Recovering the Sacred: Caring for our first generation
The tiniest members of Indian country are in crisis. Babies born to Native women are nearly twice as likely to die before their first birthday as babies born to Caucasian women. More than 8 out of every 1,000 Native babies born will die; and the number is rising.
According to the CDC, Native Americans were the only racial or ethnic group that did not experience a decline in infant deaths between 2005-2014. The most common causes of infant death among Natives are (1) congenital malformations, (2) low-birth weight due to prematurity, (3) sudden infant death syndrome (SIDS), and (4) unintentional injuries due to accidents.
Native women face many external barriers to care including: lack of insurance, inability to pay medical costs, lack of access to health and medical facilities, lack of transportation (especially in rural communities), lack of education and fear of discrimination.
According to the CDC, the Robert Wood Johnson Foundation and the Harvard School of Public Health:
• 23 percent of Native women reported being discriminated against when visiting the doctor or clinic.
• Native women are 2.5 times more likely to receive late or no prenatal care than Caucasian women.
• Close to 17% of Native women report smoking tobacco during their pregnancy.
• The majority of births occurring outside of a medical facility are among Native women, a trend that has been slowly increasing since 1990.
• Mothers who abuse drugs or alcohol may avoid medical office visits for fear of having a child taken away.
• Native women are less likely to have pediatric visits within the first week following the birth a child.
Native mothers can empower themselves by better understanding the problems and by educating themselves on ways they can help to reverse these alarming trends.
Early AND regular prenatal care TIPS
• Early prenatal care can prevent complications and educate women on ways they can protect their infant and ensure a healthy pregnancy.
• By following a healthy diet, taking recommended prenatal vitamins, engaging in regular exercise and avoiding exposure to harmful toxins such as lead and radiation can help reduce the risks of problems developing during pregnancy and promote optimal fetal growth and development.
• Controlling pre-existing conditions, such as diabetes and high blood pressure, will help to decrease serious pregnancy complications from developing.
• Routine pregnancy testing such as ultrasound imagery may detect potential birth defects.
• Routine lab screening may detect infections and conditions that can impact a mother and her baby’s health if not treated.
• Women can reduce her baby’s risk for SIDS by avoiding tobacco smoke, illicit drugs and alcohol use during pregnancy.
• Avoidance of alcohol use in pregnancy will also decrease the risk of fetal alcohol spectrum disorders.
• Taking childbirth education classes can help mothers and families reduce the risk of SIDS and unintentional injuries through awareness of infant safety and developing parenting skills.
Newborn screening is a way to check babies for serious disorders. Babies with some of these disorders may seem healthy at birth but can become very sick in a short time.
Nevada newborns are screened for 31 core and 29 secondary conditions recommended by the College of Medical Genetics and the March of Dimes. Newborn screening is done in 3 ways: blood spot screening, hearing test, and critical congenital heart disease (CCHD) screening.
Newborn screening tests are done within 24-48 hours of birth. The tests for CCHD and hearing are simple, non-invasive tests that take just a few minutes, while the blood spot testing requires a baby to have a heel stick for blood.
If a baby tests positive for any screening, it is important, even critical to receive follow up care with a pediatrician.
Newborn screening is required by law in most states: however, some states allow parents to refuse the screening, usually for religious beliefs. Given that the number one cause of death in newborns born to Native mothers is congenital malformations, it only makes sense to have newborn screening done.
Safe sleep practices are important for the safety of babies and will reduce the incidence of SIDS. Safe sleep practices include:
• Placing a baby on his or her back to sleep.
• Using a firm, flat sleep surface covered by a fitted sheet with no other bedding in the sleep area.
• Do not put soft items, toys, crib bumpers or pillows anywhere in the baby’s sleep area.
• Sharing a bedroom with a baby, with the infant crib or bed close to mothers bed, but separate.
• Using pacifiers for naps and nighttime.
• Prevent overheating.
By the way, cradleboards, by design, prevent SIDS. Other important baby care includes:
• Getting regular infant health checkups and vaccinations.
• Avoid shaking a baby, whether in play or frustration.
• Making sure to securely fasten a baby into the stroller, carrier or car seat.
• Never leave a baby unattended during his/her bath time.
Through education and engaging in practices that serve to improve pregnancy outcomes and infant safety, Native women can ensure their children are healthy and have the chance to achieve their full potential for healthy and productive lives.
“Recovering the Sacred” is a monthly women’s health-focused column from Rebecca Chavez (Western Shoshone), who is a certified nurse-midwife, women’s healthcare provider and a mother of two. If you have any questions or ideas for future topics, email her at email@example.com.
According to the Indian Health Service, more than 16% of Native people have diagnosed Type 2 diabetes and another 30% have pre-diabetes. This data indicates that Native people are twice as likely to develop Type 2 diabetes than non-natives.