Melissa Harris-Perry: New CDC data show that maternal mortality for Black women and Latinas increased sharply during the first year of the pandemic. These data reported nothing about pregnancy-related deaths for native and indigenous women despite previous studies indicating that these communities labor with substantially higher rates of maternal mortality. It's part of a troubling standard practice of many quantitative researchers but this week, Prof. Monica Macklemore told us there is a better way.

Prof. Monica Macklemore: Native indigenous people are traditionally and historically excluded because of what I think is a poor scientific excuse that their numbers are too small to be reported. Especially being a laboratory scientist and knowing that we could account for small numbers. When we have genome projects, we will have an n of one, a sample size of one person, but we'll look at 1,000 genes, and we figured out statistical methods to be able to account for that. I don't understand why we keep arguing that the numbers of native indigenous individuals, especially pregnant people, are too small for us to do any kind of analytics in terms of understanding just the basic counts.

Melissa Harris-Perry: For more on this, I'm joined now by Abigail Echo-Hawk, who's Executive Vice President at the Seattle Indian Health Board, and Director of the Urban Indian Health Institute, also an enrolled citizen of the Pawnee Nation of Oklahoma. Thanks so much for being here, Abigail.

Abigail Echo-Hawk: Thanks for having me.

Melissa Harris-Perry: Also with us is Caroline Davis, a research associate working with tribal nations and tribal organizations and a member of Navajo Nation. Great to have you here, Caroline.

Caroline Davis: Thank you. I'm happy to be here.

Melissa Harris-Perry: Caroline, I want to start with you. We were a little stunned when we saw just the erasure in the CDC data that we've been mining and trying to think through but why are indigenous women so frequently left out of data on maternal mortality.

Caroline Davis: There's definitely a lot of factors that contribute to that. The beginning of the pandemic compounded on top of those things. It's this basic, how we continue to be invisible as indigenous people and the absence of us in data, accurate media images, and historical and contemporary awareness. This is perpetuated by federal and state agencies because of what was shared just a little earlier that there's the excuse that our population is too small. There are other issues on top of that, including issues with at the point of data collection.

There are many cases where indigenous women are seeking care. They purposely don't report that they're Native American because they know the history of the systems that they're in. That it's likely that they're going to receive a better standard of care if they're not identifying as being Native American.

Melissa Harris-Perry: I want to pause right there and have you walk through that just a little bit more, Caroline so that for our listeners, who may not have that same awareness, who may not know that history. Walk me through that history just a bit, especially related to pregnancy care.

Caroline Davis: There is a lot of knowledge that has been lost because of this western approach that we take to medicine. A lot of those things are either in direct conflict or just not complimentary at all to what our traditional practices have a lot of tribal nations. For instance, the midwifery model. That probably more aligns with how tribal nations traditionally would deliver prenatal care to women when they were pregnant. This is something that even is newer in accepting that midwifery model.

I think it was a lot in maybe the '60s and '70s, where that was shifting away from that being a legitimate means of receiving prenatal care because it was so different from the western model. I think that's still true today because there's this idea that pregnancy and giving birth is a medical condition. The values of indigenous people, they don't look at it like it's a sickness. It's not a medical condition.

Melissa Harris-Perry: Abigail, help us to understand some of the direct harms that result from this kind of data erasure, this quantitative erasure of indigenous birthing people.

Abigail Echo-Hawk: We continue to see a lack of data on American Indians and Alaska Natives. Not just for birthing people but generally, in the way that data is collected around health outcomes, health disparities, and health resiliencies. As a direct result of that, we find that our treaty and trust responsibilities. The responsibility that the federal government has, for the payment of the taking away of our land is treaties that were signed, is very often determined by the number of tribal members.

When we don't have this data, that means that very often we're trying to prove to the federal government that we have people who are being affected by health disparities like maternal death, infant death. When we're not being recorded in that data, that means the resources, the policies, the intervention, the prevention efforts, are not being directed in a correct way without this data. I call this data genocide. It is one of the ongoing ways in which we are erased within this American society and it has to change.

We know that we can change the way that data is collected at the point of care, all the way to the way that it's interpreted at places like the CDC. We need to ensure that lazy epidemiology isn't being done. There's small populations, data analyses, that can take small populations data like Dr. Macklemore said and do good analysis. My team and I do it every single day. Until we see systematic change, we are continuing to be eliminated in the data and it is directly harming our people every single day.

Melissa Harris-Perry: Caroline, you were talking a bit earlier about practices, for example, in maternal health practices that don't always show up in the ways that, for example, hospitalization, medicalization of pregnancy and childbirth practices do. Talk to me about the work that indigenous-led organizations are doing to strengthen maternal health and maternal health outcomes.

Caroline Davis: There has been quite an influx in the number of organizations that are focused on indigenous birth workers. Whether that's birth centers, organizations that are training doulas, breastfeeding support workers. The approach that they're taking to this is integrating a lot more of those cultural practices that have been, I don't want to say forgotten but haven't been used for many, many, many years because of this medicalization of pregnancy. Integrating a lot of those things with some of the birth centers in first nations in Canada.

They're starting to be developed here in the United States that they're looking at it as creating this space that includes cultural aspects, includes cultural practices, in prenatal care, and in the actual time of delivering babies. That they're being brought into this nurturing environment from the time that they're born versus in a hospital. I don't think we would really categorize hospitals as being a nurturing place. These birth centers are using a lot of these values and reclaiming this indigenous knowledge in caring for pregnant women and being able to provide that support once the babies are born.

There's this expectation that's the common as far as when we're talking about Western and how that's delivered. It's like you have your baby and you go home with the baby and that's it. You're on your own. In indigenous populations, there is definitely this more surrounding support that exists within families. That's something that has never gone away.

Melissa Harris-Perry: Abigail, as I'm listening to Caroline describe differing approaches or maybe not even different but actually centering approaches where indigenous health care providers are providing care for indigenous pregnant folk. We've talked about the direct harm that happens from an elimination and erasure around data. What are some of the direct benefits that occur when we do have the data, when we do understand trends, and when we center indigenous healthcare providers for indigenous pregnant people?

Abigail Echo-Hawk: Yes. We begin to see outcomes change at the Seattle Indian Health Board, where a majority of our physicians are indigenous and people of color who work directly with our traditional Indian medicine folks. Who also work with midwives, doulas, people who have been providing that traditional care services for indigenous peoples for thousands of years. What we find in an integrated system like that are people who birth feel supported. We began to see them breastfeeding and continuing to breastfeeding after birth, which American-Indians, Alaskan natives--

Traditionally in Western society have had low rates of breast breastfeeding. They feel supported. They have opportunities for them and for their children. What we know is that it is essential for people who birth, to be able to make the choice about the kind of births they would like to have. They should have access to their traditional healers, to their midwives, to their doulas. They should have us to a hospital birth that is free of prejudice, racism, and discrimination. If that's what they choose to do, access to birthing centers.

What we find is they don't have that access. At the Seattle Indian Health Board, our healthy, thriving, birthing people, they come into our facility and they know they come into a place of safety, of wellness, of culture. Of where they are understood and supported as indigenous birthing people. I would like to see that opportunity for every birthing person in this country. We need to continue to work to expand which we do at the Seattle Indian Health Board with very limited resources care after birth.

It shouldn't stop in supporting the mothers and the babies and the people who birth six weeks, eight weeks after their babies are born. We need to continue that for at least one year.

We're seeing some expansions in some states and ensuring that that kind of care is compensated, but we're not seeing enough. We need to see a movement in this country of supporting people who birth, not just right after their babies are born, but continuing. In that, we see outcomes change. We've also focused on bringing back traditional teaching methodologies and safe sleep like cradleboards, which are traditional, safe sleep.

That meet every point that is given by the Academy of Pediatrics to support babies in safe sleep, to ensure that we don't experience such high rates of sudden infant death syndrome. When we see they're revitalizing those cultures and those traditions, we see outcomes change. We see people supported, and we know that our people who birth are moving towards health, wellness, and healing as indigenous people by indigenous people.

Melissa Harris-Perry: Abigael, say one last word for us here about solutions about evidence-based solutions for improving as you've pointed out here, not only maternal health outcomes but also health outcomes in first year of life for babies.

Abigail Echo-Hawk: We need to recognize that evidence-based solutions have been in our communities for thousands of years. It doesn't have to be Western evidence. We need to ensure that these practice-based solutions, one, that have been in our families in our tribes, and our communities are not stopped by the Western systems of medicine. They need to be incorporated and valued like we do at my agency. We need to ensure that our folks are supported, that we address the social determinants of health. Can they get to the doctor?

Do they have places where they can live and breathe and work and place safely? Are they receiving care that is free of prejudice and discrimination? We need to ensure that they receive the financial resources along with the facilities that care for them, like my own. The financial resources to do that well and from a cultural perspective. This is where we are seeing change and it needs to be invested in.

Melissa Harris-Perry: Abigail Echo-Hawk is the Director of the urban Indian health Institute, and Caroline Davis is currently a research associate working with tribal nations and tribal organizations. Thank you both so much.

Abigail Echo-Hawk: Thanks for having me.

Caroline Davis: Thank you.

 

Copyright © 2022 New York Public Radio. All rights reserved. Visit our website terms of use at www.wnyc.org for further information.

New York Public Radio transcripts are created on a rush deadline, often by contractors. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of New York Public Radio’s programming is the audio record.Melissa Harris-Perry: New CDC data show that maternal mortality for Black women and Latinas increased sharply during the first year of the pandemic. These data reported nothing about pregnancy-related deaths for native and indigenous women despite previous studies indicating that these communities labor with substantially higher rates of maternal mortality. It's part of a troubling standard practice of many quantitative researchers but this week, Prof. Monica Macklemore told us there is a better way.

 

Prof. Monica Macklemore: Native indigenous people are traditionally and historically excluded because of what I think is a poor scientific excuse that their numbers are too small to be reported. Especially being a laboratory scientist and knowing that we could account for small numbers. When we have genome projects, we will have an n of one, a sample size of one person, but we'll look at 1,000 genes, and we figured out statistical methods to be able to account for that. I don't understand why we keep arguing that the numbers of native indigenous individuals, especially pregnant people, are too small for us to do any kind of analytics in terms of understanding just the basic counts.

Melissa Harris-Perry: For more on this, I'm joined now by Abigail Echo-Hawk, who's Executive Vice President at the Seattle Indian Health Board, and Director of the Urban Indian Health Institute, also an enrolled citizen of the Pawnee Nation of Oklahoma. Thanks so much for being here, Abigail.

Abigail Echo-Hawk: Thanks for having me.

Melissa Harris-Perry: Also with us is Caroline Davis, a research associate working with tribal nations and tribal organizations and a member of Navajo Nation. Great to have you here, Caroline.

Caroline Davis: Thank you. I'm happy to be here.

Melissa Harris-Perry: Caroline, I want to start with you. We were a little stunned when we saw just the erasure in the CDC data that we've been mining and trying to think through but why are indigenous women so frequently left out of data on maternal mortality.

Caroline Davis: There's definitely a lot of factors that contribute to that. The beginning of the pandemic compounded on top of those things. It's this basic, how we continue to be invisible as indigenous people and the absence of us in data, accurate media images, and historical and contemporary awareness. This is perpetuated by federal and state agencies because of what was shared just a little earlier that there's the excuse that our population is too small. There are other issues on top of that, including issues with at the point of data collection.

There are many cases where indigenous women are seeking care. They purposely don't report that they're Native American because they know the history of the systems that they're in. That it's likely that they're going to receive a better standard of care if they're not identifying as being Native American.

Melissa Harris-Perry: I want to pause right there and have you walk through that just a little bit more, Caroline so that for our listeners, who may not have that same awareness, who may not know that history. Walk me through that history just a bit, especially related to pregnancy care.

Caroline Davis: There is a lot of knowledge that has been lost because of this western approach that we take to medicine. A lot of those things are either in direct conflict or just not complimentary at all to what our traditional practices have a lot of tribal nations. For instance, the midwifery model. That probably more aligns with how tribal nations traditionally would deliver prenatal care to women when they were pregnant. This is something that even is newer in accepting that midwifery model.

I think it was a lot in maybe the '60s and '70s, where that was shifting away from that being a legitimate means of receiving prenatal care because it was so different from the western model. I think that's still true today because there's this idea that pregnancy and giving birth is a medical condition. The values of indigenous people, they don't look at it like it's a sickness. It's not a medical condition.

Melissa Harris-Perry: Abigail, help us to understand some of the direct harms that result from this kind of data erasure, this quantitative erasure of indigenous birthing people.

Abigail Echo-Hawk: We continue to see a lack of data on American Indians and Alaska Natives. Not just for birthing people but generally, in the way that data is collected around health outcomes, health disparities, and health resiliencies. As a direct result of that, we find that our treaty and trust responsibilities. The responsibility that the federal government has, for the payment of the taking away of our land is treaties that were signed, is very often determined by the number of tribal members.

When we don't have this data, that means that very often we're trying to prove to the federal government that we have people who are being affected by health disparities like maternal death, infant death. When we're not being recorded in that data, that means the resources, the policies, the intervention, the prevention efforts, are not being directed in a correct way without this data. I call this data genocide. It is one of the ongoing ways in which we are erased within this American society and it has to change.

We know that we can change the way that data is collected at the point of care, all the way to the way that it's interpreted at places like the CDC. We need to ensure that lazy epidemiology isn't being done. There's small populations, data analyses, that can take small populations data like Dr. Macklemore said and do good analysis. My team and I do it every single day. Until we see systematic change, we are continuing to be eliminated in the data and it is directly harming our people every single day.

Melissa Harris-Perry: Caroline, you were talking a bit earlier about practices, for example, in maternal health practices that don't always show up in the ways that, for example, hospitalization, medicalization of pregnancy and childbirth practices do. Talk to me about the work that indigenous-led organizations are doing to strengthen maternal health and maternal health outcomes.

Caroline Davis: There has been quite an influx in the number of organizations that are focused on indigenous birth workers. Whether that's birth centers, organizations that are training doulas, breastfeeding support workers. The approach that they're taking to this is integrating a lot more of those cultural practices that have been, I don't want to say forgotten but haven't been used for many, many, many years because of this medicalization of pregnancy. Integrating a lot of those things with some of the birth centers in first nations in Canada.

They're starting to be developed here in the United States that they're looking at it as creating this space that includes cultural aspects, includes cultural practices, in prenatal care, and in the actual time of delivering babies. That they're being brought into this nurturing environment from the time that they're born versus in a hospital. I don't think we would really categorize hospitals as being a nurturing place. These birth centers are using a lot of these values and reclaiming this indigenous knowledge in caring for pregnant women and being able to provide that support once the babies are born.

There's this expectation that's the common as far as when we're talking about Western and how that's delivered. It's like you have your baby and you go home with the baby and that's it. You're on your own. In indigenous populations, there is definitely this more surrounding support that exists within families. That's something that has never gone away.

Melissa Harris-Perry: Abigail, as I'm listening to Caroline describe differing approaches or maybe not even different but actually centering approaches where indigenous health care providers are providing care for indigenous pregnant folk. We've talked about the direct harm that happens from an elimination and erasure around data. What are some of the direct benefits that occur when we do have the data, when we do understand trends, and when we center indigenous healthcare providers for indigenous pregnant people?

Abigail Echo-Hawk: Yes. We begin to see outcomes change at the Seattle Indian Health Board, where a majority of our physicians are indigenous and people of color who work directly with our traditional Indian medicine folks. Who also work with midwives, doulas, people who have been providing that traditional care services for indigenous peoples for thousands of years. What we find in an integrated system like that are people who birth feel supported. We began to see them breastfeeding and continuing to breastfeeding after birth, which American-Indians, Alaskan natives--

Traditionally in Western society have had low rates of breast breastfeeding. They feel supported. They have opportunities for them and for their children. What we know is that it is essential for people who birth, to be able to make the choice about the kind of births they would like to have. They should have access to their traditional healers, to their midwives, to their doulas. They should have us to a hospital birth that is free of prejudice, racism, and discrimination. If that's what they choose to do, access to birthing centers.

What we find is they don't have that access. At the Seattle Indian Health Board, our healthy, thriving, birthing people, they come into our facility and they know they come into a place of safety, of wellness, of culture. Of where they are understood and supported as indigenous birthing people. I would like to see that opportunity for every birthing person in this country. We need to continue to work to expand which we do at the Seattle Indian Health Board with very limited resources care after birth.

It shouldn't stop in supporting the mothers and the babies and the people who birth six weeks, eight weeks after their babies are born. We need to continue that for at least one year.

We're seeing some expansions in some states and ensuring that that kind of care is compensated, but we're not seeing enough. We need to see a movement in this country of supporting people who birth, not just right after their babies are born, but continuing. In that, we see outcomes change. We've also focused on bringing back traditional teaching methodologies and safe sleep like cradleboards, which are traditional, safe sleep.

That meet every point that is given by the Academy of Pediatrics to support babies in safe sleep, to ensure that we don't experience such high rates of sudden infant death syndrome. When we see they're revitalizing those cultures and those traditions, we see outcomes change. We see people supported, and we know that our people who birth are moving towards health, wellness, and healing as indigenous people by indigenous people.

Melissa Harris-Perry: Abigael, say one last word for us here about solutions about evidence-based solutions for improving as you've pointed out here, not only maternal health outcomes but also health outcomes in first year of life for babies.

Abigail Echo-Hawk: We need to recognize that evidence-based solutions have been in our communities for thousands of years. It doesn't have to be Western evidence. We need to ensure that these practice-based solutions, one, that have been in our families in our tribes, and our communities are not stopped by the Western systems of medicine. They need to be incorporated and valued like we do at my agency. We need to ensure that our folks are supported, that we address the social determinants of health. Can they get to the doctor?

Do they have places where they can live and breathe and work and place safely? Are they receiving care that is free of prejudice and discrimination? We need to ensure that they receive the financial resources along with the facilities that care for them, like my own. The financial resources to do that well and from a cultural perspective. This is where we are seeing change and it needs to be invested in.

Melissa Harris-Perry: Abigail Echo-Hawk is the Director of the urban Indian health Institute, and Caroline Davis is currently a research associate working with tribal nations and tribal organizations. Thank you both so much.

Abigail Echo-Hawk: Thanks for having me.

Caroline Davis: Thank you.

 

Copyright © 2022 New York Public Radio. All rights reserved. Visit our website terms of use at www.wnyc.org for further information.

New York Public Radio transcripts are created on a rush deadline, often by contractors. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of New York Public Radio’s programming is the audio record.

Melissa Harris-Perry: New CDC data show that maternal mortality for Black women and Latinas increased sharply during the first year of the pandemic. These data reported nothing about pregnancy-related deaths for native and indigenous women despite previous studies indicating that these communities labor with substantially higher rates of maternal mortality. It's part of a troubling standard practice of many quantitative researchers but this week, Prof. Monica Macklemore told us there is a better way.

Prof. Monica Macklemore: Native indigenous people are traditionally and historically excluded because of what I think is a poor scientific excuse that their numbers are too small to be reported. Especially being a laboratory scientist and knowing that we could account for small numbers. When we have genome projects, we will have an n of one, a sample size of one person, but we'll look at 1,000 genes, and we figured out statistical methods to be able to account for that. I don't understand why we keep arguing that the numbers of native indigenous individuals, especially pregnant people, are too small for us to do any kind of analytics in terms of understanding just the basic counts.

Melissa Harris-Perry: For more on this, I'm joined now by Abigail Echo-Hawk, who's Executive Vice President at the Seattle Indian Health Board, and Director of the Urban Indian Health Institute, also an enrolled citizen of the Pawnee Nation of Oklahoma. Thanks so much for being here, Abigail.

Abigail Echo-Hawk: Thanks for having me.

Melissa Harris-Perry: Also with us is Caroline Davis, a research associate working with tribal nations and tribal organizations and a member of Navajo Nation. Great to have you here, Caroline.

Caroline Davis: Thank you. I'm happy to be here.

Melissa Harris-Perry: Caroline, I want to start with you. We were a little stunned when we saw just the erasure in the CDC data that we've been mining and trying to think through but why are indigenous women so frequently left out of data on maternal mortality.

Caroline Davis: There's definitely a lot of factors that contribute to that. The beginning of the pandemic compounded on top of those things. It's this basic, how we continue to be invisible as indigenous people and the absence of us in data, accurate media images, and historical and contemporary awareness. This is perpetuated by federal and state agencies because of what was shared just a little earlier that there's the excuse that our population is too small. There are other issues on top of that, including issues with at the point of data collection.

There are many cases where indigenous women are seeking care. They purposely don't report that they're Native American because they know the history of the systems that they're in. That it's likely that they're going to receive a better standard of care if they're not identifying as being Native American.

Melissa Harris-Perry: I want to pause right there and have you walk through that just a little bit more, Caroline so that for our listeners, who may not have that same awareness, who may not know that history. Walk me through that history just a bit, especially related to pregnancy care.

Caroline Davis: There is a lot of knowledge that has been lost because of this western approach that we take to medicine. A lot of those things are either in direct conflict or just not complimentary at all to what our traditional practices have a lot of tribal nations. For instance, the midwifery model. That probably more aligns with how tribal nations traditionally would deliver prenatal care to women when they were pregnant. This is something that even is newer in accepting that midwifery model.

I think it was a lot in maybe the '60s and '70s, where that was shifting away from that being a legitimate means of receiving prenatal care because it was so different from the western model. I think that's still true today because there's this idea that pregnancy and giving birth is a medical condition. The values of indigenous people, they don't look at it like it's a sickness. It's not a medical condition.

Melissa Harris-Perry: Abigail, help us to understand some of the direct harms that result from this kind of data erasure, this quantitative erasure of indigenous birthing people.

Abigail Echo-Hawk: We continue to see a lack of data on American Indians and Alaska Natives. Not just for birthing people but generally, in the way that data is collected around health outcomes, health disparities, and health resiliencies. As a direct result of that, we find that our treaty and trust responsibilities. The responsibility that the federal government has, for the payment of the taking away of our land is treaties that were signed, is very often determined by the number of tribal members.

When we don't have this data, that means that very often we're trying to prove to the federal government that we have people who are being affected by health disparities like maternal death, infant death. When we're not being recorded in that data, that means the resources, the policies, the intervention, the prevention efforts, are not being directed in a correct way without this data. I call this data genocide. It is one of the ongoing ways in which we are erased within this American society and it has to change.

We know that we can change the way that data is collected at the point of care, all the way to the way that it's interpreted at places like the CDC. We need to ensure that lazy epidemiology isn't being done. There's small populations, data analyses, that can take small populations data like Dr. Macklemore said and do good analysis. My team and I do it every single day. Until we see systematic change, we are continuing to be eliminated in the data and it is directly harming our people every single day.

Melissa Harris-Perry: Caroline, you were talking a bit earlier about practices, for example, in maternal health practices that don't always show up in the ways that, for example, hospitalization, medicalization of pregnancy and childbirth practices do. Talk to me about the work that indigenous-led organizations are doing to strengthen maternal health and maternal health outcomes.

Caroline Davis: There has been quite an influx in the number of organizations that are focused on indigenous birth workers. Whether that's birth centers, organizations that are training doulas, breastfeeding support workers. The approach that they're taking to this is integrating a lot more of those cultural practices that have been, I don't want to say forgotten but haven't been used for many, many, many years because of this medicalization of pregnancy. Integrating a lot of those things with some of the birth centers in first nations in Canada.

They're starting to be developed here in the United States that they're looking at it as creating this space that includes cultural aspects, includes cultural practices, in prenatal care, and in the actual time of delivering babies. That they're being brought into this nurturing environment from the time that they're born versus in a hospital. I don't think we would really categorize hospitals as being a nurturing place. These birth centers are using a lot of these values and reclaiming this indigenous knowledge in caring for pregnant women and being able to provide that support once the babies are born.

There's this expectation that's the common as far as when we're talking about Western and how that's delivered. It's like you have your baby and you go home with the baby and that's it. You're on your own. In indigenous populations, there is definitely this more surrounding support that exists within families. That's something that has never gone away.

Melissa Harris-Perry: Abigail, as I'm listening to Caroline describe differing approaches or maybe not even different but actually centering approaches where indigenous health care providers are providing care for indigenous pregnant folk. We've talked about the direct harm that happens from an elimination and erasure around data. What are some of the direct benefits that occur when we do have the data, when we do understand trends, and when we center indigenous healthcare providers for indigenous pregnant people?

Abigail Echo-Hawk: Yes. We begin to see outcomes change at the Seattle Indian Health Board, where a majority of our physicians are indigenous and people of color who work directly with our traditional Indian medicine folks. Who also work with midwives, doulas, people who have been providing that traditional care services for indigenous peoples for thousands of years. What we find in an integrated system like that are people who birth feel supported. We began to see them breastfeeding and continuing to breastfeeding after birth, which American-Indians, Alaskan natives--

Traditionally in Western society have had low rates of breast breastfeeding. They feel supported. They have opportunities for them and for their children. What we know is that it is essential for people who birth, to be able to make the choice about the kind of births they would like to have. They should have access to their traditional healers, to their midwives, to their doulas. They should have us to a hospital birth that is free of prejudice, racism, and discrimination. If that's what they choose to do, access to birthing centers.

What we find is they don't have that access. At the Seattle Indian Health Board, our healthy, thriving, birthing people, they come into our facility and they know they come into a place of safety, of wellness, of culture. Of where they are understood and supported as indigenous birthing people. I would like to see that opportunity for every birthing person in this country. We need to continue to work to expand which we do at the Seattle Indian Health Board with very limited resources care after birth.

It shouldn't stop in supporting the mothers and the babies and the people who birth six weeks, eight weeks after their babies are born. We need to continue that for at least one year.

We're seeing some expansions in some states and ensuring that that kind of care is compensated, but we're not seeing enough. We need to see a movement in this country of supporting people who birth, not just right after their babies are born, but continuing. In that, we see outcomes change. We've also focused on bringing back traditional teaching methodologies and safe sleep like cradleboards, which are traditional, safe sleep.

That meet every point that is given by the Academy of Pediatrics to support babies in safe sleep, to ensure that we don't experience such high rates of sudden infant death syndrome. When we see they're revitalizing those cultures and those traditions, we see outcomes change. We see people supported, and we know that our people who birth are moving towards health, wellness, and healing as indigenous people by indigenous people.

Melissa Harris-Perry: Abigael, say one last word for us here about solutions about evidence-based solutions for improving as you've pointed out here, not only maternal health outcomes but also health outcomes in first year of life for babies.

Abigail Echo-Hawk: We need to recognize that evidence-based solutions have been in our communities for thousands of years. It doesn't have to be Western evidence. We need to ensure that these practice-based solutions, one, that have been in our families in our tribes, and our communities are not stopped by the Western systems of medicine. They need to be incorporated and valued like we do at my agency. We need to ensure that our folks are supported, that we address the social determinants of health. Can they get to the doctor?

Do they have places where they can live and breathe and work and place safely? Are they receiving care that is free of prejudice and discrimination? We need to ensure that they receive the financial resources along with the facilities that care for them, like my own. The financial resources to do that well and from a cultural perspective. This is where we are seeing change and it needs to be invested in.

Melissa Harris-Perry: Abigail Echo-Hawk is the Director of the urban Indian health Institute, and Caroline Davis is currently a research associate working with tribal nations and tribal organizations. Thank you both so much.

Abigail Echo-Hawk: Thanks for having me.

Caroline Davis: Thank you.

 

Copyright © 2022 New York Public Radio. All rights reserved. Visit our website terms of use at www.wnyc.org for further information.

New York Public Radio transcripts are created on a rush deadline, often by contractors. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of New York Public Radio’s programming is the audio record.