Barriers to prenatal health care for American Indian women in the Northern Plains

Background: Many American Indian women find that prenatal appointments tend to be rushed, cold, and impersonal, contradicting culturally appropriate methods of prenatal care. This ultimately affects utilization of prenatal care, and American Indian women and their infants face more health disparities as a result.

Objective/Purpose: The focus of this project was to gather data with American Indian women in the Northern Plains to acquire a better understanding of the traditional American Indian views of prenatal health care and how these traditional views have affected current prenatal health care practices.

Methodology: Eighty American Indian women from the Northern Plains were asked in qualitative interviews to respond to barriers to adequate prenatal health care.

Results: Several barriers to care were identified, including communication and literacy barriers with health care providers; institutional barriers to adequate care, including long waiting times and high turnover of physicians; and sociodemographic barriers, such as preferring nurse midwives over male physicians within Indian Health Services.

Discussion and Conclusions: Interviews with American Indian women uncovered several common themes regarding current barriers to prenatal care. Nurse midwives and the inclusion of cultural traditions were identified as important to improve quality of prenatal care. In addition, prenatal health care and healthy pregnancies need to be promoted through culturally appropriate health care and case management services. A Cultural Broker Program with pregnant American Indian women in the Northern Plains will ideally increase the utilization of prenatal health care services.