Background
Midwifery is a cornerstone of every Indigenous community. However in the United States, the practice of traditional midwifery, the presence of Native American/Alaskan Native (NA/AN) Indigenous midwives, and the ability to share Indigenous midwifery knowledge through the generations, has declined over the last several decades. The declines have had devastating impacts on maternal health and the preservation of traditional indigenous midwifery knowledge. Native American women are suffering from lack of culturally appropriate equitable care, which is resulting in higher risk pregnancies leading to an increase in adverse pregnancy and poorer infant health outcomes.
Currently in the United States, NA/AN Indigenous midwives make up only 1% of all practicing midwives. Less than 1% are unable to return to their Indigenous communities on the reservation. They are unable 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 traveling more than 1 hour away one-way from their homes to access adequate women’s health and birth services. In very rural regions like in the State of Alaska, Alaska Native women are evacuated from their homes to live closer to a hospital after 36 weeks into their pregnancy. These evacuations has led to documented high rates of maternal and infant mortality and weakened the health, strength, and spirit of Indigenous communities.
The current transnational movements taking place in the countries of Mexico, Canada, and Guatemala are working to preserve and advance traditional midwifery as a right to self-determination. Studies have shown 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.
Currently in the United States, NA/AN Indigenous midwives make up only 1% of all practicing midwives. Less than 1% are unable to return to their Indigenous communities on the reservation. They are unable 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 traveling more than 1 hour away one-way from their homes to access adequate women’s health and birth services. In very rural regions like in the State of Alaska, Alaska Native women are evacuated from their homes to live closer to a hospital after 36 weeks into their pregnancy. These evacuations has led to documented high rates of maternal and infant mortality and weakened the health, strength, and spirit of Indigenous communities.
The current transnational movements taking place in the countries of Mexico, Canada, and Guatemala are working to preserve and advance traditional midwifery as a right to self-determination. Studies have shown 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.
CWI Acknowledgement of Indigenous Midwifery
Changing Woman Initiative (CWI) acknowledges that every birth in an Indigenous community is a creation story relived and this is nation building. We value the contributions Indigenous midwives provide in their understanding of culture, plant medicine, and ceremony to support the health and well-being 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 medicine, 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 Indigenous Midwifery Fellowship is intended to work with an up and coming Native American/Alaska Native Indigenous midwife student (CPM) and/or newly graduated midwife (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:
Following one-year of completion of the program, the fellow must commit 1 to 2 years of their time to work with CWI Traditional Birth Center.
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 in aiding in White Shell Woman Homebirth Services, Corn Mother Easy Access Women’s Health Clinic, and various CWI projects and community events.
- Mentorship support will be provided while doing indigenous midwifery research and skill building around: plant medicine, health policy & advocacy, and advancing the scholarship of Indigenous maternal health and traditional medicine.
Following one-year of completion of the program, the fellow must commit 1 to 2 years of their time to work with CWI Traditional Birth Center.
The Power of One Indigenous Midwifery Program (Pilot Year - 2019)
Our 2019 Indigenous Midwife pilot fellow, Melissa Rose, showing Dine’ women how to provide lower back pressure to a laboring person. #indigenousdoulatraining
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During 2019, the first year of the program, our pilot fellow was part of the creation and development of the CWI Power of One Indigenous Midwifery Fellowship program. The program is continuously developing so future Indigenous midwives will be able to return to their own communities with Indigenous midwifery skills and knowledge. The goal of the program in its entirety is 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.
Our fellowship program is in continuous development as we navigate the ever changing needs of the communities we serve. Our 2019 pilot fellow helped with designing the initial aspects of our program, while researching access to available resources to support their own development and skill-set. They built on their skill set to include midwifery and Indigenous doula training in communities across and outside New Mexico, learning plant medicine from a local Doctor of Oriental Medicine/Curandera, and accompanying CWI Nurse midwives to births and the clinic. The 2019 pilot fellow was tasked to create a work-plan for 1 year, with self-set milestones to track their development and goals. Quarterly reports and evaluations were to be written and submitted by the fellow along with their mentor/preceptors. |
