Luján Convenes Experts to Create Roadmap for Native Maternal Health Solutions

Most American Indian/Alaska Native Pregnancy-Related Deaths Were Deemed Preventable

Washington, D.C. - U.S. Senator Ben Ray Luján (D-N.M.), a member of the Senate Committee on Indian Affairs, convened more than 55 American Indian, Alaska Native (AI/AN), and Native Hawaiian (NH) maternal health experts and organizations to create a landmark set of five reports outlining the current state of Native maternal health. The five reports synthesize national findings on maternal mortality, workforce equity, access to health care services, data sovereignty, and funding inequities.

AI/AN people face pregnancy-related mortality ratios two to three times higher than non-Hispanic White counterparts, and Native Hawaiian mortality remains similarly elevated. The reports underscore that today's disparities are the result of generations of harmful federal Indian policies, underfunding of the Indian Health Service (IHS) and Urban Indian Organizations (UIOs), and ongoing barriers to culturally-based, accessible maternal health care.

"For far too long, Native families have had to be subjected to a maternal health system that was never built for them. These reports offer a roadmap that is based on data sovereignty, community-led care, and sustained federal investment and support," said Senator Luján. "I am proud of the work these experts from across the country have led to identify solutions to the unacceptable and preventable disparities in Native maternal health outcomes. I look forward to seeing many of these solutions put to work and to making things better for Native mothers and care facilities."

"One hundred percent of maternal deaths among American Indian and Alaska Native women were found to be preventable. We know exactly where the system is failing-now we need the courage and commitment to fix it. Native Hawaiian women face some of the highest rates of hemorrhage, hypertensive disorders, and cardiometabolic complications in the nation-yet their risks remain masked by aggregated reporting. Disaggregation is not optional; it is lifesaving. Misclassification hides American Indian, Alaska Native women and Native Hawaiian women in our data-and when women disappear from the data, they disappear from the solutions. Until we correct how we count, we cannot correct how we care," said Janelle Palacios, PhD, CNM, Founder & CEO, Encoded 4 Story, Committee Member, California Pregnancy-Associated Mortality Review Committee, COVID Expert Committee

"The disparities facing AI/AN/NH birthing people are both profound and preventable. ACNM urges policymakers and partners to act on these findings by resourcing Indigenous-led systems of care, strengthening IHS infrastructure, and upholding Tribal sovereignty in workforce pathways. Equity depends on our willingness to follow-and fund-the leadership of Native communities," said Michelle L. Munroe, DNP, CNM, FACNM, FAAN, Chief Executive Officer, American College of Nurse-Midwives.

Additional quotes from report contributors can be found HERE.

The reports recommend federal action across three areas:

• Data Sovereignty, Law, and Funding: Advance Indigenous data sovereignty, modernize race/ethnicity standards, and close long-standing IHS and UIO funding gaps.

• Coverage, Workforce, and Infrastructure: Guarantee permanent 12-month postpartum Medicaid and CHIP coverage, invest in Indigenous perinatal workforce pathways, and stabilize rural and community-based maternity care.

• Safety, Mental Health, Intimate Partner Violence, and Carceral Reform: Improve maternal safety, strengthen mental health and substance use supports, and implement protections for pregnant and postpartum people in carceral settings.

Links to all five reports can be found below:

• From Barriers to Bridges: Implementing Access Solutions to Improve American Indian, Alaska Native and Native Hawaiian Maternal Health
• Strengthening Maternal Health Data to Improve Health and Wellbeing in American Indian and Alaska Native Communities
• Preventing Maternal Mortality and Morbidity among American Indian, Alaska Native and Native Hawaiian People

• Building Systems of Care: Investment in Native Maternal Health Infrastructure
• Workforce Equity in Maternal Health: Tribal and Native Community-Led Solutions

Participating organizations and contributors: American College of Nurse Midwives (ACNM), Association of Women's Health, Obstetrics and National Nursing (AWHONN), National Association of Certified Professional Midwives (NACPM), Every Mother Counts (EMC), Roanhorse Consulting, Brindle Foundation, Anchorum Health Foundation, Urban Indian Health Institute, Hummingbird Indigenous Family Services, Center for Reproductive Rights, American Association of Birth Centers, National Indian Health Board, Pacific Birth Collective, Seattle Indian Health Board, Alaska Native Tribal Health Consortium, National Partnership For Women & Families; Inter-Tribal Council of Arizona, and The Family Van & Mobile Health Map Harvard Medical School, NM Department of Health Office of Tribal Liaison.

Report Authors: Jessica Akin MSN, APRN, CNM; Jennifer Almanza, DNP, APRN, CNM; Andrea Carpitcher, MSN, RNC-OB; Seth Chase, MA; Karen Crowley, DNP, APRN-BC, WHNP, ANP, CNE; Cassaundra Jah, PhD, CPM, LM, IBCLC; Amy Kohl; Michelle Munroe, DNP, CNM, FACNM, FAAN; Felina M. Ortiz, DNP, CNM, RN, FACNM; Misty Wilkie, PhD, RN, FAAN; Hailey A. Baker MD: Janelle Palacios PhD, CNM, RN; Amanda Roedl MSN, RNC-OB; Chelsea Bellon, MPH; Charla Naone, DNP, APRN, FNP-B: Jessica Perfette, MPH ; Margaret P. Moss, PhD, JD, RN, FAAN, FADLN; Lannesse Baker; Tess Abrahamson Richards; Amy Stiffarm (HMHB-MT); Katie Hess (King County, WA); Dr. Katy Backes Kozhimannil, PhD, MPA; Alyssa Fritz, MPH, RD, CLC; Lucy Rogers, MPH ; Carla Britton, PhD, MS ; Annette Marley, MPH ; Chelsea Bellon, MPH; Charlotte Little: Kait Guild; Nicolle L. Arthun FACNM, CNM, RN; Morea Mendoza; Carolina Nkouaga, MPH, LM, CPM; Jessica Whitehawk MPH; Chelsea Bellon MPH; Angela Cruz-Traditional Medicine Practitioner; Jill Alliman, DNP, CNM, FACNM: Janet Johnson.

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