Tuba City Regional Health Care
Presentation Abstract
Roundtable on Elevating Patient-Centered Strategies for Care
In this roundtable, we are elevating the voice of patients, families, and providers regarding patient-centered strategies for care. Patients who experience severe maternal morbidity are at greatest risk of mortality. Their personal experience of severe complications during pregnancy or postpartum may result in long-term suffering, which may be worsened by the care they received, especially when it was not centered on their needs and desires. Maternal morbidity and mortality also has a lasting effect on families, as alongside every individual who is severely affected or lost during or after pregnancy is a family unit
Healthcare Disparities on the Navajo Reservation Contributing to the Increased Risk of Maternal Morbidity and Mortality in the Indigenous Population
Women of color carry a disproportionate burden of maternal mortality. In Arizona alone, American Indian women and Alaska Native women have the highest pregnancy-associated mortality ratio and 100% of these deaths were preventable. The severe maternal morbidity rate was the highest for American Indians and Alaska Natives at over 3.5x the rate for non-Hispanic White women and the severe maternal mortality rate was again the highest for women living in rural communities versus women living in urban communities. Safety bundles that are in alignment with the Alliance for Innovation on Maternal Health as well as the California Maternal Quality Care Collaborative, in addition with standardized protocols for both primary care, emergency room facilities, and obstetric units would be an integral step in improving care. Implicit bias and racism in medicine needs to be acknowledged as an important factor in maternal morbidity and mortality, especially amongst the Indigenous population. Through awareness and training, healthcare bias can be a piece of history to look back on and learn from. Training native providers is critical in addressing the problem of implicit bias and racism. It is important to see more resources allocated to Indian Health Service facilities to bring highly skilled providers to areas that have difficulty with recruitment. The future of improving care to the Indigenous maternal population must include an emphasis on mental health facilities, domestic violence shelters, and substance abuse and rehab programs. Improving these areas and allocating funds would make a large impact on overall maternal health. Future research goals should address mandatory implementation of safety bundles for emergency care, urgent care, and labor and delivery services.
About Dr. Whitehair
Dr. Jennifer Whitehair is a graduate of Northern Arizona University with a Bachelor of Science in microbiology and emphasis in health pre-professions. She earned her Medical Degree from the University of South Dakota and was a participant in the Indians into Medicine Program during medical school. After medical school, Dr. Whitehair finished her obstetrics and gynecology residency program at the University of Arizona and graduated with the prestigious Outstanding Surgeon’s award. She then went on to fulfill her 4-year commitment for her Indian Health Service Scholarship requirement on the Navajo reservation in Tuba City, Arizona at Tuba City Regional Health Care Corporation. After her commitment was served, Dr. Whitehair continued to serve and has spent the last 16 years providing women’s health care to Indigenous Women on the Navajo Nation, which is also home to the Hopi Tribe and the San Juan Southern Paiute. Dr. Whitehair is a Board-Certified Obstetrician and Gynecologist and fellow of the American Congress of Obstetricians and Gynecologists (ACOG). She served as the Chief of Surgical Services for 6 years and holds an academic position as a Clinical Assistant Professor of Obstetrics and Gynecology for the University of Arizona, College of Medicine. Dr. Whitehair was a recipient of the Outstanding Teacher and Mentor Award for medical residents and students. She has also recently received ACOG’s William Haffner Award for excellence in serving an Indigenous population. Dr. Whitehair has 20 years of experience in obstetrics and gynecology and has special interests in urogynecology to include female pelvic prolapse and urinary incontinence surgery as well as minimally invasive surgery. She feels special pride in providing patients with incontinence and pelvic prolapse a new take on life when they have suffered in silence for years, often living with no running water or basic resources.
As a Diné woman herself, Dr. Whitehair felt a strong calling back to her family’s ancestral home near Tuba City, Arizona after being raised in California where her father spent his adulthood after he was removed from the reservation by missionaries. When she visited this land as a child, she felt a strong call to the Sacred Peaks, later learning their cultural significance. She also wanted to follow in the footsteps of her great grandfather’s work as a medicine man. Her training as a doctor led her back here to serve her community and fulfill her mission of providing evidence-based care to an underserved population.
Dr. Whitehair is also committed to grassroots efforts that serve her community. During the height of the first wave of the COVID-19 pandemic, she was a vital catalyst connecting resources from off the reservation to the people on the Navajo Nation. She coordinated with multiple different non-profit organizations and countless individuals to deliver masks, hand sanitizer, food, cleaning products, and other supplies to the community at a time when there was a dire need. She personally distributed masks and bottles of hand sanitizer directly to the community members by coordinating with local officials.
Dr. Whitehair splits her time between Flagstaff and Tuba City, Arizona. She resides with her husband, father, and two daughters.
Conflict of interest disclosure does not apply because Dr. Whitehair is a federal employee.