{"id":17665,"date":"2021-11-02T20:35:45","date_gmt":"2021-11-03T00:35:45","guid":{"rendered":"https:\/\/www.indianz.com\/News\/?p=17665"},"modified":"2021-11-02T20:35:46","modified_gmt":"2021-11-03T00:35:46","slug":"cronkite-news-navajo-mother-works-to-improve-maternal-care-for-native-women","status":"publish","type":"post","link":"https:\/\/indianz.com\/News\/2021\/11\/02\/cronkite-news-navajo-mother-works-to-improve-maternal-care-for-native-women\/","title":{"rendered":"Cronkite News: Navajo mother works to improve maternal care for Native women"},"content":{"rendered":" \"Nicolle<\/a>
Nicolle Gonzales, a Navajo nurse midwife and the founder and executive director of Changing Woman Initiative, poses for a photo at an indigenous doula training in Window Rock, Arizona, on Thursday, October 24, 2019. She believes it\u2019s important to have a safe space for Native women to talk about the health problems they face. \u201cThe things that women experience, we don\u2019t always talk about,\u201d she said. \u201cFor me, holding a space and creating a space allows women to have those conversations, but also to heal and to build collaboration and support beyond this training.\u201d (Photo by Delia Johnson\/Cronkite News)<\/figcaption>\r\n
Q&A: Navajo woman starts nonprofit to improve maternal health<\/div>\r\n
Tuesday, November 2, 2021<\/div>\r\n
By Laura Bargfeld and Natalie Skowlund<\/div>\r\n
Special for Cronkite News<\/div>\r\n
cronkitenews.azpbs.org<\/a><\/div>\r\n

<\/P>\r\nPHOENIX, Arizona — When Nicolle Gonzales gave birth to her three children in a hospital setting, the care felt routine and mechanical. Having worked as a nurse with the Indian Health Service, Gonzales also noticed the gaps in support and accessibility that left many Native American women with insufficient care during pregnancy and birthing.

<\/p>\r\nHer concerns drove her to become certified as a midwife and, in 2015, to launch the nonprofit Changing Woman Initiative<\/a> to address maternal health disparities in Indigenous women.

<\/p>\r\nThe U.S. faces higher rates of pregnancy related deaths than other developed nations, and Indigenous mothers are 2 to 3 times<\/a> as likely to die as white mothers. The causes are multifaceted, but racism and lack of access<\/a> are among the factors, experts say.

<\/p>\r\nChanging Woman provides culturally centered care and birthing services both in tribal communities and at a new walk-in clinic in Albuquerque, New Mexico. The initiative also offers training and education so that more Indigenous women can help one another.

<\/p>\r\nAs she settled in at her Albuquerque headquarters, Gonzales, who is Navajo, spoke with Cronkite News about the need for policy shifts around maternal health care and the importance of providing culturally appropriate services. The interview has been edited for brevity.

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Nicolle Gonzales performs a smudging ceremony at doula training on the Navajo Nation in this file photo from 2019. Smudging cleanses the body by burning herbs and plants in a shell and fanning the smoke around a person, like a smoke bath. Photo by Delia Johnson \/ Cronkite News\r\n<\/figcaption>\r\n<\/figure>\r\n

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What motivated you to start Changing Woman?<\/div>\r\nThe biggest push was feeling like our Native women needed advocacy on a higher level. I just didn’t feel I was making the changes I wanted to see as a nurse. (As a midwife), I felt like I could be in decision-making spaces and have a little bit more pull in the hospital setting to make decisions with Native families.

<\/p>\r\nIt wasn’t until I was in midwifery school that I saw a more clear understanding of the health disparities that Native communities experience around birth care and services \u2013 so many gaps around culturally centered care, even just having family present for births, transportation, access to care. A lot of the research around maternal health is focused on death and dying, and really highlights diabetes and hypertension. \u2026 But there wasn’t a lot of discussion around why these were outcomes.

<\/p>\r\nHaving worked in a hospital as a nurse and then as a midwife later in my career, it’s really hard to make some changes in systems that are already established. I felt like creating a nonprofit to do specific work around direct services, community outreach for training and, of course, policy advocacy work was really necessary. The initial goal was to start a birth center for Native families, and then it grew into something a lot bigger.

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All this month, we are sharing #WOCtoWatch \u2013 leaders making a difference. Today, we are featuring Nicolle Gonzales, the founder of @ChangingWomanIn, the first Native American led birth organization.<\/p>\n\t\t<\/a>\n\t<\/div>\n\t

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What obstacles do Indigenous women face in getting proper care during pregnancy?<\/div>\r\nThere’s lots of little nuances. It can get into racism and implicit bias. \u2026 A lot of the care that Native women get is from non-Native providers. They work in a system that might be there for a limited time, and then they leave. When you get people coming in and out of those communities, there’s no ability to build trust. \u2026

<\/p>\r\nIn some of these places where there are maternal health deserts, there aren’t a lot of services. \u2026 People have to travel long distances. It is really vital to engage those communities in learning those skills themselves.

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What are some other barriers to appropriate maternal health care?<\/div>\r\nThe way private sector hospitals function, they try to fit in as many people as they can in a day. They could see 20 prenatal clients in one day, and women get 15 minutes, maybe, in that time to talk to their provider.

<\/p>\r\n(Indigenous women) might have to travel a little bit further just to find a provider to see \u2013 that’s a barrier. Making an appointment to get seen \u2013 that could be a barrier.

<\/p>\r\nThen there\u2019s the cultural differences, and seeing somebody outside of their community who may not be aware of traditional activities. A Native woman might miss an appointment, and it can be misconstrued that they\u2019re not interested or that they don’t want care because their commitment to their communities takes a lot of their time and maybe they don\u2019t get to all the appointments. But that blame and shame gets placed back on them. …

<\/p>\r\nThere’s a lot of little obstacles that they have to overcome. \u2026 Maybe she has lots of kids. Maybe some of these clinics don’t have a lot of space for kids and don’t want them there. So how would they get to appointments if they had to always find child care? All of these little things add up, and it makes it more challenging for them to go out to get care.

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