Infant mortality rates for Indigenous babies are the second highest in the country, centered between the huge disparity between Black and white babies. There are several factors but most of them boil down to continued genocide. This may sound extreme to non-Indigenous people, but Indigenous people connect the dots. We remain “the vanishing race,” conveniently seeming to disappear so that government responsibility also disappears. There are things we can do, as a community, to lessen this.
It isn’t realistic to suggest that we close ranks and stop engaging in inter-tribal or inter-racial relationships. That’s just not how love works. Even though many of us get excited to meet a fellow Indigenous person and are willing to date within our own community, it just doesn’t always work out that way. For urban Indigenous women, the difficulty of even meeting other single Indigenous people and the much larger access to people of other ethnicities makes it far more likely that we will date, marry and have children with a non-Indigenous person.
Where we can exert some control and create change is in birth outcomes – maternal and infant health and mortality rates. Urban Indigenous women, like many poor women of color, are less likely to have access to proper prenatal care. I have miscarried 7 times, not always aware that I was pregnant until then. While I try not to blame myself, had I known I was pregnant I would have made some different lifestyle choices. For example, one of my miscarriages started when I lifted a heavy bag of laundry as part of my job duties at an adult foster care home. If I knew I was pregnant, my employer would have adjusted my duties given my extensive history of miscarriages. In my one successful pregnancy, I had no idea I could be pregnant so soon after a miscarriage of twins. When I finally went to a clinic, they told me I was twelve weeks along. My own health, and the well-being of my child, would have been assisted by having proper care earlier. I was lucky that my son was very healthy, but I required a job change, partial bed rest and extensive monitoring throughout the pregnancy to ensure his health.
Access to care and to other necessary resources such as quality food, stress management, stable housing, trauma recovery and childbirth education dramatically impact birth outcomes. Further, those same supports contribute to increased breastfeeding rates, lowered postpartum depression rates or length and lowered rates of neglect and abuse. It takes a team of support for a person to go through pregnancy, childbirth and parenthood, especially if there are long-standing underlying disparities of care, support and health caused by ethnicity, culture and poverty. For Indigenous women, those disparities are pretty stark so it only stands to reason that more support is needed.
Additionally, finding culturally sensitive support can be challenging, especially for urban Indigenous women who may be isolated from other Indigenous people or not be able to find culturally competent health care or other support services. Those of us who do not have tribal enrollment also do not have access to Indian Health Services, including the newer urban clinics that are popping up. Many urban areas now have programs designed specifically to provide culturally competent support to Black parents who face the highest rates of infant mortality, and many of those programs have expanded or built sister-programs to address the unique needs of Limited English Proficient Latino/Hispanic families. Such programs may provide volunteer/community doula services, parent-to-parent mentoring, reproductive planning services, childbirth or parenting classes or other related services, but generally they do not provide more than two of these types of services in one program. Frequently, they are prepared and willing to also serve Indigenous families, though they do not advertise their services directly to us.
The key to a healthy and safe pregnancy and birth is in taking care of ourselves first. Get connected with what services exist in your community as early as you can. The clinic I went to not only provided a lot of services in-house, but was happy to refer me to many other programs through which I got a parent-to-parent mentor, a free in-home course in nutrition and meal-planning, and more. Don’t be afraid or ashamed to ask your doctor for recommendations. Most programs know of other programs that may benefit you but they won’t know what you need if you don’t ask, so once you are connected to one service, ask them what else exists. We have to build community where we can find it.