Surprisingly, there are some statistics which can be found relating to Tāi (gender neutral word for Mother) and Xuē (Children). The prenatal care for mothers in Bexar County is demonstrated in statistics from the Status of Women Report; “Among pregnant women within the San Antonio UIH service area, 71.7% of AI/AN women began prenatal care in the first trimester compared to 79.0% of NHW women”. Additionally, the report also demonstrates that American Indian and Alaskan Native Women receive no statistically measurable prenatal care within their third trimester and those with a lack of total prenatal care is 1.3 times that of non hispanic white women.

According to the status of women report: “Women who receive late or no prenatal care are at risk for having undetected complications during their pregnancy that can result in severe maternal morbidity and mortality and serious consequences to the unborn infant including low birthweight, preterm birth, and morbidity, and mortality.” Additionally, we understand that Texas has one of the worst maternal and infant mortality rates in the world “An article in the journal Obstetrics and Gynecology showed that in 2010 the rate in Texas was 18.3 deaths for every 100,000 births. By 2015, that jumped 87 percent, to 34.2 deaths. The numbers are extreme in comparison to other countries’ statistics listed by the World Health Organization: Italy (2.1 deaths per 100,000 live births), Japan (3.3) and France (5.5).”. Clearly, we are failing mothers and infants in Yanaguana.

In a system created by and for white men it can be understood that the failures of the medical system are partially due to their complete lack of perspective and even more so in their outright desire to be subjective, oppress, exploit, and kill native women. Seeing that this has been a long-standing issue in Yanaguana, AITSCM has created various buffers to address this ignored epidemic of infant and maternal mortality. As the medical industry fails native women, a re indigenization approach or decolonization to the medical field centers the work of doulas and repositions their importance. A direct and indigenous way to address the lack of prenatal care throughout various trimesters is the usage of doulas. AITSCM addresses these issues by their program Seventh Generation Birthing Services.

There is a statistically measurable benefit of doula work. An article by American College of Obstetricians and Gynecologist stated: “…birthing people who have doula support, including lower rates of maternal and infant health complications; lower rates of preterm birth and low birth weight infants; lower rates of cesarean sections (C-sections), which are associated with higher rates of maternal mortality and severe maternal morbidity, …”(American College of Obstetricians and Gynecologists, “Obstetric Care Consensus: Safe Prevention of the Primary Cesarean Delivery” (Washington: 2014), available at https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2014/03/safe-prevention-of-the-primary-cesarean-delivery). Another study showed the psychological benefits of having a doula: “doula support is linked to reduced rates of postpartum depression and anxiety as well as increased positive feelings about the birth experience and ability to influence one’s own pregnancy outcomes” (Gruber, Cupito, and Dobson, “Impact of Doulas on Healthy Birth Outcomes”; Bohren and others, “Continuous support for women during childbirth”; Wendy-Lynne Wolman and others, “Postpartum depression and companionship in the clinical birth environment: A randomized, controlled study,” American Journal of Obstetrics and Gynecology 168 (5) (1993): 1388–1393, available at https://www.sciencedirect.com/science/article/abs/pii/S0002937811907704.). The usage of Doulas delivers the care that is missing from the western medical system as another study demonstrates that there was a huge barrier due to lack of communication; ‘… physicians who seemed too busy to ask or respond to patient-related questions…physician did not care about the patient or his or her reasons for seeking care, and an overall lack of trust of physicians, especially White physicians and “modern ways of medicine.”’ (J Transcult Nurs. Author manuscript; available in PMC 2014 Jul 15 . Published in final edited form as: J Transcult Nurs. 2012 Jan; 23(1): 29–37. Published online 2011 Nov 3. doi: 10.1177/1043659611423826).

In a world consumed with materialism and financial gains, profits and their margins take precedence over the concerns and feelings of native Birthing peoples. An indigenous medical approach is one that is holistic and intentional, disregarding capitalistic efficiency and embracing the voices of Birthing peoples as well as their concerns. This type of care is clearly revolutionary not only in its ability to transcend maternal and infant mortality but also in its non-hierarchical structure of doctor patient relationships and its reposition of native birthing peoples. A lack of care and technological technique driven approach concerning medical practices of western society leads to mortality among native peoples. 

Furthermore, we must bring recognition to the reality that mothers are not the only ones who give birth. This system causes us to completely disregard and not reflect on gender outside the binary. The desire to implement recognition, and liberation, of these multiple sacred genders is based in understanding that solidarity against settler colonialism and the patriarchy is essential in obtaining the liberation of women, and not just women and girls but men and boys as well. That is to say, all of our oppression and liberation is tied together in a web that cannot be dissolved in the elevation of oppression of another. Beyond that, we, knowing the struggles of being native against a white supremacist state, should have compassion and empathy for those experiencing similar marginalization and erasure. Since the gender binary is a colonial construct, it is unnatural and deeply unaligned with our most native and indigenous forms of being. Our most ancient and sacred ceremonies recognize and include those outside a gender binary so we should do better to be inclusive of these intentional damaged, erased, and displaced genders. It can be assured if more research was done on the plights of birthing non-binary and trans peoples that severely shocking and destructive patterns of the western medical system would be found and could then be healed.