Maternal Morbidity and Mortality in Native American Women: A Model for Restructuring Maternal Health Care Systems

Kameron Jones, Mary Boyes, Honors College, Virginia Commonwealth University 701 W Grace Street, Richmond VA, 23284-2010

Severe maternal morbidity and mortality have increased steadily in the United States since the 1980’s;
Native American women experience obstetrical complications or death at a disproportionately higher rate
than other populations. From 2011-2016 in the U.S., the Native American Maternal Mortality Ratio
(MMR) was 30.4 deaths per 100,000 live births compared to an overall MMR of 18 deaths per 100,000
live births. This study investigated the structure of maternal health care systems and how the lack of
standardization, coordination of care, and training increased the risk of severe maternal morbidity or
obstetrical complications and pregnancy-related death in Native American women in the Southwest/West
Coast region. To identity gaps as well as strategies for optimizing the quality of care at Indian Hospitals,
existing research was reviewed, and three areas of focus were identified: the need for interdisciplinary
collaboration among providers (obstetricians, midwives and family physicians), lack of labor
management practices and protocols, and the availability of culturally responsive training. Findings
included the following: Interdisciplinary practice prioritizes coordination among maternal care providers
which leads to more cohesive care and improved outcomes. Labor management protocols should include
criticality assessments for severe morbidity and mortality to identify women who are at-risk for
complications and ensure the availability of specialized providers for each birth. And finally, hospitals
and birthing centers should offer culturally competent training to address and mitigate implicit bias,
improve intercultural communication, and promote understanding and trust between providers and the
communities they serve. The lack of available data on maternal morbidity and mortality in Native
American women limited this study. Further research would be beneficial to better understand the clinical
background and birth outcomes of Native women and to develop solutions that are both evidence-based and culturally responsive.

Additional Abstract Information

Presenter: Kameron Jones

Institution: Virginia Commonwealth University

Type: Poster

Subject: Native American Studies

Status: Approved

Time and Location

Session: Poster 9
Date/Time: Wed 12:00pm-1:00pm
Session Number: 6003