The 130th Annual Meeting of APHA

Abstract #40951

Geradine Simkins, RN, CNM, MSN, Perinatal Nurse Consultant, Birthways Midwifery, Inc., Michigan Inter-tribal Council, 275 Cemetery Rd, Maple City, MI 49664, 231-228-5857, gera@speedconnect.com and Elizabeth Knurek, MPH, Health Services Division, Inter-Tribal Council of Michigan, Inc, 3601 Mackinaw Trail, Sault Ste. Marie, MI 49783-9286.

Statement of problem/issue: Michigan’s American Indian babies die at a rate that is two-to-three times higher than the rate for White babies. In addition, the incidence of SIDS is three-to-four times higher. The MITC’s Healthy Start Project has provided an opportunity to explore and address some of the factors contributing to these disparities.

Methods: “Talking Circle” focus groups were held to collect qualitative data on how tribal women perceive the availability and quality of perinatal services, clarifying factors contributing to poor perinatal outcomes. Talking Circles focused on five key areas: perinatal services; healthcare education; access and barriers to care; cultural issues; and community MCH agencies.

Findings: By examining experiences of Native American women several themes emerged that may be factors in compromised MCH health. The central theme is the desire for access to culturally appropriate, high-quality care. Descriptions of the health care systems serving reservation communities included: rural practices, distance to providers, care rendered by family practice generalists, lack of access to specialty care providers and advanced care facilities. Additional themes included a desire to access MCH care at Tribal clinics which would provide a sense of continuity and less fragmentation of services. Further, many participants stated that the home visits provided by the project’s Healthy Start nurses were highly valued, and often were the only source of information, guidance, and social support related to pregnancy, postpartum concerns, and infant care. Talking Circle participants identified three favored models of care over the current biomedical model: traditional Native American healing practices; the midwifery model of care; and public health models.

Learning Objectives:

• 1) Learn a method of culturally competent qualitative research which serves as a data collection and analysis method and as a healing intervention for participants.
• 2) By listening to the stories of Native American women, gain an understanding of systemic factors that may contribute to poor perinatal outcomes as well as models of care that may contribute to better outcomes.

Keywords: American Indians, Maternal and Child Health

Related Web page: www.itcmi.org

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Michigan Inter-Tribal Council
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Consultant