New Resources Support Maternal Health For American Indian And Alaska Native Communities


This Native American Heritage Month, the Centers for Disease Control and Prevention (CDC) is launching a suite of new maternal health resources for American Indian and Alaska Native (AI/AN) communities to raise awareness of urgent warning signs during and after pregnancy.

A good measure of a country’s health is how well their systems and communities are taking care of their expecting and new mothers. While the maternal mortality rate decreased globally from 2000 to 2017, the United States (U.S.) continues to find itself struggling. In 2020, the U.S. experienced a rate of 23.8 maternal deaths per 100,000 live births –up from 2018 and 2019 and one of the worst in the developed world.

The maternal death rate for American Indian and Alaska Native (AI/AN) women is consistently higher than the U.S. national average, and AI/AN woman have a higher prevalence of postpartum depression (14%-29.7%) when compared to the U.S. average (11%). The disparity demands action. Mothers are the carriers of life and hold a sacred place in our societies, with this role being even more revered in many AI/AN cultures. People who are pregnant and postpartum must be given the necessary care and attention to fulfill this role, and their voices must be heard. They can tell the stories of their bodies, and we need to listen.

In 2020, the CDC launched the Hear Her campaign to help women and communities keep mothers and babies healthy by listening to each other, encouraging women to speak up and raise concerns, and connecting with help when needed.

Given the disparities that American Indian and Alaska Native people experience, CDC recognized the importance of developing culturally appropriate resources for AI/AN audiences and met with partners at the National Indian Health Board (NIHB) to discuss needs and considerations for serving AI/AN communities. AI/AN cultures have distinct ways of talking about pregnancy, and AI/AN women have unique experiences with medical systems and traditional care.

CDC listened and in January 2021 issued a “Dear Tribal Leader Letter” to inform Tribal leaders across the nation of its intention to develop resources to serve AI/AN communities. Since then, the Hear Her team has been connecting with Native women to learn about their experiences with pregnancy-related complications, including accessing care, managing their own health and wellbeing, and connecting with their families, friends and communities. These experiences helped to craft new culturally resonant messages, testimonial videos and resources which are now being launched through the Hear Her campaign.

The project is supported through a partnership and funding from the U.S. Department of Health and Human Services, Office of Minority Health as well as partnership with the CDC Foundation, with support from Merck through its Merck for Mothers Program. The Hear Her AI/AN campaign was also made possible by input and assistance from the National Indian Health Board as well as other American Indian colleagues and partners.

The new resources include:

  • Testimonials from five American Indian women who experienced pregnancy-related complications.
  • Conversation guides, palm cards and posters that help AI/AN pregnant and postpartum people recognize urgent maternal warning signs and get the care they need.
  • Materials to support healthcare professionals who serve AI/AN communities in their delivery of respectful, culturally appropriate care.

Although deaths related to pregnancy are rare, most are preventable. We lose too many mothers each year from complications related to pregnancy, especially within AI/AN communities. Mothers are sacred carriers of life, and we must do more to keep mothers healthy and safe by hearing their concerns and ensuring they get the care. The Hear Her campaign represents one important step to raise awareness about urgent maternal warning signs and help save lives.

Robert Foley, M.Ed., Senior Project Director working with the Hear Her AI/AN campaign.
Eric Strunz
Eric Strunz is a program officer, Noninfectious Disease Programs, for the CDC Foundation.