stress levels go down

• Mental health improves

• Substance use decreases

• Community support increases

• People feel more empowered to advocate for themselves

The Problem:Colonization and genocide haven't just destroyed land and killed people. They've also:

• Disrupted traditional birth practices

• Separated people from elders who hold knowledge

• Made cultural practices illegal (and in some cases, still do)

• Forced Indigenous people into Western healthcare systems that don't respect their traditions

What Needs to Change:

Supporting Indigenous maternal health means:

• Funding Indigenous-led birth centers

• Training and supporting Indigenous midwives and doulas

• Respecting traditional healing practices

• Creating space for cultural ceremonies during pregnancy and birth

• Letting Indigenous communities lead their own healthcare solutions

Culture isn't just nice to have. It's a form of resistance. It's a way to heal. It's a lifeline.

The Bottom Line:

Indigenous maternal mortality isn't just about individual health problems. It's about:

• Ongoing genocide

• Poverty created by that genocide

• Racism in healthcare

• Domestic violence and addiction driven by trauma

• Living in healthcare deserts

• Attacks on healthcare access

• Disconnection from cultural practices that could help

If we want to reduce Indigenous maternal mortality, we need to address ALL of these issues. And we need to support Indigenous communities in reclaiming their cultural practices and leading their own solutions.

Native women deserve better. They deserve access to quality healthcare. They deserve to be treated with respect. They deserve their cultural practices to be honored. They deserve to survive pregnancy and childbirth.

This is what reproductive justice looks like: addressing the systems that are killing people while supporting the cultural practices that heal.