Maternal Health in Focus at Indigenous Health Symposium

Taking place Nov. 12 at the Jacobs School of Medicine and Biomedical Sciences, the event featured speakers, panelists and audience discussion while seeking to highlight Native people’s unique challenges, outlooks and qualities in terms of maternal health and community care.

The Jacobs School and UB’s Department of Indigenous Studies partnered to host the symposium to amplify and address Indigenous inequities.

“Our goals were to shed light on the health inequities surrounding maternal wellness and highlight the actionable and impactful work that is being done to address these inequities,” says Anyango Kamina, PhD, assistant dean for student development and academic enhancement and interim unit diversity officer at the Jacobs School. “By focusing locally, we hoped to engage our audience with the work that is being done in the Western New York area and share ways that they can get involved.”

Pete Hill, special initiatives director at the Native American Community Services of Erie and Niagara Counties, began his presentation by recounting a seemingly simple task: He attempted to find a suitable definition for “health.”

But the vastness of the term and all it encompasses made doing so difficult. Further, trying to pinpoint and define “Indigenous health” becomes a bigger challenge because of the diversity and expansiveness among Indigenous people, he said.

“In the U.S., there are 574 federally recognized nations and tribes, each one having its own culture and way of thinking about health,” he said. “Health in one community may not be similar or equivalent or translatable to another community.”

Hill later reflected on audience-submitted definitions of health while underscoring that it describes much more than a physical state. Equally important are emotional, mental and spiritual health, he said, the latter of which could relate to religion and faith but also to helping others and recognizing connections to the natural world.

“For Indigenous people we have a lot of teachings and understandings about our relationships to each other, to ourselves, and to the natural world, especially when it comes to maternal health,” he said.

According to Hill, a pregnant person’s partner is considered pregnant too in Haudenosaunee culture — even if not carrying a baby, they share in preparing for and raising that child.

Additionally, care for a new child and for the natural world can even affect distant future generations, he said. “A lot of Native people and nations and tribes use this idea of the seven generations, that what we do today has an impact seven generations into the future.”

Still, Indigenous people continue to face significant health burdens and inequitable rates of mortality and disease.

“Here’s a list of about 35 different health issues,” Hill said, displaying an array of health challenges on the screen, from suicide to diabetes to COVID mortality rates. “And, unfortunately, Native people aren’t doing too well on any of them.”

Part of the problem, Hill said, relates to historical trauma stemming from Indigenous people’s long history of oppression, forced assimilation, and cultural and political erasure that persists today. “If there’s historical trauma, it has a direct impact on health disparities that we see,” he said.

That’s why health care providers need to consider all aspects of a person’s health, Hill said, especially when caring for Indigenous patients and mothers.

During the second half of the symposium, panelists shared Indigenous experiences and perspectives on maternal health and well-being. Among Indigenous communities, optimizing maternal health faces both unique and universal difficulties.

Shavonne Stevens, a Seneca doula on the Cattaraugus Reservation and founder of Love What I Doula family and birth services, said that she became a doula to fulfill a need among her community.

“The reason I became a doula is to be the person I needed during pregnancy, birth, and postpartum and to help with breastfeeding struggles,” she said. “Most importantly, someone who looks like me, makes me feel safe and heard, and someone I can trust to come support me and even speak up and advocate for me.”

Ashley Lickers, a Haudenosaunee midwife working under the exemption from the Cayuga nation of Six Nations of the Grand River territory, emphasized the practice of holistic and comprehensive care. “Indigenous midwifery understands the whole self,” she said. “The practice of Indigenous midwifery acknowledges the emotional health of somebody, it acknowledges the spiritual health of someone, it acknowledges their physical health.”    

Yet seemingly past colonial policies are still present and affect Indigenous people’s health and practices surrounding maternal health today. “It’s very clear that colonial policies and practices in the late 19th century ... created just absolute public health disasters on many of these reservations,” said Brianna Theobald, PhD, associate professor of history at the University of Rochester. Part of the problem was the “criminalization of Indigenous healing systems,” Theobold said, that forever impeded beneficial practices.

While some Indigenous patients have been mistrustful of health care providers and systems, medical communities themselves have not acted reliably. “Historically, medical systems have not acted in a trustworthy way toward Native communities and Native people,” said Meredith Palmer, PhD, MPH, assistant professor of indigenous studies in UB’s Department of Geography, who moderated the panel.

Despite historical and ongoing challenges, the ability to provide culturally competent care that stresses maternal safety and well-being is critical. “There are three things that you should be able to say yes to while in labor: Do I feel like I’m in a safe place? Do I feel like I trust my body? And do I feel like I trust my support people and my care providers?” Lickers said. “As a midwife, the care that we provide can shape the future of our communities.”