Access to reproductive health services among American Indian women: A qualitative study
Abortion, Contraception
Awarded 2014
Small Research Grants
Sarah Baum, MPH
Ibis Reproductive Health

Objectives: Native women have disproportionately high rates of unintended pregnancy and sexual violence, and low rates of contraceptive use compared to non-Native women. Native women’s sexual and reproductive health (SRH) is tied to the history of systematic oppression, racism, and coercion against Native communities in the US. This project aimed to facilitate a deeper understanding of SRH research and advocacy priorities within the Native community. Methods: We had ten conversations with Native leaders and non-Native allies in the SRH field. Through these conversations, we explored perspectives on access to SRH services, including abortion, and priorities for future work among both urban and rural Native women. Results: There were four key themes that emerged from the conversations with Native leaders and allies, including 1) the importance of shared goals and decision-making with Native leadership; 2) complex systems of health care coverage and limited access within Native communities; 3) the importance of understanding historical coercion and oppression regarding pregnancy, access to SRH services, and the perception of research; and 4) centering current policies and injustices in identifying priority research areas. Conclusions: SRH research with Native women must center Native women in the research question and the research process. Research will likely be most useful if it evaluates current policies and the impact they have on women’s access to SRH services. Researchers must be explicit about their awareness, respect, and integration of historical marginalization and oppression of Native women in their work.