Native American Identity

Long time no hear!  I have had the pleasure of being interviewed by the daughter of a collogue of mine for a paper she was writing. After reading it, I thought it would be a great topic for this blog.  I think she does a great job of discussing the topics of White Public Space, Indexicality, and Native American Identity. At which it is the title of her paper.  Obviously you will find one "Mindy" sounding pretty close to someone you know.  I like what she has to say in this little quote 

"An individual can be both "too Indian" to function in a white space and "not Indian enough" at the same time.  Native Americans have to meet certain expectations when dealing with white people in white public spaces, but, as these expectations are primarily defined by white people, there is an entirely different set of expectations in interacting with other Native Americans."

Katie is a chemical engineering major at the Colorado School of Mines who has plans to continue on for her PhD in Archeology and this is what she had to say....





White Public Space, Indexicality, and Native American Identity

Introduction

I am one eighth Absentee Shawnee. Every year, even though I am not enrolled in the school, the University of New Mexico offers me scholarship money because I am an Indian. When I was in elementary school I got to bring in authentic Indian artifacts for show and tell as a symbol of my Native American heritage. I live in New Mexico where I am exposed daily to Native American cultures. But that is the extent of my involvement with the Native American aspect of my identity. I do not feel like I can truly call myself Native American. The fact that one eighth of my ‘blood’ is Absentee Shawnee does not mean that I know anything about the culture of the Absentee Shawnee people. I have not lived with them or suffered with them. I can walk down the street without arousing even the slightest suspicion that I have Native blood. I am guilty of having what is known as ‘white privilege’ even as I, with my Certified Degree of Indian Blood (CDIB) card, have access to the very resources intended for those without this privilege. In searching for a job or applying to colleges I can claim to be not only a woman, which makes me a minority in the STEM fields, but a Native American as well because, according to my CDIB card, I am Absentee Shawnee. In dealing with landlords, professors, or any authority figure, I have never had to worry if I am being discriminated against due to my Native blood because I look, dress, and act white. What does it mean that I can change who I am, that I can choose which parts of my identity are emphasized, to fit the circumstances in which I find myself? This practice of changing identity is known in anthropological circles as a reframing of identity. My goal in writing this paper is to examine the ways in which reframing, in the ‘specific’ case of Native Americans, contributes to which aspects of identity are made salient during any given interaction.

            The word specific above is in single quotes because “Native American” is not very specific at all. The term “Native American” conjures up images of feathered headdresses, teepees, and medicine men dancing around a fire. The words invoke a romantic and stereotypic ideal of a downtrodden indigenous people that suffered through the destruction of their beloved homeland at the hands of the white man. But what these words definitely do not encompass is the wide range of cultures that comprise the groups of people that lived here before the Europeans arrived. Author Lila Abu-Lughod, in her article “Do Muslim Women Really Need Saving? Anthropological Reflections on Cultural Relativism and its Others”, points out the dangers of homogenizing any group of people. Even within a group of very similar individuals there is always variation in values. Categorizing all 565 federally recognized tribes in the United States using only one term is homogenization on a very large scale. In my paper I am going to analyze reframing of identity as it pertains to Native Americans. Unfortunately it is not within the scope of my work to fully analyze a single particular tribe; nor can I analyze even a fraction of all the tribes in the United States, let alone the entirety of the Americas. The tribes that are specifically included in my analysis in order to develop my argument include the Sioux Indians, the Navajo Nation, the Poarch Band of Creek Indians, and the Seminole Tribe of Florida. While I understand that my findings will not reflect any particular tribe nor can they accurately reflect the situation of the entire group of Native American people, I believe that the data I have chosen can be used to make comparisons and establish general trends. I do not intend to misrepresent a very diverse group of people by analyzing only a handful of them; however I will use the term “Native American” throughout my report because I am analyzing general patterns and because using one term is much more succinct than listing all 565 federally recognized tribes.

Theory

            In order to paint a complete picture, I am going to define several terms that will appear throughout my paper - first, identity. Identity, to borrow from Bucholtz and Hall (2005), is “the social positioning of self and other” (p.2). Identity is important only because of the impact it has on interactions with the other. It is a very fluid concept that incorporates pieces of all of the aspects of an individual’s life. The idea that identity is dynamic rather than fixed makes it essential to establish the context in which taking advantage of this feature, or reframing, becomes necessary.

This leads me to the white public space. Jane Hill develops this concept in her paper “Language, Race, and White Public Space” as “an arena in which …disorder on the part of whites is rendered invisible and normative, while the …behavior of members of [minority] populations is highly visible and the object of constant monitoring” (p.6). In other words, a white public space is an arena of interaction between two groups in which whites, with their invisible privilege, can act however they wish without any fear of social reprisal, but where members of minority groups face negative repercussions for any deviance from expected behavior. In such a space, acceptable behavior is defined by whites. In the United States most, if not all, interactions between the majority and minority take place in a white public space. This may not be a conscious decision on the part of the interactants but it tends to be inevitable because the creation of a white public space is often invisible to the white participants.

Cultural capital, as it will be used in this discourse, is what allows individuals to succeed in white public spaces. Philippe Bourgois, in his article “Workaday World – Crack Economy”, examined the motivations behind the creation of a crack economy in Harlem. He found that most of the cocaine dealers he spoke with actually preferred legal work but they felt that they could not find a place in corporate America due to their lack of the requisite cultural capital. Not only were their living conditions and educational opportunities a world apart from those of their white counterparts, but they also felt that the opportunities they did have forced them to reject some of their cultural values, especially their dignity. Gaps like these, gaps which would seem to be insignificant in the grand scheme of things, have forced cocaine dealers into choosing between working outside the law or accepting demeaning positions that force them to participate in a white public space. This discrepancy between the cultural capital that a group possesses and the cultural capital required for success in white public spaces, the same discrepancy that leads to reframing, is reinforced by indexicality.

            An index, much like the index finger on the human hand, points from one object to another. The classic example is smoke as an index of fire. If there is smoke, it means that there is a fire. Indices are not the same thing as stereotypes. Stereotypes do not have to be, and rarely are, based in fact. Stereotypes index a society’s belief about another group of people. The stereotype that all New Mexicans speak Spanish or that we need green cards to travel to other states is an index of the popular belief that New Mexico is comprised mainly of illegal immigrants.

All of the anthropological definitions discussed so far do not have any purpose except where they are used in analyzing people. I am going to examine some of the ways in which these definitions impact the identities of Native Americans.

Historic Interactions

            Historically, relations between whites and Native Americans have been conducted from a platform that reflects white beliefs in their own superiority. There was a sense of duty: whites must educate the backwards Indian and save him from himself. This ‘white man’s burden’ was used to justify many of the historic interactions between the whites and the Native American tribes. These historic interactions set the stage for the development of a white public space. The wants and needs of any society are culturally defined. As put by Ruth Benedict, in her book Patterns of Culture, “Each [culture,] from the point of view of another [culture,] ignores fundamentals and exploits irrelevancies” (p.24). Thus some character trait or behavior that is highly valued by one group of people may be of next to no importance to another group of people. The institution of poll taxes is a clear example of this concept as it pertains to my research question. Native American tribes were self-sufficient and independent. They could get whatever they needed from the land that they lived on. By demanding a poll tax, the white settlers forced the tribes to change their lifestyles. Not only was the concept of money distinctly European, but the skills needed to acquire it favored European cultural capital.

The shift in focus from things that Native Americans were good at, areas where Native American cultural capital was extremely valuable, to an arena dominated and dictated by white men, an arena where the only cultural capital of import is that of the white men, led to the devaluation of Native American cultures. Poll tax is not the only instance of forced societal change in a way that privileged white skill sets. Rather than changing the demands of the white public space to appreciate the cultural capital of minority groups, Native Americans were sent to boarding schools and forced to speak English in an attempt at assimilation. The goal of such measures was to equip Native Americans for success in interacting in white public spaces by eliminating every trace of their culture.

Expectations

            White public spaces operate based on behavioral expectations. In other words, an individual can only interact in a white public space if they operate within acceptable behavioral boundaries. More often than not, these acceptable boundaries are defined and reinforced by whites, although they can also be defined and reinforced by Native Americans themselves. Jessica Cattelino has written several papers on the subject of casino gaming in the Seminole nation. She has found that the Seminole nation is caught in what she calls a “double-bind”: the Seminoles have become relatively wealthy as a result of gaming, but white expectations are that Indians are supposed to be poor. Since the Seminoles have defied that expectation there has been a push to terminate their federally recognized status as a Native American tribe, the very status that allows the tribe to operate casinos in the first place.

Kelly Fayard conducted research among the Poarch Creek Indians during her examination of the role that blood quantum plays in defining Native American identity. She found that, to the Poarch Indians, “defining someone as ‘Indian’ had less to do with a Certified Degree of Indian Blood (CDIB) card than with the way in which they acted or looked” (p. 82). Specifically, “what draws the people together [is] discrimination” (p. 82). The Poarch Creek Band of Indians expect other Indians to be discriminated against. A lack of discrimination is indicative of a non-Indian status.

Peggy Wilson looked at the academic performance of Sioux Indian high school students. She points out the many structural and cultural barriers that prevent Sioux students from achieving the academic success of which they are capable. These barriers range from the physical layout of non-reserve classrooms to the racist remarks of white students. One Sioux student observed that attendance policies that were lax when a white student missed class were suddenly strictly reinforced when a Sioux student missed class (p. 375). These very real, but overlooked, issues create the expectation on the part of non-Native faculty members that the Sioux students are actually incapable of reaching the same educational standards expected of white students. Expectations on the part of white teaching faculty create a white public space in which Sioux students are ill-equipped for success. Rather than accounting for the difference in cultural capital, Sioux students are held to the same, or sometimes higher, standards as white students and are punished the moment they fall short of those standards. These expectations are clearly communicated to the Sioux students and, in response, many do not try to fight an unfair system: they drop out of school. This reinforces the expectation that Native Americans are not capable of obtaining a high school education, which in turn eliminates any possibility of removing cultural barriers, which means that Sioux students have to struggle to develop the correct cultural capital, which means that they have a harder time than white students, which means that faculty expect less of them and treat them as less than, which leads them to drop out, and so on. Wilson summed it up nicely: “Low expectations become a self-fulfilling prophecy” (p. 379).

Stereotypes and Indexicality

In all of this talk about expectations and white public space, I have yet to touch on stereotypes. As stated in the theory section, stereotypes index the naturalized associations that one society forms about another. In other words, stereotypes about Native Americans index white beliefs about Native Americans. They reinforce the expectations that lead to white public spaces. There was a recent controversy that reflects the power of indexicality. No Doubt recently released a music video for their song “Looking Hot”. In the video lead singer Gwen Stefani and bassist Tony Kanal are depicted as Native Americans that are captured by the other band members, who are depicted as cowboys. Many of the complaints against the video had to do with its generic nature. The clothing, behavior, and symbols used in the video did not reflect on any one particular tribe but rather represented white ideas of what Indians are, namely that they are not white. This stereotype indexes the white belief that Native Americans can be lumped together into one large group of non-whites. As discussed earlier, this view is inaccurate. Unfortunately it plays a large role in white public spaces. The uniqueness of each tribe is often overlooked in Government policies even as the differences between “Indians” and whites are emphasized.

Another example is embodied in the phrase “off the reservation”. This phrase is often used when talking about some action or thought that is viewed as completely crazy. Not only do the words themselves imply that Native Americans belong on reservations, but the concept serves as an index of white beliefs that it would be irrational for there to be a space for Native Americans in mainstream white society. The term “Indian giver” is applied to individuals or groups that give a gift and then take it back. This term could be an index of white beliefs that Native Americans are unwilling to share, which leads to ideas like those propagated by Governor Ratcliffe in Pocahontas when he refused to believe that the Natives had no gold. On the subject of Pocahontas, popular media has constantly indexed white beliefs that all Native Americans are spiritually connected with the land and, being so involved, are unwilling to fully exploit their resources.

Indexicality serves as a constant reminder of the expectations placed on Native Americans and their role in the white public space. They must be in tune with the Earth, as exemplified by Pocahontas when she teaches John Smith to “paint with all the colors of the wind”. They must be generic, as perpetuated by media like “Looking Hot”. They must accept the idea that they belong on reservations, as indicated by the catch phrase “off the reservation”. But most of all, they must not expect to find a place in white public spaces if they do not meet indexed expectations. Perhaps the concept was put best by Vine Deloria in his book Custer Died for Your Sins: “…the Sioux were presented with an authority figure who bemoaned the fact that whenever he visited the reservations the Sioux were not out dancing in the manner of their ancestors. In a real sense, they were not real [Indians]” (p. 87). White expectations were that the Sioux lived just as their ancestors did; that their culture is static. When the Sioux do not fall into that neat category, when they gather the cultural capital to make a stand in white public space, their status as Native Americans is denounced, both by whites and by other Indians. This is where reframing comes in.

Reframing

            All of the previous discussion has been building towards a single idea: an individual can be both “too Indian” to function in a white public space and “not Indian enough” at the same time. Native Americans have to meet certain expectations when dealing with white people in white public spaces, but, as these expectations are primarily defined by white people, there is an entirely different set of expectations in interacting with other Native Americans. These Native American expectations were briefly touched on earlier in the discussion about Kelly Fayard’s work, but I do not feel knowledgeable enough about Native American cultures to outline them as I have done with white expectations and indices. Likewise, I do not wish to reduce my conclusion to broad assumptions based on the very indices that lead to reframing in the first place. Since I, as stated in the introduction, am not a Native American and I cannot therefore evaluate instances of reframing in my own life, I decided that the best course of action would be to interview an individual who is intimately familiar with the situation from the perspective of a Native American. In order to answer my research question I interviewed a Navajo woman to whom I was introduced through a mutual acquaintance. For the sake of anonymity I am going to refer to my interviewee as Mindy.

            I do not want to be guilty of one of the things that Vine Deloria criticizes anthropologists for: seeing what I want to see. At the same time I struggled with asking neutral and non-leading questions that would provide the answer to my research question of their own volition. Being a novice in the art of interview, I hope that I have achieved some balance between the two extremes, however I would caution the reader to remember that the following is my, probably very biased, interpretation of another complex individual’s life and that I may have taken some key response out of context in a way that negates the spirit in which it was given. If that should be the case, I apologize to my source. It is not my intention to misrepresent her in any manner; I am extremely grateful for her assistance. With that being said, after two email interview sessions I have found several instances of reframing in the context of a white public space in Mindy’s life.

            One of the things Mindy spoke about was her upbringing and her challenges in ensuring that her children are raised differently than she was while remaining appreciative of their positions in life. These challenges include instilling in her children a knowledge of their Navajo heritage. She talked about some of her difficult childhood experiences and how she simultaneously wants to “show them how lucky they are without exposing them to the pain” that she and her husband faced growing up. She pointed out that her children only see the struggles that are part of the lives of most Native Americans in the media or through their parents’ stories. Mindy also mentioned that it is difficult for her to teach her children about their Navajo heritage because they do not live near the reservation.

            Mindy is married to a man form San Ildefonso Pueblo. Being Navajo herself and working and living in a white public space, Mindy has to navigate between the expectations of three very different cultures on a daily basis. We had a brief conversation about her experiences working in a white public space and the different responses she got from the people in her life. Mindy said that her “own Navajo family has always pushed education to better us and to pursue [a] better way of life, so they have always been supportive” of her decision to find employment. On the other hand, her husband’s family “doesn’t ask about [her] work, and generally views [her] career as ‘selfish’ and not being very motherly”. This view is the exact opposite of that held in the white community, namely that it is selfish to stay at home and focus on being a parent. In order to even obtain a job in the white public space, Mindy had to get a higher education. Since she lives closer to her husband’s family, this meant that she “had to ask for them to help support [her] husband and 3 children” while she attended school. Traditionally, her husband’s Pueblo is patriarchal. His family’s disapproval of Mindy’s educational achievements is an index of the patriarchal nature of the Pueblo.

            Mindy works as a women’s health care provider. She described some of the ways in which her occupation in the white public space interacts with her Native background. She specifically mentioned the role of traditional ceremonies and dances: “When someone dies, they hold a 4 day event and they choose cooks for the event. In the Tewa or Navajo tradition, when you are asked to do something like this, even to participate in a particular dance, you can’t turn it down. So whatever outside job you have, you basically have to take time off to attend to your Native traditional doings.” In a white public space that does not recognize something even as universally necessary as maternity leave, taking time off to attend to important ceremonies is likely not encouraged, and yet this is an integral part of Mindy’s identity as a Native American. In another instance, Mindy talked about some of the ways that she combines traditional Navajo beliefs with her job. She prays “with [her] corn meal prior to going into work to have a clear mind” and she “care[s] for women in a way that aligns with …traditional [Navajo] teachings of thinking, speaking, and acting in a positive manner”. I believe that this is an instance cultural hybridization: Mindy is not hiding or diminishing her Navajo identity, nor is she hiding or diminishing her scientific education. Rather she is blending the two together to create a new public space; one in which the beliefs and expectations of Native Americans bear just as much relevance as the beliefs and expectations of whites.

            Essentially, Mindy has to maintain her identity as a Navajo woman while socializing in an environment dominated by Pueblo expectations and working in a white public space. Thus, when Mindy goes to work, although she is still a Navajo woman, she is primarily a health care provider. When she visits her husbands’ family, she is primarily a woman. When she is teaching her children about their heritage, she is primarily a Navajo. All of these are very subtle instances of reframing of identity.

Conclusion

            I examined reframing of Native American identity in light of the creation of white public spaces, indexicality, and expectations. In order to do this as accurately and objectively as possible, I interviewed Mindy, a Navajo woman. Through my interaction with her I learned that identity reframing does indeed occur in the daily lives of Native Americans. While the work I have done here is by no means conclusive, I have found that the reframing of Native American identities brings historical interactions, white expectations, Native American expectations, and stereotypes together in a very complex way. Simply stating that a Navajo woman acts differently at home than she does at work in a white public space does not do justice to the forces at play within Native American cultures and interactions with white public spaces. Unfortunately, I do not have the skill set to perform a more complete analysis.

Bibliography

1.      “Anthropologists and Other Friends”. Vine Deloria. Custer Died For Your Sins, Chapter 4, pp. 78-100.

2.      “Do Muslim Women Really Need Saving? Anthropological Reflections on Cultural Relativism and its Others”. Lila Abu-Lughod. American Anthropologist, Vol. 104, No. 3 (Sep., 2002), pp. 783-790. American Anthropological Association.

3.      “Identity and interaction: a sociocultural linguistic approach”. Mary Bucholtz and Kira Hall. Discourse Studies, Vol. 7(4-5).2005. pp. 585-614. SAGE Publications.

4.      “Language, Race, and White Public Space”. Jane H. Hill. American Anthropologist, New Series, Vol. 100, No. 3 (Sep., 1998), pp. 680-689. Published by: Wiley on behalf of the American Anthropological Association

Article Stable URL: http://www.jstor.org/stable/682046

5.      “‘Out here we just thought everybody who was part of our family was Indian’: Race and Indian Identity in Poarch”. Kelly Fayard. Kinship and Blood Quantum, Chapter 4, pp. 82-106.

6.      “The Diversity of Cultures”. Ruth Benedict. Patterns of Culture, Chapter 2, pp. 21-44 (1934). First Mariner Books, 2005.

7.      “The Double Bind Of American Indian Need-Based Sovereignty”. Jessica Cattelino. Cultural Anthropology, Vol. 25, Issue 2 (2010), pp. 235-262. American Anthropological Association.

8.      “Trauma of Sioux Indian High School Students”. Peggy Wilson. Anthropology & Education Quarterly, Vol. 22, No. 4 (Dec., 1991), pp. 367-383. Published by: Wiley
Article Stable URL: http://www.jstor.org/stable/3195660

9.      “Workaday World – Crack Economy”. Philippe Bourgois. Conformity and Conflict. (2000), pp. 172-180. Published by: Boston: Allyn and Bacon.



My Worlds Collide

             

                 Many times over my Native traditionalist perspective and life not only crosses paths with my very modern one, but they often collide.  You all hear me talk all the time about merging these two perspectives and ways of living, not easy by the way.  I am left wondering, does it ever get any easier?  As things are ramping up with the birth center, my time has become more and more limited.  Gone are the hours to write, read, and sort through the many ideas that float through my mind.  Hello schedule!  Thankfully, I have had the wonderful opportunity to be apart of some amazing talking, planning, and thinking sessions.  Let me tell you, there is some amazing work being done in Native American communities.  It's nice to know that I am in good company and that somehow this network of innovative thinkers and doers have welcomed me with open arms. However, now is the time to leave the talking aside and put these ideas on the ground.

           It is here that I find myself, after months of talking up a storm about traditional birth practices, merging traditional healing ways and knowing, and developing a wellness model, the time has come to do it.  However, my problem now is my time is so limited.  I'm actually in the process of writing a grant to support future talking circles and to aid in the development of this wellness model that is so needed.  I find myself serving on several health boards and student development boards, but I am also being pulled away from the work that really matters to me.  This too, I will have to eventually find a balance.  

Our elders call this "Hózhó" which translates into living in a manner that works towards creating and maintaing balance, harmony, beauty, and order. 

               This is actually a central thread of Navajo philosophy and a way of life I strive to live by.  However, straddling the two worlds and it feels at times, time zones is not easy.  I yearn to spend time with a traditional Navajo healer, learn more of my traditional language and songs, as well as spend time discussing our life ways.   Time is precious.  I think eventually I will give myself up completely to this way of life, I just wonder at what point when this will occur and when will my teacher be revealed to me.  If you want to know my happy place, it is when the sun is rising, I have my corn meal in my right hand, and my silent prayer to the holy people is being whispered into the early morning sounds of a new day.  It's not the idea of power, money, influence, or any of those egotistical signs that you as a professional have made it.  This still continues to be a misunderstanding for those who don't know me well, I use my education to make a difference and hopefully to assist in bringing people together.
                 On another note, I often wonder if I will be able to continue to keep up this blog.  I'm committed to sharing my experiences with a wider audience, however I hope to eventually pass this onto another  Native woman and possible midwife.  If there is anything I have learned, I can't possible shoulder this alone.  Furthermore, it's time to starting doing, rather then planning to do....

Transforming Our Communities Through Women's Medicine

                  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. 

Weaving New Threads

            Well it’s been about two months since I’ve last posted anything.  I don’t know about you, but there has been a lot going on.  In my personal life and in my professional one.  However, the point of this post is not to discuss either in to much detail rather to shed some light on a few current issues.  Much to my dismay, I’m still commuting to Albuquerque weekly and sometimes more, for work.  For those of you reading this blog who are not familiar with New Mexico, it is generally a very rural state.  Most of the employment opportunities for certified Nurse Midwives is in Albuquerque, the opportunity for us to branch out to work in the rural parts of the state are limited. As it stands, Los Alamos does not have a Nurse Midwife at its hospital, Espanola Presbyterian hospital does not have a Nurse Midwife at its hospital.  Santa Fe does have 3 three nurse midwives working with two practices to provide full-scope midwifery care to the community, however this relationship is still at the beginning stages and currently they are not at a place to where they can expand their nurse midwifery care services.  The Santa Fe Indian hospital does not offer Nurse-Midwifery care and the women who receive care at this setting will have to transfer their care to a surrounding practice at 30wks. 

            To further compound this issue, when the possibility to work as a full-scope nurse midwife close to home did present it’s self to me, the details of a work agreement is what had me saying “no.”  My question to you is, how many nurse midwives sign contracts that have non-compete clauses and line items stating that if they left the practice they could not work within a certain millage of the practice for a number of months, after leaving.  To me, this is what limits providers from opening practices and setting up healthcare delivery clinics in rural settings. 

            From the business end, I am told that the clinics are protecting their investment and on the side of providing care to women in rural NM; they are actually monopolizing the care of women.  Ok, now I’m going to give you my Native perspective on this way of thinking and doing things.  As a Native American, the thought of signing my rights away from working in an area that has historically been our stomping grounds is offensive.  By monopolizing who can care for women in rural settings by requiring providers to sign these contract agreements, is only compounding the issue of access to care rather then addressing it.  This western way of thinking that business is business is what got us into this mess to begin with.

            You can imagine that the homebirth midwifery community is booming in this area, because there are not enough OB’s or Nurse Midwives to care for this community of women in hospital settings.  I don’t think that the shift from hospital to home birth is a bad thing, but rather another option presenting itself.  However, my point is, women have to have access to birth services and right now that is a major issue. Based on the 2010 census for Rio Arriba County, the approximate population is 44,000, 31% of that population is younger then 19.  16% identified themselves as being Native American, 71.3% Hispanic, and 12.8% white non-Hispanic.  19.7% of the 44,000 are living below the poverty level. 

            According to the 2009 PRAMS report, NM ranks last in the country for recommended levels of prenatal care, which means women are not accessing prenatal care early enough and are receiving less then 5 prenatal visits during their pregnancy.  Why does this matter? This contributes to low birth weight and preterm birth weight babies being born in New Mexico.  So what were the identified barriers to prenatal care, 1) Could not get an appointment; 2) Did not have enough money or insurance; 3) Did not have a Medicaid card.

            Obviously, there is need here for birth services and women’s health.  However, what I’m finding is that there are many barriers for midwives who are interested and invested in setting up alternative healthcare delivery system.  For one even though the concept of birth centers is not new, how and who regulates them is.  As it stands the current birth centers here in NM are running into problems with insurance reimbursement.  Insurance companies reimburse hospitals and practices for the provider who provided the birth serves and they also get reimbursed for the facility that these birth services take place.   Some insurance companies are not reimbursing the birth centers for the facility that they are providing birth services in.  This lack of reimbursement from insurance companies actually makes it harder for birth centers to provide services. 

            So what is a rural midwife like myself to do?  Developing a new way to care for women in my rural setting takes time and defiantly sacrifice.  I’m feel blessed to be working with a team of motivated women who all see the writing on the wall and continue to hack away at the cement wall that years of bureaucracy, business deals, and policy have built to keep innovative thinkers from thinking outside the box.  All I can do is say my morning prayers, stay the course, and make sure my morals remain true to the beautiful birth center that is growing into a reality…Blessings.

Cultural Context of Woman

      There are special times in each woman's life when she no longer is the girl, but is asked to step up and be a woman.  I am thankful that in the cultural context of girls becoming women, we have our ceremonies to help us be molded in the image of changing woman.  Our responsibilities as care takers of our families are laid out for us in song, in prayer, with chanting, with women singing together in praise of the path we will soon have to walk.  I want to share a moment with you that I had a couple of weeks ago.  I think it is a great representation of the transference of knowledge and responsibility.

      "As I stood facing the East watching the bright orange light come over the horizon, I was thinking to myself, wow what a beautiful sunrise, I can see why the early morning is a woman's time to pray for blessings and to pray over the water.  In our teachings, life begins in the east, woman are a representation of life, and it is our blessings that bring hope, love, charity, and happiness to our families.  I stood there holding my prayer feathers on my right hand and my shawl hanging over my left shoulder.  I raised my prayer feathers four times to the East to bring blessings to the water that would soon be shared by all in that prayer meeting...."

       My mom usually brings in water for our family peyote meetings, but for this one special occasion she had asked me to bring these wonderful blessings to our family.  As a daughter and mother, I felt a great sense of knowledge and responsibility being passed to me by my mother.  I have actually had the pleasure of bringing in water for our family meeting once before, but I don't remember it quite like this. After giving blessings to the water, I then bring it into the meeting and ask for blessings from the fire place.  When my mom used to bring in water, she would sit there looking beautiful in front of the fireplace and praying...and praying.  My brothers and sisters used to joke about how long our mothers prayer was, but now that I was sitting there in front of that fire place, the responsibility was placed on me to pray for  my whole family.  It was only then that I understood why her prayers were so long, because a mothers prayer is long and said with tears.

        I keep these moments close to my heart, because I feel like our true selves come out in certain circumstances and it seems like only in these moments do we get a glimpse of what we are here to do.  As a new and young mother I remember struggling with the new role I found myself in.  I think many women whether or not they are intentional in their efforts to become mothers, struggle with their own identities.  I am a woman before I am a mother or am I a mother before I am a woman?  I don't find these roles or identities mutually exclusive, rather they are a balance of individuality that is necessary for harmony.  In Navajo philosophy, the male and female aspects of our selves are necessary for harmony which allows for health, wellness, and balance.  It is when these elements are not balanced that we experience imbalance and become not well.  

        Going back to our cultural teachings surrounding roles, it is through our clan that the intimate relationship between mother and child is reinforced through the mothers clan.  It is through the blood flow of your grandmother and mother that allows you to know your mothers love.  And it is through her love that teaches you to love yourself.  We recognize that we have many mothers, like mother earth and water woman, it is understood they are all looking out for us, but it is also our responsibility to love and respect them.  You call them "Shimá" 

       As that it this the week to recognize the work that Midwives do, I thought it would be nice to talk a little bit about women and our roles as mothers and educators.  As midwives we too are mothers and educators and we have the pleasure of having a small piece in the very private exchange of a woman becoming a mother, a man becoming a father, and a families legacy expanding.  It really is a beautiful thing.

Blessings to You!

Reflections

              Perhaps because it is a cloudy and rainy day it is a good time for reflection.  It's been a busy summer with many projects pulling me in different directions.  I think its my restless nature that is a bit frustrated with the baby steps each of my projects are taking, but mostly likely that is the creator teaching me patience. We submitted a grant proposal to the National Geographic All Roads Seeds Grant, but have yet to hear anything about it.  The good news is that those who have not been selected for funding have already heard that they were not selected.  However, the deadline for the next round of grant proposals is nearing and I am left wondering whether we need to resubmit or not.  This film business is a whole new world for me, I recently attended a few film screenings during the Indian Market in Santa Fe, NM.  Boy, what a panorama of artistic talent!  I was happy and excited to meet the film makers, actors and producers of some of the films that were screened.  I also got to meet my producer Tracy Rector.   After many phone conversations, Facebook messages, and some computer face time, the world of computers left us and we got to meet face to face.  So glad we are both on board with this project.  She is just as excited about this as I am.
             As for the birth center, thanks to the dedicated women working on this project between meetings, things appear to be moving along nicely.  We have finally all agreed on a name.  The Breath of My Heart Birthing Place, in Tewa it is "Navi pin haa un muu " which means "you are the breath of my heart."  As that this will be a place where the baby takes it's first breath of life, I think the name is befitting!  We have also spent a lot of time on our mission and vision statement.  With many revisions and time, this is what we all finally agreed on.

Vision:  To attain greater community wellness through the growth and reclamation of birth traditions and practices in Northern New Mexico, by cultivating a nurturing an environment that welcomes all families’ cultural strengths, and Ways of Knowing.

Mission:  To bring to reality a sustainable birthing place that celebrates pregnancy and birth as a sacred rite of passage through midwifery care.  To raise awareness and promote wellness, growth, and healing in our multi-cultural communities by honoring woman as our first environment.

You can follow our progress at: http://www.bomhbirthplace.org/

             We are currently working on a logo and I am happy to say that I was selected as one of the board members.  We are in the process of adding additional board members and working on bylaws.  Basically the nuts and bolts of our birth center is being worked on right now.  I am also in the process of collected and learning about Pueblo traditional birth practices.  It will be an ongoing project for me and I hope to meet with each of the Northern and Southern Pueblos to talk about traditional birth practices.  This is a BIG task and an exciting one.  The first talking circle will be held in Tesuque Pueblo sometime this month.  I was blessed to have met with an amazing woman and elder who seems just as motivated as I am,  to see our traditional birth knowledge and language return to our communities.  I have to say, our last visit was very touching and encouraging.  After our visit I went home, burnt some cedar and prayed for more people like that to be placed in my path.
              She was a great reminder that our ancestors are always there and waiting to listen to our prayers and provide the healing knowledge to walk in a good way.  With my weekly and sometimes daily commuting to Albuquerque for work and other family matters; it is easy for it to weigh heavily on my spiritual needs and ability to connect with what is really important.  But it's people like her who help bring me back to center with what is really important. As that is what I am thankful for.
           My family and I recently participated in Corn Dance in our village and I definitely prayed for the strength, clarity and courage to move forward in a good way.  It is still a constant challenge to maintain a certain level of balance between work, family, and my spiritual needs as an individual.  As it is so easy to get caught up in the busy comings and goings of daily life.  So if anyone sees a young Native woman speeding down I-25 from Santa fe with my pow-wow music blasting in the early AM or very late PM..it could be me.  It seems lately the sunrise and the sunset have becoming my morning and evening blessings on my way to a busy life!..

My Midwife Advised....

               Have you ever worked in a fast food restaurant, high volume department store or hospital? More importantly have you ever worked at one of these establishments while pregnant?  I'll be honest and say that while pregnant with my last child I worked as a full-time labor and delivery nurse.  Fresh out of college and rearing to begin my career in nursing, it was during this time that I was quite surprised to find that I was pregnant with my third child.  Having experienced three miscarriages prior to this pregnancy I didn't hold out hope that this one would carry to term.  But low and behold, my son was a fighter from the start.  It was during this time that I was applying for labor and delivery positions near my home and I count my blessings that a small hospital near by took me under their wings, 6 months pregnant and all.  I had initially applied at another hospital close by, but I didn't get the job. However,  I did have the sinking feeling that my pregnancy had something to do with it. But this can never be proven, because discrimination is against the law....right?
               After starting my job, I didn't want to tell my co-workers that I was pregnant, for one I felt like it would be held against me.  Like I would be considered weak for acting tired and not working as hard as everyone else.  As I got to know everyone a little better, I revealed my little secrete.  All though I don't know who I was fooling, kinda hard to hide a 6 month old belly. What I remember of those first few months of working was that I was extremely tired after being on my feet for 12 hrs, sometimes I was to busy to take a break to eat a meal, and as soon as I came home I would lay on the couch with my feet up.  My back hurt and it usually took me a couple of days to feel rested again.  The demands of working as a nurse were sometimes out of my control.  I don't think anyone expected me to go all day without eating, that was up to me.  However, being short staffed and handling multiple tasks were not under my control. So I did what most women in my situation,  I pulled up my big girl panties and went to work.  To this day, my co-workers remember how hard I worked when I was pregnant, they say "you never complained at how tired you were, you just went all day like the rest of us."  I have to say, the woman in me was proud that I was able to work just as hard as everyone else, but I now look back and wonder why I risked the health of my baby to work so hard.
             I am sharing this story because I feel a bond with women who are pregnant and are working at fast food restaurants, high volume department stores and hospitals.  It breaks my heart every time I have to write a note to their employer asking for more frequent rest breaks, even most recently hearing that a friend of mine was not able to bring her own healthy meals to work because they were only allowed to eat food from the fast food restaurant they worked at.  I find that these places tend to be Walmart, Sonics, McDonalds, and even varies hospitals.  Some of these women are anemic because they are not getting the proper nutrients in their diet and some are underweight because they are working so hard.   Even after having their babies and now faced with returning to work breastfeeding will stop, because they don't have time to pump at work, they can't take the time to eat appropriately at work, or there is just no place to pump.
              Each of these encounters have me taking a closer look at NM labor laws and scrutinize what is in place. Furthermore,  knowing that what is in place is not good enough for pregnant women.  The midwife in me says "pregnancy is not a medical condition" but if you are pregnant and are working at a place where your pregnancy has to be treated like a medical condition to be treated humanly, perhaps something is wrong with where you are working.  Unfortunately, with jobs being scarce and businesses looking to get more bang for their buck, it feels humanity has gone out the window.  I am not sure what the answer is to this problem, I just know I am in a place to advocate for the women in my care.  I am also learning which establishments treat their pregnant workers well and which ones show no mercy.  These places need to be held accountable for the humane treatment of all their employees.