By Danielle Hansen
Brittany Simplicio has a long-term goal: to open the first traditional childbirth center on the Navajo Reservation that would give Native women an additional option to receive care and give birth outside of a hospital setting.
For now, Simplicio, Diné and Zuni Pueblo, is doing her part to help revive traditional Native childbirth practices among Native communities in Albuquerque, where she studied nurse-midwifery at the University of New Mexico. She graduated in May, making her the eleventh Native nurse-midwife in the United States. Simplicio has completed clinical rotations at Northern Navajo Medical Center in Shiprock, New Mexico, and Tsehootsooi Medical Center in Fort Defiance, Arizona.
The National Congress of American Indians recognized Simplicio with their second annual Native Graduate Health Fellowship as part of their commitment to preparing the next generation of Native leaders for careers in the medical field. The National Congress selected Simplicio from 40 applicants. The fellowship includes a financial award of $5,000 and professional development in tribal health policy.
Simplico told Indian Country Today Media Network she considered the fellowship to be a wonderful opportunity.
She has a great interest in health policy, she said, and the fellowship meant a “wonderful opportunity” to learn about tribal health policies in more detail. “I can take this knowledge back to my community and use it to enhance the wellness of Native women and families through the implementation of various programs that I have envisioned.”
Simplicio had completed clinical rotations at Northern Navajo Medical Center in Shiprock, and Tsehootsooi Medical Center in Fort Defiance, Ariz., where she focused on the Navajo Nation. Her long-term goal is opening the first traditional childbirth center on the Navajo reservation to give Native communities an additional option to receive care and birth their babies outside of a hospital setting.
“Traditional Native childbirth practices can and will be revived through collaboration between the community, providers, the hospital, and tribal elders that share the same goal of incorporating traditional cultural wisdom and healing within the Western medical model. Women are the center of the household,” she said. “If women are healthy physically, mentally, and spiritually, then their families are healthy too.
Midwives take a holistic, nurturing approach to physically and emotionally supporting an expecting mother through pregnancy, labor, delivery and the recovery period. Certified nurse-midwives are registered nurses with advanced training in obstetrics, gynecology and midwifery.
Full-scope certified nurse-midwives also screen for sexually transmitted infections, breastfeeding problems, gestational diabetes and nutrition.
Historically, Natives had midwives within their various tribes. There have been traditional midwives in Native history and we are trying to continue the tradition for Navajo tribes, said Deborah Crabbe, Indian Health Service (IHS) affiliate president.
The IHS first assigned a nurse-midwife in 1969 to a remote village in Alaska. Over the years, Native women have come to be five times more likely to acquire a nurse-midwife than non-Native women.
Indian Health Service hospitals have found that nurse-midwives offer a cost-effective, patient-friendly solution to the challenge of providing women’s health care to Native American women, according to an informational booklet produced by the IHS and the American College of Nurse-Midwives.
Simplicio is confident that with more Native midwifes, indigenous communities will embrace the practice.
“Traditional Native childbirth practices can and will be revived through collaboration between the community, providers, the hospital, and tribal elders who share the same goal of incorporating traditional cultural wisdom and healing within the Western medical model,” she says. “Women are the center of the household. If women are healthy physically, mentally and spiritually, then their families are healthy too.”
Although most midwives are non-Native, nine IHS-funded facilities have successful midwifery programs. A 1973 study at one of them, Fort Defiance Indian Hospital in Arizona, showed marked improvements in pregnancy outcomes after five years of nurse-midwifery care. Another such facility, the Alaskan Native Medical Center in Anchorage has 12 full-scope midwives and is the largest midwifery service in the IHS. Their care extends to remote outlying communities such as the Pribilof Islands.
Other IHS facilities with midwifery programs include Northern Navajo Medical Center; Chinle Comprehensive Health Care Facility on the Navajo Nation; The Native Women¹s Health Care in Rapid City, South Dakota; Phoenix Indian Medical Center; Santa Fe Indian Hospital; Tuba City Regional Health Care in Arizona; and W.W. Hastings Indian Hospital in Tahlequah, Oklahoma.
Unfortunately, statistics show that Native women often receive late, inadequate or no prenatal care during pregnancy. Simplicio points out the unique barriers Native women have when it comes to accessing health care, particularly transportation. She has cared for Native women who must travel 1 to 2.5 hours for an appointment.
For that reason, she said, “I would love to someday find funding for a mobile prenatal/women¹s health RV or van so that providers can travel to women that live miles off dirt roads or who may not have reliable transportation in Indian country.”
This article originally appeared in the magazine of the Indian Country Today Media Network.