NewsdayTV's Shari Einhorn speaks to mothers and nurses about the postpartum effects for indigenous people. Credit: Newsday

Ahna Red Fox, a member of the Shinnecock Nation, had a traumatic first experience giving birth.

As a young mother — 19 — she said doctors discouraged her plan for a natural water birth. She was required to stay in her hospital bed during labor to monitor her baby’s heart rate, turned down painkillers and faced complications after giving birth. She said it felt like she wasn’t being heard by doctors and nurses at the hospital. 

In the months that followed, Red Fox admitted herself to the ER with chest pains and shortness of breath that she later learned were panic attacks. She felt depression and post-traumatic stress disorder.

“I was very upset and it took me 2½ years to realize I experienced that trauma in the hospital. I just listened to the doctors because I figured that was the best thing for me,” she said.

WHAT TO KNOW

Indigenous mothers were three to seven times more likely to die by suicide than any other demographic, according to a study that looked at nearly 12,000 pregnancy-associated deaths

Stigma around discussing mental health in the Shinnecock Nation can discourage women from speaking up about issues like postpartum depression, according to Ahna Red Fox, a member who works on maternal health issues.

A new program, funded by a $2,500 grant, aims to train Shinnecock Nation providers in screening mothers for perinatal mood disorders and to connect. them with resources.

According to a study led by a Michigan State professor that looked at nearly 12,000 pregnancy-associated deaths, indigenous mothers were three to seven times more likely to die by suicide than any other demographic.

And yet, said Red Fox, now 26, there is a stigma around discussing mental health in the Shinnecock Nation, discouraging women from speaking up about issues like postpartum depression.

Red Fox — with the help of Hofstra University assistant professors Mary Banahan and Amy Roberts — hopes to change that.

Red Fox, who was inspired by her experience to become a doula serving the Shinnecock Territory, recently became the first provider to be trained by Banahan and Roberts to screen Shinnecock Nation mothers for perinatal mood disorders such as postpartum depression and anxiety. She connects them with the Postpartum Resource Center of New York, which is based in West Islip.

She has also distributed 1,000 palm cards, with a photograph by Red Fox of her cousin and her son in Native attire, that read: “The Shinnecock Indian Nation wants families to know that before, during and after having a baby, parents may feel sad, fear, worry and alone. You are not alone. You are not to blame. You will feel better and be well with help.”

The cards are printed in both English and the Shinnecock language. Red Fox says she has placed the cards at the Shinnecock health clinic and preschool.

Hundreds of palm cards have been distributed in an effort...

Hundreds of palm cards have been distributed in an effort to help Shinnecock Nation mothers with perinatal mood disorders. Credit: Randee Daddona

She said postpartum care is rarely discussed and indigenous people generally have to look toward outside medicine, due to lack of access to adequate care and resources.

"We have a lot of trauma built up that isn’t discussed that goes hand in hand,” Red Fox said of her community. “A lot of people are scared of the stigma of something being wrong and they don’t want to talk about it so they don’t take advantage.”

‘We’re here … to help every mom’

Red Fox’s training was funded by a $2,500 grant through the National Commission on Certification of Physician Assistants.

Banahan and Roberts, physician assistants who have had their own struggles with maternal mental health, were inspired to seek the grant after learning of the Michigan State study's findings on postpartum suicide.

As fellow Long Islanders, they chose the Shinnecock Nation as their focus. The community consists of nearly 1,600 members and about half live on the East End territory.

“The Shinnecock Indian Nation are our neighbors … We’re here, especially as clinicians, to help every mom. So, if there are moms not getting the help they need, that’s what we do as clinicians,” said Banahan, who volunteers with the Postpartum Resource Center of New York.

Rather than offer services themselves, Banahan said they opted to instead train providers already working in the Shinnecock community.

“Women in general get relegated to margins and Native American women and Alaskan women are especially affected by being underserved," Banahan said. “Their moms and families would be much more comfortable to someone reaching out from their own community.”

Red Fox said she was nervous at first connecting with Banahan and Roberts, as people outside the community, but she quickly realized how much of the birth process is not discussed, particularly in the Shinnecock Nation.

“I think now in the outside world, it’s becoming more of a topic of discussion. We don’t talk about it enough. You get your postpartum checkup and they ask questions, but it’s not really in depth,” Red Fox said. “It’s not even a topic of conversation.”

Part of the problem, she said, is medical providers who don’t understand her community.

“A lot of the time when you’re going to the outside … you have to conform and assimilate. It’s not culturally sensitive to who we are when we’re being seen on the outside,” she said.

She said the training offered by Banahan and Roberts was met with skepticism by other members of the Shinnecock Nation.

Noting the previous trauma of colonization and the treatment of Native Americans in the United States, she said, “We’re bearing so much, but not held up or supported and kind of just pushed aside.”

She added: “All of these things … play a part into who we are now and why we don’t come forward to talk about things. It’s rooted in that stigma. It’s kind of a taboo. It’s an uncomfortable conversation a lot of people don’t want to have, but it needs to be had.”

Red Fox is the only member of the Shinnecock Nation to complete the training, but said she wants to share the information with others.

And she hopes she can show mothers a different way forward.

Red Fox said her second child was born with the help of an indigenous midwife and a Shinnecock doula. Her partner built a birthing lodge on her maternal grandmother’s land, with fire keepers and Shinnecock singers.

“I looked to the stars and cried. I can't believe I just did that,” she said. “After all I experienced in my first birth, it completely healed me to give birth on my land, surrounded by so much love and support from people who actually heard me.”

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