A Model of the Determinants of Maternal Mortality for Indigenous Women

Abstract

Aims

To present a model of the determinants of maternal mortality for Indigenous women—social, structural, political and biological.

Design

Non-Indigenous academicians and an Indigenous tribal citizen and scholar partnered to amplify Indigenous women's voices.

Method

With epistemic decolonisation and Indigenist feminism as our theoretical basis, we used theory derivation to create a model of the determinants of Indigenous maternal mortality.

Results

Risk factors include biological warfare and ongoing cultural genocide. We also identified protective factors like resilience and cultural connectedness. Finally, we illustrate complex and multifaceted relationships among and between these concepts in a model of the determinants of Indigenous maternal mortality.

Conclusion

Solutions that address determinants of Indigenous maternal mortality are critical for Indigenous families to flourish. Academic researchers and tribal communities must continue to partner to support the safety and vitality of Indigenous women.

Implications for the Profession

Our model can inform nursing and other research, including interdisciplinary research, policy development and trauma-informed, culturally relevant clinical practice to address disparities in maternal mortality that Indigenous women experience.

Impact

Despite increasing attention to the United States' maternal health crisis, stark disparities persist between groups of women. At its peak in December 2021, Indigenous maternal mortality was 118.7 deaths per 100,000 live births—the highest of all groups, and almost 5 times higher than that of their White counterparts (26.6).

Reporting Method

Not applicable.

Patient or Public Contribution

Three members of the public who identify as Indigenous agreed to review and comment on the model specifically from their Indigenous lens.