Understanding Prenatal Health Care for American Indian Women in a Northern Plains Tribe

Abstract

Early and regular prenatal care appointments are imperative for the health of both the mother and baby to help prevent complications associated with pregnancy and birth. American Indian women are especially at risk for health disparities related to pregnancy and lack of prenatal health care. Previous research has outlined a basic understanding of the reasons for lack of prenatal care for women in general; however, little is known about care received by pregnant women at Indian Health Service hospitals. Qualitative interviews were carried out with 58 women to better understand the prenatal health experiences of American Indian women from one tribe in the Northern Plains. Several themes related to American Indian women’s prenatal health care experiences were noted, including communication barriers with physicians, institutional barriers such as lack of continuity of care, and sociodemographic barriers. Solutions to these barriers, such as a nurse midwife program, are discussed.

The Impact of Racism and Midwifery's Lack of Racial Diversity: A Literature Review

“…Salam Ward et al (N = 31) and Sawyer (N = 17) both used a combination of focus groups and individual interviews, while Hanson (N = 58) relied solely on individual interviews . Salam Ward et al and Sawyer investigated the experience of African American women, while Hanson looked at the experiences of women from one American Indian tribe in the Northern Plains.…”

“…Elsewhere in the study, she explicitly contrasts the care received from nurse‐midwives and physicians stating that the respondents had a preference for nurse‐midwifery care due to continuity of care, longer visits with more teaching, and more frequent gender concordance. She never describes, however, a mechanism by which nurse‐midwifery care is different from the specifically racial critique of “white physicians and ‘modern ways of medicine.’” (p32)…”

Weaving dreamcatchers: mothering among American Indian women who were teen mothers

“…, Barlow et al . ) experience interpersonal violence while pregnant (Mylant & Mann ), access little to no prenatal care (Hanson ), entertain suicidal ideation (Yoder et al . ) and report elevated depressive symptoms (Ginsburg et al .…”

“…Regional differences in American Indian (AI) teen birth rates exist, ranging from as high as 123Á2 in the Indian Health Aberdeen service area, to 24Á3 in the California service area (Wingo et al 2012). These women are more likely to smoke (Amparo et al 2011), drink and use drugs (Tenkku et al 2009, Barlow et al 2010) experience interpersonal violence while pregnant (Mylant & Mann 2008), access little to no prenatal care (Hanson 2011), entertain suicidal ideation (Yoder et al 2006) and report elevated depressive symptoms (Ginsburg et al 2008), placing them at risk for preterm birth, low birth weight and infant mortality (Alexander et al 2008). Few studies have taken a life course perspective to interview adult women about their teen pregnancy experience (Smithbattle 2005, Palacios & Kennedy 2010.…”

Development of a Biomedical Program of Research in the Blackfeet Community: Challenges and Rewards

“…American Indian (AI) communities have disproportionately high rates of heart disease, diabetes, cancer, and obesity (Sarche & Spicer, ). In these communities, exposure to trauma and adversity often begins during the gestational period (Hanson, ; Long & Curry, ) and can persist into adulthood with high rates of traumatic or negative life events and higher overall levels of chronic psychological stress (Manson et al., ). In addition, AIs are affected by historical trauma , or the legacy of numerous traumatic events, the consequences of which are transmitted intergenerationally (Brave Heart, ; Evans‐Campbell, ).…”