Strengthening cultural identity and resilience among perinatal indigenous women to address health disparities: a narrative review

Purpose American Indian/Alaska Native (AI/AN) women are 2.3 times more likely than non-Hispanic white women to die from pregnancy-related causes. In addition, resilience and a strong sense of cultural identity have been linked to positive health outcomes. Therefore, the purpose of this paper is to investigate the relationship among culture, resilience and maternal health among AI/AN women and offer culturally adapted perinatal intervention recommendations for Indigenous populations around the world. Design/methodology/approach The authors conducted a narrative review using PubMed Central, Sage Journals database, NCBI, Elsevier and Wiley using the following search terms: “Indigenous,” “perinatal,” “cultural,” “intervention,” “maternal,” “pregnancy,” “health disparities” and “resilience.” Inclusion criteria consisted of peer-reviewed papers and evidence-based intervention Web pages published in English between 2000 and 2023. Findings Key intervention themes that emerged during this review included home visiting/birthing and family support; perinatal mental health; breastfeeding promotion; and Indigenous midwifery and doula services. Practical implications of culturally adapted perinatal interventions for Indigenous women include the consideration of factors that affect program implementation such as stigma and accessibility. Policymakers must confront underfunding of public health programming and work to expand programs and interventions beyond urban centers. Finally, future research should examine strengths-based public health approaches and conduct randomized controlled trials to study the effectiveness of interventions. Originality/value This research is valuable to the field of public health because it demonstrates that by using a strengths-based approach to population health, the authors may leverage the relationship among cultural practices, resiliency and health to address AI/AN maternal health disparities.