Sometimes being in business is not just about getting rich. Sometimes it’s about enriching the lives of those your business serves. This is the case with the project Nicolle Gonzales has carved out as her legacy to Indian Country, and it’s a story worth listening to.
With the cost of childbirth the highest in the world — averaging $13,000 for a vaginal delivery and $17,000 for a C-section — few rural indigenous women can afford conception to post-partum care. This has contributed to an infant mortality rate of 8.3 percent overall, second only to Non-Hispanic Black Women and their infants who, tragically, fare 3 percent worse in the delivery room and the first year following delivery.
American Indian women also have “…more adverse maternal risk factors (e.g., unmarried and <18 years of age) than Whites and Hispanics,” resulting in “…higher risks of low [infant] birth weight and preterm birth and elevated risks of postneonatal and infant mortality,…” SIDS, injury, and infection caused or complicated by perinatal health issues including obesity, diabetes, alcoholism, and smoking as well showing up erratically — or not at all — for maternity visits, according to Gonzales.
Gonzales, whose goal is “To have a healthy, thriving population…” believes that providing culturally focused birth experience, training indigenous midwives, and advocating for health policy specific to Native women will go a long way in turning the tide on these dire statistics. This translates into funding a birth center to cut not only delivery costs, but to provide perinatal and other women’s health services that will defray the cost of births at the proposed center.
Gonzales, whose degrees alone would allow her a more than comfortable life without seeking such a monumental challenge, has set her sights on forging the first center of midwifery in the United States, hopefully on tribal land. Though, as she readily admits, birth centers are not a new business model, she and her corporate donors are optimistic that this model will allow Native women — and their children — who only have Medicaid to pay for such services, to profit physically and emotionally from such a clinic. To develop a business model for the indigenous community meant untangling the complex of law and policy that governs healthcare facilities. Now, with knowledge in hand, she and her underwriters are ready to transition to the implementation of a freestanding clinic.
Members of CWI team strategizing and collaborating with Roanhorse Consulting. (Courtesy Gonzales)
However, by Gonzales’ own admission, the clinic is still in the planning stage. Originally scoped for the Pojoaque Pueblo, she is now seeking a new location within 30 minutes’ drive of Santa Fe, New Mexico, as well as finding the full $7 million in funding it will take to construct the facility within the year. With $500,000 in hand, however, she intends to open a free clinic one day a week starting in August 2018 to provide home birth services, health services, health assessments, pediatric and other unmet health needs of both Native and non-Native families in the area, although Native families will be prioritized. The effort is an entirely Native led, Native health collective. While the focus is on providing birth services, training indigenous midwives, and health advocacy for Native women, current efforts include generating information for clients in their own language, diet consultation — especially cutting out barriers to access Women, Infants, and Children (WIC) so that it will become part of their care, teaching Native women about Native practices that have been somewhat lost over time, and reestablishing links to best Native practices for clients.
But Gonzales is undaunted. “We can do this, it’s possible. I say never to knock an idea before it’s tried. It’s so easy to be lazy about it or believing that our women are getting care at a hospital and that is good enough. That’s been our mainstay for the last fifty years, but good enough is not good enough anymore — just look at the statistics.”
So, while it may not make her rich, she is content with the potential outcome. And for that, she is all in.
