Native American women are more likely to die during or shortly after a pregnancy than other American women, says a new report issued by the Centers for Disease Control and Prevention (CDC). The new findings reflect the first time ever that the CDC has looked at pregnancy-related mortality among American Indians, Alaska Natives, Hispanics and Asian/Pacific Islanders.
Between 1991 and 1997, 3,193 women of all races died of pregnancy-related complications in the United States. This translates into an overall ratio of 11.5 deaths per 100,000 live births. During that same period, the ratio among white women was 7.3. In contrast, the ratio among American Indians and Alaska Natives was 12.2.
The CDC report does not identify why there is such a disparity between ethnic groups—“That’s the $64,000 question,” says Katie Baer at the CDC in Atlanta—but several culprits are suspected: higher rates of poverty, less access to health care, lower rates of insurance coverage, and language and cultural barriers to pre-natal care.
In Montana, Native Americans have the highest rates of teen pregnancy, sexually transmitted diseases and drug and alcohol abuse, says Kitty Felix, case manager for health services at the Missoula Indian Center. Felix says that for both historical and cultural reasons, Native American women can be reluctant to seek out prenatal care, or tend to do so later in their pregnancies.
“The more traditional people who live on the reservation are very private and very distrustful of the government in general, but of Indian Health Service in particular,” says Felix.
The reasons for this are varied, she adds, though back in the 1940 and ’50s, one doctor in Browning was known to have given many Indian women hysterectomies, whether they needed one or not.
“The saying up in Browning is, you don’t go up to a hospital unless you want to die,” she says.
But if improving education among Montana’s minorities might seem like part of the solution, the recent legislative session shows that policymakers prefer to keep their focus on abstinence-only programs. Montana ranks ninth in the nation in teen pregnancy, with a rate of 43 pregnancies per 1,000 teenaged girls. Nonetheless, there is no state requirement that Montana schools teach sexuality education or sexual health. This session, Rep. Tom Facey (D-Missoula) sponsored a bill that would have required the Office of Public Instruction to verify that all sex education curricula taught in schools include only medically accurate information. That bill died in committee.