Indigenous midwives and doulas provide critical support to maternal health

Aspen Mirabal has traveled across Northern New Mexico working with women during pregnancy, birth and postpartum. A member of Taos Pueblo, her work as a doula focuses on ensuring Indigenous women deliver safely in and out of hospitals. 

“Sometimes clients don’t know how to advocate for themselves if this is new for them,” said Mirabal about the language spoken among providers in hospitals. Doulas can help with that.  

Nicolle Gonzales saw a similar need as Mirabal and decided to pursue midwifery. 

“I was very unhappy seeing how the community was being taken care of in hospitals,” Gonzales said. “That really pushed me to go back to school and become a nurse midwife.”  Gonzales later formed a nonprofit health organization called Changing Woman Initiative with a focus on reclaiming Indigenous cultural birthing practices. 

Today, an effort is growing to make it easier for Indigenous people to access doulas and midwives from their own communities, like Mirabal and Gonzales. Prior to the establishment of the Indian Health Service (IHS), the federal medical system that serves Native populations, most Indigenous births happened outside hospitals with the assistance of women.

Growing New Mexico maternity care deserts bring long drives, increased worry

Christina spent much of 2023 traveling to Santa Fe for medical care during her pregnancy. She’d leave home about two hours before each doctor’s visit for the roughly 100-mile one way trip from her home in northern New Mexico’s rural Mora county, in case accidents or construction caused traffic slowdowns. Two years ago, she would have received her care 30 miles down the road at Alta Vista Hospital in Las Vegas. But the hospital closed its delivery care unit in June 2022. 

“People say it’s because they weren’t getting paid enough, I don’t really know why but they closed,” said Christina, who asked New Mexico In Depth not to use her last name to protect her and her newborn’s privacy. “So I have to go to Santa Fe.”

Her high-risk pregnancy forced the trip to Santa Fe three times a week in her final months, with transportation costs running about $150 a week.