I continue to have an ongoing dialogue about the importance and significants of increasing the number of Native American midwives to serve as innovators and ambassadors for their tribes. This process of reviving indigenous knowledge through midwifery, I feel, is vital to the growth and the vitality of our tribes. Unfortunately, this perspective of providing culturally appropriate care from an indigenous perspective is still poorly understood or respected from the medical community and yes..non-native individuals. When I discuss our health statistics and our struggles as indigenous peoples to non-natives, I am generally met with empathy, but rather our way of life and healing practices are not viewed as primary ways of healing, but are thought to be our "religion." When I try to explain further the importance of our culture and how it plays an important role in our livelihood, and more importantly that it is not a "religion," this to is still met with confusion. I further begin to explain the racial exploits of our history and how this has shaped how we view the medical community, the existence of hospitals, and our relationships with the modern world, suddenly they get offended. I don't view myself as a "racial" person, but rather I have a deep understanding of how historical trauma has played a role in my indigenous identity. I feel like these conversations are important to bridge the misunderstandings of our past and pave a healing path to our future, especially since the majority of Native American women continue to access healthcare delivery systems that do not reflect an indigenous perspective, but rather a liner hierarchy, with much importance placed on evidence based research and "proven" ways of healing.
Obviously, I am an educated woman and I understand the significants and importance for evidence based research, however I don't use it as a way to elevate my status in my community, more or less it's having this knowledge and being able to effectively communicate with the "other world" is where I see its significants. The interesting thing is, my status in my community is based on how often I participate in traditional ceremonies and my level of traditional knowledge and traditional meal preparation, not how many degrees I hold. This in itself is not well understood in the non-native community, because in this "other world" much importance is placed on ones economic status and ability to effectively support your views based on valid sources of "evidence."
In light of these misunderstandings and by continuing to work in what it feels like two very different realms, I see the importance of Women's Medicine. I would describe Women's Medicine by this; having a sense of community, understanding and respecting the balance between people and nature, being of good mind, seeing equal value in different tasks and ways of thinking, and understanding the mystery of life, spirituality, and our origins of life. Naturally, this philosophy of "being" is reflected in much of our spiritual and cultural practices, at which it is why I see it to be of much importance. Unfortunately, in relationship to our historical trauma, it seems our understanding and respect for Women's Medicine has been misplaced. According to the CDC the five leading causes of death in Native American women are heart disease, cancer, unintentional injuries, diabetes, and stroke. Additionally, Native American women are twice as likely to experience violent victimization by means of rape, sexual assault and physical abuse.
In reference to childbearing practices, Native American women are not accessing prenatal care in the first trimester, have high rates of smoking, and are more likely to develop diabetes during pregnancy as compared to the black and white ethnic groups. These childbearing health disparities between Native and White infants are related to higher rates of poverty, lower levels of maternal education, and limited use of prenatal care (Grossman, 2002). At which Native American women are at risk for poor childbearing outcomes like gestational diabetes, fetal alcohol syndrome, pregnancy induced hypertension, and large infants (macrosomic). Macrosomia, or babies born weighing more the 4,000 grams or 8 lbs 13 oz, are associated with excessive maternal weight gain and diabetes related to maternal obesity. These factors contribute to neonatal morbidity and injury like shoulder dystocia, cesarean deliveries, and maternal injuries.
Now that I've painted a picture for you, how do we begin to address these issues in our Native communities? Perseverance, innovation, and understanding our history as indigenous peoples comes to mind. Basically having an understanding that stress from social differences can have health impacts. These internal and external stresses accelerate the pressure to adopt unhealthy behaviors and further add in the deterioration of health in Native American women. Thankfully, the impact of historical trauma is well documented, but identifying contributing factors is only the first step of healing generations of trauma. By developing culturally based wellness and healing models to help women identify and in corporate positive coping practices, will we be able to start to make positive changes for the future. By encouraging Native American women to remember their healing medicine as a vital piece to healing their ancestoral trauma, will we be able to stop the cyclical transmission of intergenerational trauma. It is here that our work as midwives we can begin to make an impact to transform our communities.