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The U.S. faces a maternal health crisis that disproportionately impacts certain groups of people. American Indian and Alaskan Native (AIAN) women experience significantly higher rates of maternal mortality and morbidity compared to non-Indigenous populations—Indigenous women are nearly four times more likely to die from pregnancy-related complications than non-Indigenous women.
In the face of this pressing situation, digital healthcare represents a powerful way to improve outcomes for Indigenous communities. By offering virtual care and increasing opportunities for education, health plans and employers can overcome some of the barriers preventing Indigenous people from accessing equitable, high-quality maternal healthcare.
Addressing the gap: Indigenous maternal health challenges
Rooted in historical discrimination and further exacerbated by current medical biases and barriers, these challenges faced by the community underscore the need for urgent action to improve Indigenous maternal health outcomes.
Historical discrimination
The history of discrimination faced by Indigenous people has, over time, culminated in markedly disparate maternal health outcomes, including an increased risk of perinatal mood disorders, low birth weight, preterm birth, and gestational diabetes. Structural factors including historical patterns of forced migration, reproductive coercion, and child placement policies have had a significant impact. Trauma stemming from systemic racism, colonization, and cultural erasure also contribute to these negative outcomes.
Medical discrimination
Many Indigenous birthing people do not have access to high-quality care today, resulting in significantly worse maternal health outcomes among this population compared to their white counterparts. Implicit bias and discrimination among healthcare providers contribute to these poor outcomes. AIAN parents are more likely than white women to experience discrimination and delays in care. They also often see a different provider each time they attempt to access prenatal care, denying them the benefits of care continuity. Studies also show that 29 percent of AIAN women report experiencing discrimination when going to the doctor or a clinic, compared to 17% of white women.
Access to high-quality care
Accessibility is a contributing factor to many of the poor maternal health outcomes experienced by Indigenous people.
A large portion of AIAN members receive healthcare through the Indian Health Services (IHS), which is significantly underfunded. A federal report found that the IHS's 2022 budget—close to $7 billion—funded less than half of what patients needed.
As a result, many people aren't able to access the care and services they need before, during, and after pregnancy, which has devastating effects on birthing parents and their babies alike. AIAN women are three to four times more likely to begin care in the third trimester, which can lead to increased risks and complications during pregnancy.
Studies also show that 21 percent of AIAN women of reproductive age (15-44) are uninsured, in contrast to just 8 percent of white women. The lack of insurance often serves as a barrier to accessing timely and quality care, exacerbating the maternal health challenges faced by this population.
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