Committee Opinion 515, “Health Care for Urban American Indian and Alaska Native Women” Full Text.
“Sixty percent of American Indian and Alaska Native women live in metropolitan areas. Most are not eligible for health care provided by the federal Indian Health Service (IHS)…compared with other urban populations, urban American Indian and Alaska Native women have higher rates of teenaged pregnancy, late or no prenatal care, and alcohol and tobacco use in pregnancy. Their infants have higher rates of preterm birth, mortality, and sudden infant death syndrome than infants in the general population…the American College of Obstetricians and Gynecologists encourages Fellows to be aware of the risk profile of their urban American Indian and Alaska Native patients and understand that they often are not eligible for IHS coverage and may need assistance in gaining access to other forms of coverage. The American College of Obstetricians and Gynecologists also recommends that Fellows encourage their federal legislators to support adequate funding for the Indian Health Care Improvement Act, permanently authorized as part of the Patient Protection and Affordable Care Act.”
2016 Alaska Site Visit
In April 2016, teams of AI/AN Committee members, liaisons, and IHS consultants performed site visits to Tribal facilities and urban clinics. Teams assessed staffing, equipment, and quality of maternal and child care. After their respective visits and assessments, teams reconvened in Anchorage to write and compile a consultative report on the status of the facilities and possible suggestions for improvement of care.
2017 and 2018 Great Plains and Billings Area Site Visits
In April 2017 and 2018, teams of AI/AN Committee members, liaisons, and IHS consultants will perform site visits to IHS facilities and urban clinics in the Great Plains and Billings Areas.
TEVA Grant and LARC Trainings
In 2014, the AI/AN Women’s Health Program received grant funding from Teva Pharmaceuticals, Inc. to provide evidence based, hands-on training in the provision of Long Acting Reversible Contraception (LARC) to women’s health providers practicing in Indian Health and Tribal sites. Unintended pregnancy is a significant health concern in the U.S, and women of color and low socioeconomic status experience higher rates of unintended pregnancy, birth and abortion. LARC methods are the most effective reversible contraceptive methods and have the potential to reduce unintended pregnancies, but adequate clinician training has proven to be a barrier in providing Native women with LARC options. The AI/AN Women’s Health program used the TEVA funding to perform needs assessments and determined the availability of LARCs in the Indian Health Service and tribal sites in the Alaska and Great Plains Areas. Once these assessments were recorded, training programs and hands-on workshops were designed and implemented by expert faculty and trainers for interested clinicians. Follow ups and evaluations of recently trained LARC clinicians were conducted to ensure competency.
Rural Maternal Safety
The multidisciplinary Rural Maternal Safety working group met on August 4, 2014 to develop recommendations for ensuring safety in low birth volume facilities. Recommendations to the Indian Health Service (IHS) based upon the extensive breadth and depth of the experience of the nationally recognized participants in the provision of skilled maternity and newborn care in rural and remote settings were developed. Currently, these recommendations are being made into an ACOG position statement.
Committee on AI/AN Women’s Health Breakfast
In conjunction with the 64th Annual Clinical and Scientific Meeting of The American College of Obstetricians and Gynecologists held on May 14nd-May 17th in Washington, D.C., the Committee of AI/AN Women’s Health held a breakfast for current and past committee members, ob-gyns working full time in American Indian/Alaska Native health, and ACOG Fellows who have served American Indian/Alaska Native women.