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Abstract
American Indian/Native American (AI/NA) women experience postpartum depression (PPD) at a disproportionate rate compared to the rest of the United States population. Despite this known prevalence, little research exists exploring essential factors related to postpartum depression among them. Specifically, the experiences of AI/NA women during the postpartum period pertaining to their culture, birthing and mothering expectations, self-sufficiency, and transportation barriers, and trauma (personal and historical). This dissertation research uses the theory of becoming a mother, historical trauma framework, and reproductive justice framework as they all relate to both personal and historical trauma of AI/NA women and offer an innovative approach to informing future interventions. Becoming a mother (BAM) entails the transition to motherhood, including preparation during pregnancy, birthing, and evolution of identity formation. Many BAM behaviors are tied to PPD development, which warrants research attention. Beyond that, the historical context of marginalization of indigenous motherhood through practices such as forced sterilization and abortion, as well as the erasure of cultural mothering practices warrants the use of reproductive justice and historical trauma frameworks. This dissertation explores Keetoowah mother’s postpartum experiences using story inquiry to guide interviews with recent mothers within the United Keetoowah Band of Cherokee Indians in Oklahoma (Keetoowah or UKB). Additionally, the project explores participant’s perspectives on unique risk and protective factors relating to postpartum mental health, including culture, personal and historical trauma, and self-sufficiency barriers. The overarching goal of the proposed project is to gather pilot data to inform future quantitative inquiry regarding unique risk and protective factors for the development of postpartum depression among AI/NA women. The findings of this story inquiry include shared stories discussing the past, present, and future. Within the past, mothering was revered, and there were many traditional beliefs centered around a mother’s womb and the power it had to alter the outer world. During the present story, mothers expressed concern for lack of culturally responsive perinatal care providers, community stigma towards discussing mental health issues, and the need for more interventions provided by those who share their cultural values and spirituality. The story the mothers saw for the future included ways to increase cultural socialization, culturally responsive perinatal and mental health care, and an increase in services that would better support mothers during the perinatal process, including increased access to transportation and culturally relevant mental health interventions. These pilot data serve as a theoretical basis for the future development of community-based participatory interventions that are culturally sensitive and wanted by tribal members. Implications for social work include increasing social work focus on recruiting and retaining AI/NA students to practice within their communities, increasing specialization in maternal mental health, and addressing social work practices that have been historically harmful to AI/NA peoples. Implications for research include further investigations of unique AI/NA experiences of BAM, community-based intervention research, and research surveying the link between racism, historical trauma, and maternal mental health outcomes.
