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Indigenous ‘helpers’ train to combat high maternal mortality rates

Women in the U.S. are more likely to die from pregnancy-related causes than anywhere else in the developed world, according to the Commonwealth Fund. Native American women face some of the highest rates of death, and in Arizona, those disparities are even more profound. From the Cronkite School of Journalism, Jennifer Alvarez reports on an effort to fight maternal mortality among Native Americans.

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  • Judy Woodruff:

    Women in the United States are more likely to die from pregnancy-related causes than anywhere else in the developed world, according to the Commonwealth Fund.

    Native American women face some of the highest rates of death. And in Arizona, those disparities are even more profound.

    From the Cronkite School of Journalism, Jennifer Alvarez reports on a unique effort to combat maternal mortality among Native Americans.

    This story was filmed prior to the pandemic.

  • Woman:

    OK. sweep your teepee. Sweep your teepee.

  • Jennifer Alvarez:

    On the Navajo Nation…

  • Woman:

    Make fire.

    (LAUGHTER)

  • Jennifer Alvarez:

    … Native women finish up a day of training with a traditional game. They're learning how to be doulas, or people trained to support women through pregnancy and birth.

  • Melissa Brown:

    Basically, they're helpers. And I always compare it to like how we help each other in ceremonies. Like, that's how we should help each other during birth and pregnancy and parenting.

  • Jennifer Alvarez:

    Melissa Brown knows just how important these helpers can be.

  • Melissa Brown:

    My first birth that I had when I was a teenage mother was very traumatic. I didn't understand how my body worked. I didn't understand how labor and delivery worked. I was very scared. I didn't have very much support.

    And so when I got pregnant with my second daughter, when I had an indigenous midwife, it made all the difference. I had an unmedicated, beautiful birth. It completely changed my life.

  • Jennifer Alvarez:

    It's the first time they have had a training like this here, and workshop participant Becki Jones says it's a community without a lot of the same resources afforded to urban or suburban areas.

  • Becki Jones:

    We're a desert for everything. Food, reproductive health care, maternity care.

  • Jennifer Alvarez:

    Ramona Antone-Nez is senior epidemiologist at the Navajo Epidemiology Center.

  • Ramona Antone-Nez:

    The hospital isn't just around the corner, just around the block. A lot of our care takes probably an hour or so just to get to health care facilities.

  • Jennifer Alvarez:

    As a result, many women may miss screenings, prenatal checkups, or other appointments at which early problems might be identified. The CDC reports maternal mortality jumped from 7.2 deaths per 100,000 births in 1987 to 16.9 deaths in 2016.

    And Black and Native women are two to three times as likely to die from pregnancy-related causes than white women.

  • Melissa Brown:

    Something needs to change, not only here, but in other indigenous communities.

    So, what happens in a lot of communities is, we're bringing in non-indigenous people who don't have that lived experience and delivering health education in a way that doesn't make sense to a lot of people in the community.

  • Jennifer Alvarez:

    So, Brown teamed up with Nicolle Gonzales, founder of the Changing Woman Initiative, to teach women how to use traditional practices to improve maternal health.

  • Melissa Brown:

    We are our own experts in our community. We can help ourselves. We can empower ourselves. We can educate ourselves.

  • Jennifer Alvarez:

    Gonzales says indigenous women are lucky to have just half of the prenatal visits they're supposed to.

    The Changing Woman Initiative held its indigenous doula training inside this hogan, which the women say was representative of a mother's womb. We weren't able to film inside during the workshop because they wanted to maintain a safe space for indigenous women.

    Together, they hope to help Native women cope with trauma and loss.

  • Nicolle Gonzales:

    To have a really, like, frank conversation about death and miscarriage and abortion and pregnancy was really, like, the heart of the issue I think a lot of people wanted to know about.

  • Melissa Brown:

    It's so much more than just the doula training and learning about birth. It's about learning about ourselves, connecting with our own healing. And there's a lot of healing that happens in this training.

  • Jennifer Alvarez:

    A lot of that healing especially happened during these moments.

  • Nicolle Gonzales:

    Seeing everybody laugh and enjoy themselves and, like, be in their traditional dress, I wish the world would see Native women like that, that we're not sick, we're not dying, we're not vulnerable, we're not our disease.

  • Jennifer Alvarez:

    For the "PBS NewsHour," I'm Jennifer Alvarez with Cronkite News in Window Rock, Arizona.

  • Judy Woodruff:

    Such an important program. And we hope it's doing well now.

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