Each year, 700 women in the United States die as a result of pregnancy-related complications. In fact, the United States has the highest maternal mortality ratio of all high-income countries—16.7 maternal deaths per 100,000 live births. For Indigenous/Alaskan Native women, that number is even higher: Indigenous/Alaska Natives are 2.3 times more likely to die from pregnancy-related complications than their white counterparts. While recent years have seen growing national attention to the U.S. maternal mortality crisis, research and advocacy for Indigenous peoples’ maternal health in the United States has been limited. This research gap includes the Alaskan Native peoples—Iñupiat, Yupik, Aleut, Eyak, Tlingit, Haida, Tsimshian, and multiple Diné tribes.

“We need more Indigenous midwives,” said Claire Dion Fletcher, an Indigenous Potawatomi-Lenape Registered Midwife and co-chair of the National Aboriginal Council of Midwives (NACM), at a recent Wilson Center event with the United Nations Population Fund (UNFPA) and the International Confederation of Midwives about Indigenous midwifery. Globally, Indigenous women experience worse maternal health outcomes than non-Indigenous women. In the United States, risk of maternal death is twice as high for Native women than white women, while in Australia the risk is four and a half times higher.

“As we face a global pandemic that has taken the lives of more than 800,000 people as of right now around the world, we certainly have to recognize the particular impacts that that has had on women and girls and their lives,” said Rep. Chrissy Houlahan (D-PA), at a recent event hosted by CARE and UNFPA about the global impact of COVID-19 on women and girls. While women make up 70-80 percent of frontline healthcare workers globally, they have also been disproportionately affected during the pandemic by increased rates of gender-based violence, lack of access to sexual and reproductive healthcare, and economic and food insecurity.

“Achieving true progress on sexual and reproductive health and rights requires a comprehensive approach and a commitment to tackling deeply entrenched inequities and injustices of which marginalized communities continue to bear the brunt,” said Dr. Herminia Palacio, President and CEO of the Guttmacher Institute. She spoke at a recent Wilson Center event where speakers analyzed findings from the Guttmacher Institute on the state of sexual and reproductive health and rights (SRHR) globally.

“Reproductive justice is the right to reproductive health care, and the right to have children or not, the right to the healthiest possible pregnancy and birth, and the right to raise children in a safe and healthy environment. These rights will be challenged by climate change, including increasing temperatures,” said Linda Goler Blount, President and CEO of the Black Women’s Health Imperative, at a recent webinar on the intersections of environmental and reproductive justice on maternal health, climate change, and birth outcomes. The webinar was held on Juneteenth, the holiday commemorating the end of slavery in the United States, and many panelists’ remarks amplified the significance of the date. “Make this Juneteenth another beginning. One where we commemorate the end of climate injustice for Black and Brown people who bring life into this world,” said Blount.  

“The past months have been profoundly difficult for our nation, and for Black communities in particular,” said Representative Lauren Underwood (D-IL-14) at a recent March of Dimes event on the impact of structural racism on maternal health. COVID-19 has highlighted health outcome inequity caused by race and racism. Though Black people constitute 13 percent of the U.S. population, the CDC estimates they represent over 30 percent of COVID-19 cases.