The United States is in the midst of a maternal health crisis. Indigenous and Alaska Native peoples are 2.3 times more likely to die from pregnancy-related complications than their white counterparts. In Alaska, unequal socio-economic status, lack of access to hospitals and quality health services, systemic racism, and a history of colonization drive these disparities in maternal health outcomes. “Weathering”—the deterioration of communal health outcomes caused by persistent socio-economic disadvantages—contributes to many poor maternal health outcomes for Alaska Native women. On top of these systemic problems, climate change impacts threaten to widen the existing disparities for Alaskan Native women.

“We need more Indigenous midwives,” said Claire Dion Fletcher, an Indigenous Potawatomi-Lenape Registered Midwife and co-chair of the National Aboriginal Council of Midwives (NACM), at a recent Wilson Center event with the United Nations Population Fund (UNFPA) and the International Confederation of Midwives about Indigenous midwifery. Globally, Indigenous women experience worse maternal health outcomes than non-Indigenous women. In the United States, risk of maternal death is twice as high for Native women than white women, while in Australia the risk is four and a half times higher.

“The world is at risk of losing millions of women and children due to reductions in coverage of essential services, reversing hard-earned progress towards the SDGs [Sustainable Development Goals] to date and posing catastrophic consequences for households and communities,” said Dr. Koki Agarwal, Project Director of the United States Agency for International Development’s (USAID) MOMENTUM Country and Global Leadership award, at a recent event on the importance of ensuring continuity of maternal, newborn, and child health services, voluntary family planning, and reproductive health care during the COVID-19 pandemic. The event was the first in a series of virtual country knowledge exchange discussions organized by USAID’s MOMENTUM Country and Global Leadership, led by Jhpiego and partners.

“Today is the International Day of the Midwife, a day when we come together as a global health community to celebrate midwives, and the commitment of the midwifery profession globally to saving lives and upholding the rights of women to a safe and positive birth,” write the authors of the Global Call to Action: Protecting Midwives to Sustain Care for Women, Newborns and their Families in the COVID-19 Pandemic. Midwives are essential to the health and protection of women and newborns. The World Health Organization (WHO) estimates that 83 percent of all maternal deaths, stillbirths, and newborn deaths could be averted with the full package of midwifery care.

“This is a unique moment—a crisis that has demanded action for decades and is now getting the attention it deserves,” said U.S. Representative Lauren Underwood (D-IL-14) at a recent event on maternal health and disparities hosted at George Washington University’s Milken Institute School of Public Health. The United States has the highest maternal mortality rate among high-income countries and for every maternal death, there are 70 “near-misses.” It is important to take a “life-course” approach to address this issue from a policy perspective, said Underwood.