Race and Place Matter: Inequity in Prenatal Care for Reservation-Dwelling American Indian People

Author:

Thorsen Maggie L.1ORCID,Palacios Janelle F.12ORCID

Affiliation:

1. Montana State University, Bozeman, MT, USA

2. Kaiser Permanente Northern California, Oakland, CA, USA

Abstract

Early initiation and consistent use of prenatal care is linked with improved health outcomes. American Indian birthing people have higher rates of inadequate prenatal care (IPNC), but limited research has examined IPNC among people living on American Indian reservations. The current study uses birth certificate data from the state of Montana (n = 57,006) to examine predictors of IPNC. Data on the community context is integrated to examine the role of community health in mediating the associations between reservation status and IPNC. Results suggest that reservation-dwelling birthers are more likely to have IPNC, an association partially mediated by community health. Odds of IPNC are higher for reservation-dwelling American Indian people compared to reservation-dwelling White birthers, highlighting intersecting inequalities of race and place.

Funder

National Institute of General Medical Sciences

Publisher

SAGE Publications

Reference66 articles.

1. Advisory Committee on Infant and Maternal Mortality. 2022. “Making Amends: Recommended Strategies and Actions to Improve the Health and Safety of American Indian and Alaska Native Mothers and Infants.” Reports of the ACIMM. Rockville, MD: Advisory Committee on Infant and Maternal Mortality. https://www.hrsa.gov/sites/default/files/hrsa/advisory-committees/infant-mortality/birth-outcomes-AI-AN-mothers-infants.pdf.

2. Alaska Native Birthworkers Community. 2023. “Who We Are.” https://www.nativebirthworkers.org/.

3. American College of Obstetricians and Gynecologists. 2018. “Recommendations to the Indian Health Service on American Indian/Alaska Native Pregnant Women and Women of Childbearing Age with Opioid Use Disorder.” Reports of the American College of Obstetricians and Gynecologists. Washington, DC: American College of Obstetricians and Gynecologists. https://www.ihs.gov/sites/opioids/themes/responsive2017/display_objects/documents/acogguidelines2018.pdf.

4. Perinatal and Infant Health Among Rural and Urban American Indians/Alaska Natives

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