Background
Midwifery is a cornerstone of every Indigenous community, however in the United States, the practice of traditional midwifery, the presence of NA/AN Indigenous midwives, and the ability to share Indigenous midwifery knowledge through the generations, have all declined over the last several decades. This has had devastating impacts on maternal health and the preservation of traditional indigenous midwifery knowledge. In the United States, Native American women are suffering from lack of culturally appropriate equitable care, which is resulting in higher risk pregnancies which is having adverse pregnancy and poorer infant health outcomes.
Currently in the United States, NA/AN Indigenous midwives only make up 1% of all practicing midwives. Less than 1% aren’t able to return to their Indigenous communities on the reservation to serve their people in a capacity that is sustainable or supported outside of federally run health programs like Indian Health Services. Further, NA/AN women are still having to travel more than 1 hour away from their homes to access women’s health and birth services. In some regions like Alaska, Alaska Native women are evacuated from their homes to live closer to a hospital after 36 weeks into their pregnancy. This has led to documented high rates of maternal and infant mortality and weakened the health, strength, and spirit of Indigenous communities.
Currently in the United States, NA/AN Indigenous midwives only make up 1% of all practicing midwives. Less than 1% aren’t able to return to their Indigenous communities on the reservation to serve their people in a capacity that is sustainable or supported outside of federally run health programs like Indian Health Services. Further, NA/AN women are still having to travel more than 1 hour away from their homes to access women’s health and birth services. In some regions like Alaska, Alaska Native women are evacuated from their homes to live closer to a hospital after 36 weeks into their pregnancy. This has led to documented high rates of maternal and infant mortality and weakened the health, strength, and spirit of Indigenous communities.
There are current transnational movements happening in Mexico, Canada, and Guatemala to preserve and advance traditional midwifery as a right to self-determination, as that Indigenous communities and midwives experience the same detrimental outcomes and challenges as those in surrounding nations. While these movements are occurring, Indigenous midwifery in the United States is experiencing a rebirth to ensure equitable reproductive, sexual and maternal health access to NA/AN Indigenous women in their traditional territories, outside of current federally run programs like Indian Health Services.
Changing Woman Initiative acknowledges that every birth in an Indigenous community, is their creation story relived and that this is nation building. We value the contributions that Indigenous midwives provide in their understanding of culture, plant medicines, and ceremony to support the health and wellbeing of women in their care. We also understand that prior to the medicalization of birth, NA/AN Indigenous midwives attended majority of births in the homes of community members. They also were very knowledgeable about plant medicines, ceremony, and seen as medicine women of their communities.
Changing Woman Initiative acknowledges that every birth in an Indigenous community, is their creation story relived and that this is nation building. We value the contributions that Indigenous midwives provide in their understanding of culture, plant medicines, and ceremony to support the health and wellbeing of women in their care. We also understand that prior to the medicalization of birth, NA/AN Indigenous midwives attended majority of births in the homes of community members. They also were very knowledgeable about plant medicines, ceremony, and seen as medicine women of their communities.
- Indigenous Midwives are protectors: Of space, of families, of culture, of generations, of collective Indigenous rights.
- Indigenous Midwives are facilitators of ceremony and cultural practice: Cultural practices have a protective effect in health, and are a tool that creates better outcomes.
- Indigenous Midwives have many more skills to offer: Indigenous midwives are not being used to their full potential and have skills that do not exist elsewhere in the healthcare system.
Transforming Our Future
The Power of One Fellowship is intended to work with an up and coming Native American/Alaska Native Indigenous midwife student(CPM) and/or newly graduated (CNM) to support transforming maternal health discourse through supporting self-determination of education and skill development of one or two fellows.
The one-year fellowship program is intended:
- To support inter-personal leadership growth in Indigenous midwifery.
- Allow for time to learn with traditional midwives/medicine people of their territory.
- Develop research around Indigenous midwifery that would support and measure the impact of indigenous midwifery.
- Train with Changing Woman Initiative throughout the year providing homebirth, clinic, and women’s health at the local shelter.
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2019 The Power of One Pilot Program
During the first year, our pilot fellow(s) will be part of creating a fellowship program for future Indigenous midwives, who will be able to return to their communities with the Indigenous midwifery skills and knowledge to create culturally supported healthcare systems based on evidence based research and with the support of transnational Indigenous midwives from across the United States and Canada.
While designing our program and getting access to the necessary resources to support their own development and skill-set, we will be measuring their experiences with monthly evaluations, reports from their mentors/preceptors, and guiding their learning experiences.
While designing our program and getting access to the necessary resources to support their own development and skill-set, we will be measuring their experiences with monthly evaluations, reports from their mentors/preceptors, and guiding their learning experiences.
Evaluation
Fellows will be asked to create a work-plan for 1 year, with self-set milestones to track their development and goals. Quarterly reports and evaluations to be written by fellow and mentor/preceptors.
Upon completion of fellowship, exit interviews will be held and evaluation of entire program will be completed.
Upon completion of fellowship, exit interviews will be held and evaluation of entire program will be completed.
