Native Communities Lead Fight to Save New Mothers

Rhonda Swaney was six months pregnant when severe stomach pain sent her racing to the emergency room on Montana's Flathead Indian Reservation. Hours after a normal prenatal checkup, she delivered a stillborn baby and nearly died herself.

That was 50 years ago, but Swaney says Native American mothers still face the same inadequate care she received. The numbers prove her right.

In 2024, Native American and Alaska Native people had the highest pregnancy-related death rate of any major group in America, according to the CDC. The agency found that most, if not all, of these deaths were preventable.

Now Native organizations are taking action. They're joining state maternal mortality review committees and building their own panels to investigate deaths that happen during pregnancy or within a year after birth.

These committees do more than count losses. They analyze each case, track patterns, and issue recommendations to save future mothers.

Kim Moore-Salas co-chairs Arizona's review committee and leads its Native American subcommittee. A member of the Navajo Nation, she sees this work as protecting the heart of tribal communities.

"Our matriarchs, our moms, are what carries a nation forward," she said.

The CDC found that 68% of Native pregnancy deaths happen between delivery and one year postpartum. Most occur between 43 days and a year after birth, when many mothers have stopped receiving regular medical care.

The federal government promised healthcare to 575 federally recognized tribes through signed treaties. But the Indian Health Service remains severely underfunded and understaffed.

A 2024 study revealed that 75% of Native pregnant people don't have access to Indian Health Service care when giving birth. Over 90% of Native births happen outside IHS facilities.

For those who do deliver at IHS hospitals, care often falls short. A 2020 federal report found that 56% of labor and delivery patients received care that didn't follow national clinical guidelines.

The Ripple Effect

The push for tribal participation in maternal mortality reviews represents a fundamental shift. Instead of outsiders analyzing Native deaths, tribal members with traditional knowledge and lived experience are leading the investigations.

Four models are under consideration: individual tribal committees, regional panels covering the 12 Indian Health Service areas, one national committee, or Native subcommittees within state panels. Each approach honors tribal sovereignty while building the data needed to demand better care.

Cindy Gamble, who is Tlingit and serves on Washington state's maternal mortality review panel, has watched the committee's membership diversify over her eight years of service. More Native voices at the table means more accurate understanding of what's actually happening in tribal communities.

These committees received federal funding through the 2018 Preventing Maternal Deaths Act, though that support faces uncertainty as Congress debates appropriations. But the tribal organizing continues regardless, driven by communities who refuse to accept preventable deaths as inevitable.