Abstract
Despite increasing attention to the well-documented maternal health crisis in the U.S., stark disparities persist between groups of women. In December 2021, Indigenous mothers experienced 118.7 maternal deaths per 100,000 live births, whereas their White counterparts had 26.6 [1]. Maternal mortality is a multifaceted, complex issue that complicates the health and wellbeing of Indigenous women, yet the root causes of this disparity are not well-described. We need a deeper understanding of the determinants of health (social, structural, biological, political) that contribute to Indigenous maternal mortality. Indeed, the existing literature lacks adequate theoretical understanding to address this phenomenon. Therefore, the purpose of this project was to develop a model of the determinants of maternal mortality for Indigenous women in the U.S.
Methods: Non-Indigenous academicians and an Indigenous tribal citizen partnered to amplify Indigenous women’s voices. Situated in decolonizing [2] and Indigenist [3, 4] paradigms, we used Walker and Avant’s theory derivation [5] to create the model.
Results: We identified social, structural, political, and biological pathways to Indigenous maternal mortality. Risk factors include biological warfare and ongoing cultural genocide. Protective factors included resilience and cultural connectedness. Finally, we illustrate complex and multifaceted relationships among and between these concepts in the model.
Implications: Solutions that address determinants of Indigenous maternal mortality are critical for Indigenous families to flourish. Ideally, this model will inform the nursing research, policy development, and trauma-informed and culturally relevant clinical practice that is needed to eliminate the disparities in maternal mortality that Indigenous women experience. Academic researchers and tribal communities must continue to partner to support the safety and vitality of Indigenous women.
Notes
References:
1. Centers for Disease Control and Prevention. Provisional maternal mortality rates. 2024; Available from: https://www.cdc.gov/nchs/nvss/vsrr/provisional-maternal-deaths-rates.htm.
2. Vizcaino, R., On epistemic decolonization: Praxis beyond metaphors, in The Peace Chronicle: The Magazine of the Peace and Justice Studies Association. 2020.
3. Luebke, J., et al., The utility of postcolonial and Indigenous feminist frameworks in guiding nursing research and practice about intimate partner violence in the lives of American Indian women. Journal of Transcultural Nursing, 2021. 32(6): p. 639-646.
4. Tuhiwai Smith, L., Decolonizing methodologies: Research and Indigenous peoples. 1999, London: Zed Books Ltd.
5. Walker, L.O. and K.C. Avant, Strategies for theory construction in nursing. 6th ed. 2019.
Sigma Membership
Beta Delta at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Health Equity or Social Determinants of Health, DEI/BIPOC, Theory, Maternal Mortality, Indigenous Women
Recommended Citation
Heck, Jennifer L.; Parker, Judy Goforth; Konrad, Kathryn M. L.; Svenson, Ingrid; and Jennings, Annika, "A Model of the Determinants of Maternal Mortality in Indigenous Women" (2025). International Nursing Research Congress (INRC). 105.
https://www.sigmarepository.org/inrc/2025/presentations_2025/105
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
A Model of the Determinants of Maternal Mortality in Indigenous Women
Seattle, Washington, USA
Despite increasing attention to the well-documented maternal health crisis in the U.S., stark disparities persist between groups of women. In December 2021, Indigenous mothers experienced 118.7 maternal deaths per 100,000 live births, whereas their White counterparts had 26.6 [1]. Maternal mortality is a multifaceted, complex issue that complicates the health and wellbeing of Indigenous women, yet the root causes of this disparity are not well-described. We need a deeper understanding of the determinants of health (social, structural, biological, political) that contribute to Indigenous maternal mortality. Indeed, the existing literature lacks adequate theoretical understanding to address this phenomenon. Therefore, the purpose of this project was to develop a model of the determinants of maternal mortality for Indigenous women in the U.S.
Methods: Non-Indigenous academicians and an Indigenous tribal citizen partnered to amplify Indigenous women’s voices. Situated in decolonizing [2] and Indigenist [3, 4] paradigms, we used Walker and Avant’s theory derivation [5] to create the model.
Results: We identified social, structural, political, and biological pathways to Indigenous maternal mortality. Risk factors include biological warfare and ongoing cultural genocide. Protective factors included resilience and cultural connectedness. Finally, we illustrate complex and multifaceted relationships among and between these concepts in the model.
Implications: Solutions that address determinants of Indigenous maternal mortality are critical for Indigenous families to flourish. Ideally, this model will inform the nursing research, policy development, and trauma-informed and culturally relevant clinical practice that is needed to eliminate the disparities in maternal mortality that Indigenous women experience. Academic researchers and tribal communities must continue to partner to support the safety and vitality of Indigenous women.
Description
This session presents a conceptual model of the determinants (social, structural, political, and biological) of maternal mortality for Indigenous women including risk and protective factors, and relationships among and between the determinants. Ideally, this model will inform the nursing research, policy development, and trauma-informed and culturally relevant clinical practice that is needed to eliminate the disparities in maternal mortality that Indigenous women experience.