Maternal Mental Health and Keetoowah Women: Past, Present, and Future

December Maxwell, University of Texas at Arlington


American Indian/Native American (AI/NA) women experience postpartum depression (PPD) at a disproportionate rate. Poor transportation services and systems increase the risk of PPD prevalence in AI/NA populations, particularly since those in more rural areas have a marked deficit in reliable, safe, and affordable transportation. Little research exists exploring the specific experiences of Native women during the postpartum period relating transportation barriers and use to their culture, birthing and mothering expectations, and self-sufficiency This proposed dissertation research uses qualitative inquiry to explore how historical marginalization has impacted transportation use, access, mobility, and mental health.  The long-term goal of this research is to offer insights and an innovative approach to informing future interventions for AI/NA mothers, particularly those in rural locations. This proposed project targets mothers from a specific tribe, the Keetoowah, to evaluate postpartum experiences by using narrative story-building to interview 10-15 recent mothers. This project aimed to explore unique risk and protective factors relating to postpartum mental health such as transportation and self-sufficiency barriers. Additionally, one specific aim of the proposed project includes creating a cohesive thematic representation of Keetoowah mothers’ stories regarding their postpartum experiences through qualitative analysis.


These themes indicated that policies on increasing transportation efforts in rural tribal areas could impact maternal mental health outcomes. Also, the need for home-visiting programs for postpartum mothers is another aspect of practice change which is impacted by limited transportation options for postpartum mothers in rural tribal areas. These results indicate a need for public transportation access to be included in healthcare costs of the tribe since transportation limits the use of perinatal health care as well as postpartum mental health care among the tribe's mothers. 

Project Details

Project Type:
Project Status:
In Progress
End Date:
December 31,2020
UTC Grant Cycle:
NITC 16 Dissertation Fellowships 2019
UTC Funding: