Maternal Health Disparities Research Articles

Background: Previous studies have reported disparities in maternal cardiovascular health across different U.S. regions; however, the impact of geographic variation on outcomes in peripartum cardiomyopathy (PPCM) remains poorly understood. Objective: To evaluate geographic variations in outcomes of PPCM across U.S. census regions, focusing on sociodemographic and clinical risk factors. Methods: This retrospective study analyzed 2008–2022 data from the National Inpatient Sample (NIS), encompassing 66,368 weighted PPCM hospitalizations. Baseline characteristics across geographical regions were analyzed using descriptive statistics and chi-square tests. Multivariable logistic regression evaluated associations between geographical regions and in-hospital mortality outcomes, adjusting for race, income, and comorbidities. Results: Among 66,368 weighted PPCM hospitalizations, the South accounted for 48.3% of PPCM cases, followed by the Midwest (22.0%), West (15.8%), and Northeast (13.9%; p<0.001). Black patients comprised 51% of Southern cases vs. 37% in non-Southern regions (p<0.001). Southern cases were disproportionately from the lowest income quartile (47% vs 36%; p<0.001). Southern populations demonstrated statistically significant comorbidity burdens, including hypertension (45.9% vs 37.7%, p<0.001), obesity (26.0% vs 23.6%, p<0.001), and chronic kidney disease (6.1% vs 5.2%, p=0.02). Geographical analysis of PPCM mortality revealed significant disparities, with Southern residence associated with 40% higher adjusted odds of mortality compared to other regions (aOR=1.40, 95% CI=1.04–1.87, p=0.025) after controlling for race, income, and comorbidities. Black race (aOR=1.83, 95% CI=1.26–2.65, p=0.001) and chronic kidney disease (aOR=3.81, 95% CI=2.53–5.73, p<0.001) were key predictors. Interestingly, hypertension was associated with lower odds of mortality (aOR=0.53, 95% CI= 0.37–0.75, p<0.001). Conclusion: Geographical disparities in in-hospital mortality of PPCM persist after adjustment for socioeconomic and clinical factors, with the Southern U.S. demonstrating a significantly elevated burden. Addressing systemic drivers of regional inequities is critical to improving maternal cardiovascular outcomes.

Background: Social determinants of health (SDOH), particularly adverse physical, housing, and environmental conditions, are increasingly recognized as key drivers of maternal and cardiovascular health disparities during the fourth trimester. This study investigates the impact of SDOH on postpartum cardiovascular and related outcomes in a large, real-world U.S. population. Methods: A retrospective comparative outcomes analysis was performed using the TriNetX U.S. Collaborative Network, comprising electronic medical records from 64 healthcare organizations. Two cohorts of females aged 15–60 years at delivery and postpartum were compared between 2008 and 2023: one with documented SDOH related to the social environment (n = 18,411 after matching) and one without SDOH (n = 18,411 after matching). Propensity score matching was used to balance baseline characteristics. Outcomes were assessed over a one-year period following delivery and included mortality, acute myocardial infarction (AMI), stroke, heart failure, peripartum cardiomyopathy, preeclampsia/eclampsia, venous thromboembolism (VTE), and major adverse cardiovascular and cerebrovascular events (MACCE). Results: Patients exposed to SDOH had significantly higher risks of all-cause mortality (Risk Ratio [RR]: 3.43, p < 0.001), AMI (RR: 2.10, p = 0.048), and 3-point MACCE (RR: 2.85, p < 0.001). Risk for peripartum preeclampsia was also elevated (RR: 1.22, p < 0.001). Survival analysis confirmed significantly lower survival probabilities in the SDOH group for several outcomes. The matched cohort analysis showed these disparities persisted even after adjusting for key demographic and clinical confounders. Conclusion: Exposure to adverse SDOH conditions during the peripartum period is associated with a significantly higher risk of maternal cardiovascular and mortality outcomes. These findings underscore the importance of addressing structural and environmental inequities to improve maternal health and reduce postpartum cardiovascular risk.

Strengthening Perinatal Services Through Social Care: Outcomes of a Quality Improvement Initiative for a Health Center-Based Perinatal Care Program.

Maternal health disparities in the United States continue to disproportionately affect Black and minority women, especially in states like Mississippi where maternal mortality rates remain among the highest in the nation. This study explores how social support influences the utilization of prenatal and postpartum care among Black women in this high-risk context. Data were drawn from a 2024 cross-sectional survey of 157 Black women in Mississippi. Participants either were currently pregnant or had experienced pregnancy. Logistic regression models, including Firth's penalized likelihood estimation, were used to assess the relationship between reported social support and maternal healthcare use, adjusting for key demographic, socioeconomic, and clinical variables based on Andersen's Behavioral Model. Women who reported strong social support were significantly more likely to have received prenatal care (β = 1.12, p = .0069), with the effect persisting across fully adjusted models. A similar positive association was observed for postpartum checkups in partially adjusted models (β = 0.81, p = .0081), although significance diminished when accounting for enabling and need-related factors. Interaction analyses revealed that social support combined with access to emergency obstetric care markedly increased the likelihood of both prenatal and postpartum care utilization. These findings underscore the vital role of social support in improving maternal healthcare uptake among Black women in Mississippi. Strengthening support networks and ensuring access to critical services may be key strategies for reducing persistent racial and geographic disparities in maternal health outcomes.

Abstract Background: Community-based nursing programs (CBNPs) have been a cornerstone of India’s strategy to reduce maternal and child health disparities, especially in rural and underserved areas. This meta-analysis evaluates their effectiveness in improving neonatal and maternal outcomes. Methods: A systematic search was performed across PubMed, Scopus, CINAHL, Web of Science, and the Cochrane Library for studies published between 2000 and 2024. Eligible studies included randomized controlled trials (RCTs) and quasi-experimental studies conducted in India evaluating community-based nursing or health worker-led interventions on maternal and child health outcomes. PRISMA 2020 guidelines were followed. Data were pooled using a random-effects model, and heterogeneity was assessed with I². Results: Twenty-one studies (n = 42,318 participants) were included. Community-based nursing interventions were associated with a significant reduction in neonatal mortality (RR = 0.78; 95% CI: 0.70–0.87; p < 0.001), and improved rates of exclusive breastfeeding at 6 weeks (RR = 1.34; 95% CI: 1.18–1.52). Institutional delivery rates increased modestly (RR = 1.19; 95% CI: 1.05–1.34). Subgroup analyses indicated greater effects in rural, low-resource states. Conclusions: Community-based nursing programs significantly improve neonatal survival and maternal health behaviors in India. Integrating such programs into primary health systems should remain a national priority. Keywords: Community Health Nursing; Maternal Health; Child Health; Rural Health; India; Meta-analysis

Maternal and Child Health (MCH) supports a broad array of programs to improve the availability and access to high quality preventive and primary health care for mothers and their children. But despite these policies, IPs/ICCs face a myriad of obstacles when accessing public health systems. The study documents and analyzes the maternal and child health practices of Indigenous Peoples in Sitio Bacao, Palayan City and assesses the impacts of such practices on their health status. This study is anchored on Larker’s Maternal and Child Health Theory (1969), supported by Bowby’s Attachment Theory and Ainsworth’s Child Development Theory (1978). The study used the descriptive and ethnographic methods of research. Primary data was collected through key informant interviews with Aeta mothers, survey questionnaires and field observations. Dietary practices of Aeta mothers and their children’s nutrition were triangulated using secondary data, analysis of Rural Health Unit (RHU) records and survey to the availability and utilization of health services and facilities. Socio-demographic profile of the respondents shows significant relation with their maternal and child health practices such age, education, income and geographical location of the respondents. The study argues that there is much to be desired when it comes to the maternal and child health standard of the Indigenous Peoples of the Philippines.

BackgroundAsylum-seeking and refugee women face significant maternal health disparities in the UK, prompting the emergence of doula and birth companion organisations to provide advocacy and support. This study examines how these organisations train volunteers on advocating for anti-racism in maternity care settings and supporting their clients.MethodsSemi-structured interviews were conducted with representatives from 12 doula service organisations across the UK, plus two training experts. Interviews explored organisational structure, volunteer recruitment and training, and mechanisms for reporting discriminatory incidents. Data were analysed using grounded theory approaches.ResultsThree key themes emerged: volunteer motivations and expertise varied significantly, with many lacking lived experiences of forced migration; organisations demonstrated inconsistent capacity to document and report racism but saw the need to implement systems; and volunteer demographics often failed to reflect client populations due to structural barriers limiting participation from marginalised communities.ConclusionWhile birth companion organisations provide essential advocacy for asylum-seeking women, systemic barriers limit their full potential. Moving toward paid positions and addressing underlying healthcare racism are necessary for meaningful change. Doula service organisations should be better funded and integrated into the national health system.

Black birth givers are 3 times more likely to die from pregnancy than their white counterparts (Center for Disease Control, 2022). While global maternal mortalities have been declining since the early 2000’s, U.S. deaths have increased drastically, more than doubling between 2000 and 2014. Black mothers are dying at the highest rates of maternal mortality than any other racial group in America (Patterson et al., 2022). Amid the reversal of Roe vs. Wade this year, access to quality healthcare continues to be under attack, impacting the livelihoods of birthing people across the nation. Now more than ever, failures in the American health system require critical attention. The disparities in maternal health outcomes are a direct result of medical racism which was born out of chattel enslavement in the U.S. The repercussions of slavery have enacted and continue to enact violence against Black mothers. It is crucial to address the historical roots of maternal health inequities in order to find solutions. This paper will examine the legacies of enslavement in America and its role in shaping modern racial disparities in maternal mortality rates in the US today. Additionally, it will explore Black women led alternatives to healthcare in order to find methods for mitigation. The research will address public health specialists and policymakers in order to emphasize the gravity of this issue and the need for action to address these disparities.

BackgroundAnemia remains a major public health concern among children under two years of age in low- and middle-income countries. Childhood anemia is associated with several adverse health outcomes, including delayed growth and impaired cognitive abilities. Although several studies in Nepal have examined the determinants of anemia among children aged 6-23 months using nationally representative data, alternative modeling approaches remain underutilized. This study applies a Bayesian analytical framework to identify key determinants of anemia among children aged 6-23 months in Nepal.MethodsThis cross-sectional study analyzed data from the 2022 Nepal Demographic and Health Survey (NDHS). The dependent variable was anemia in children (coded as 0 for non-anemic and 1 for anemic), while independent variables included characteristics of the child, mother, and household. Descriptive statistics including frequency, percentage and Chi-squared test of associations between the dependent variable and independent variables were presented. Bayesian binary logistic regression model was used to identify significant determinants of anemia. A noninformative normal prior with mean 0 and variance 1000 was assumed to derive the posterior distribution for the model coefficients. The Gibbs sampling method was executed to obtain posterior samples, and the results were summarized using posterior mean, odds ratio, standard error, Monte Carlo error, and 95% credible interval (CrI).ResultsThe analysis of data from 685 children aged 6-23 months revealed several determinants of anemia. Compared to children aged 19-23 months, children aged 6-12 months had 3.15 times higher odds of anemia (95% CrI: 2.02 - 4.91) and those aged 13-18 months had 2.35 times higher odds (95% CrI: 1.53 - 3.61). Second-born children had 1.49 times higher odds (95% CrI: 1.001 – 2.23) than first-born children. Mothers who did not take deworming medication during pregnancy had 1.57 times higher odds of having an anemic child (95% CrI: 1.14 – 2.51) compared to those who took such medication. Children living in the Terai region had 2.45 times higher odds (95% CrI: 1.53 – 3.98) than those living in the Hill region. Ethnicity also plays a role, as Dalit children had 2.29 times higher odds of anemia (95% CrI: 1.03 – 5.04) and Janajati children had 2.73 times higher odds (95% CrI: 1.24 – 5.92), compared to Muslim and other ethnic groups.ConclusionKey determinants of anemia among children aged 6-23 months in Nepal include child’s age, birth order, maternal intake of deworming medication during pregnancy, ecological region, and ethnicity. These findings highlight the necessity for targeted interventions that address demographic factors, maternal health, and geographic disparities to reduce childhood anemia in Nepal.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-24581-4.

Discussions around racial disparities in obstetrics occur in varied silos including the media, communities, and medical institutions. Yet, whether and how these discussions occur in the context of the patient-clinician relationship is unknown. We sought to explore clinician perspectives on conversations with patients regarding racial disparities in maternal health using a qualitative approach. We enrolled perinatal clinicians (N=14) across two hospitals within one academic health system from August 2023 to March 2024, purposively sampled by self-identified race or ethnicity and role until thematic saturation was achieved. Semistructured interviews using the Health Equity Implementation Framework evaluated prior experience with and optimization of disparities counseling, focusing on patient-clinician race concordance, comfort levels, barriers, ideal circumstances, and recommended content for conversations about racial disparities in maternal health. Interviews were coded with a content analysis approach by two coders with high interrater reliability (κ>0.8). Clinicians universally recognized the effect of race, specifically racism, on U.S. maternal outcomes. Conversations about racial disparities most frequently arose 1) when Black patients voiced fears of dying or concerns about bias in their care or 2) in the context of recommending aspirin for preeclampsia risk reduction. Black clinicians felt more comfortable with these discussions, attributed to lived experience and practice. Although most clinicians agreed that conversations with patients about racial disparities are important, they identified barriers such as fear of patient reactions (particularly with discordant race), time constraints, and unclear actionable response. Our findings, along with ongoing work on the patient perspective, highlight the need for respectful, informed conversations centering patient experiences. As awareness of racial disparities grows, perinatal clinicians must develop capabilities for discussing race constructively, practicing relationship-centered care, and promoting psychologic safety for Black patients.

Background:Adolescent pregnancy remains a critical global health challenge, disproportionately affecting low-resource settings and jeopardizing the health, well-being and socioeconomic prospects of young mothers and their children. Globally, 75% of adolescent births occur without adequate medical care, exacerbating risks of maternal and neonatal complications. In Zimbabwe, where cultural, economic and structural barriers further limit healthcare access, adolescent girls face heightened vulnerabilities.Objectives:This qualitative study explores the lived experiences and perceptions of adolescent mothers regarding maternal health services in Chiredzi district, Zimbabwe.Design:This study employed a phenomenological approach to capture diverse perspectives on maternal healthcare.Methods:In-depth interviews with 20 purposively sampled adolescent mothers (aged 15–19) attending Chiredzi General Hospital were conducted in March 2025, immediately after ethical approval was obtained (ethics number: NUST/IRB/2025/38). Data collection continued until thematic saturation was achieved. Interviews were transcribed verbatim and analysed using inductive thematic analysis.Results:Analysis revealed 4 primary themes and 24 subthemes, highlighting key barriers to maternal healthcare access. Financial constraints, inadequate transportation and fragmented health services were prominent structural challenges. Sociocultural factors, including stigma, discriminatory attitudes and restrictive gender norms, further deterred care-seeking behaviours. Participants emphasized the need for adolescent-friendly health services, community-based education programs and economic support to mitigate these barriers. Stakeholder engagement, involving policymakers, traditional leaders and healthcare providers, was identified as critical for developing sustainable intervention strategies.Conclusion:Addressing the maternal health disparities faced by adolescent girls requires a multifaceted, intersectional approach. Structural interventions, such as improving healthcare accessibility and affordability, must be coupled with community-level initiatives to combat stigma and promote gender equity. Empowering adolescents through education, economic opportunities and culturally sensitive support networks is essential to fostering long-term resilience. Policymakers and program implementers must prioritize adolescent-inclusive health strategies to ensure equitable maternal health outcomes in Zimbabwe and similar settings.

Black birthing people are intrinsically valuable individuals, as well as members of families, organizations, communities, and society. Yet, gendered racism exposes them to unique sources of stress that can accelerate physiological aging, increase risk for adverse health conditions throughout the lifespan, and contribute to preventable morbidity and mortality risk during pregnancy, delivery, and the postpartum period. Existing research focuses on coping strategies Black birthing people can employ to alleviate the effects of stress from gendered racism. While efforts to provide immediate stress relief are essential, interventions to reduce gendered racism in Black birthing people's environments and prevent future stress exposures are necessary to eliminate persistent and severe maternal health disparities. This critical narrative literature review applies a psychological framework of radical healing (French et al., 2020) to explore the relationship between resistance strategies and factors associated with maternal health. Specifically, this paper synthesizes evidence about strategies to empower Black birthing people and their communities with strength to resist gendered racism at internalized, interpersonal, and institutional levels. It also explores opportunities for organizations and institutions to combat gendered racism and promote equitable maternal health outcomes. Implications for future research, practice, and policy are discussed.

To address the maternal health crisis in the United States, it is important to closely examine the epidemiologic trends of and racial and ethnic disparities in maternal cardiovascular health. We used statewide birth hospitalization and vital statistics records from California (2007-2019; N=6 117 886) to examine the prevalence, trends, and racial and ethnic disparities of hypertensive disorders of pregnancy overall (ie, chronic hypertension, gestational hypertension/preeclampsia, or eclampsia), and chronic hypertension and gestational hypertension/preeclampsia separately. We also examined a construct indicating ideal cardiovascular health before and during pregnancy using the subset of data with information available on clinical cardiovascular health indicators (ie, hypertension, diabetes, smoking, body mass index [kg/m2], and gestational weight gain adjusted for gestational age; N=5 636 185). To quantify racial and ethnic disparities, we used modified Poisson regression models (with robust standard errors), controlling for sociodemographic characteristics, pregnancy-related factors, and year fixed effects. The age-standardized prevalence of adverse outcomes worsened over time for all racial and ethnic groups. Compared with non-Hispanic White (White) individuals, non-Hispanic Black mothers had higher risk of hypertensive disorders of pregnancy (risk ratio [RR], 1.60 [95% CI, 1.59-1.62]), including chronic hypertension (RR, 2.34 [95% CI, 2.29-2.38]) and gestational hypertension/preeclampsia (RR, 1.50 [95% CI, 1.49-1.52]). American Indian/Alaska Native mothers were less likely to have ideal cardiovascular health both before (RR, 0.66 [95% CI, 0.65-0.67]) and during pregnancy (RR, 0.80 [95% CI, 0.78-0.81]) compared with White mothers. These differences persisted throughout the study period. Our findings reveal stark racial and ethnic disparities in maternal cardiovascular health, highlighting the urgent need to investigate and address their structural determinants.

In September 2022, the National Institutes of Health (NIH) launched the Connecting the Community for Maternal Health (CCMH) Challenge as part of the Implementing a Maternal Health and Pregnancy Outcomes Vision for Everyone (IMPROVE) initiative (12). The IMPROVE initiative prioritizes research to reduce preventable maternal mortality, mitigate severe maternal morbidity, and address health disparities. The CCMH challenge sought to reduce maternal health disparities by enhancing research capacity within community-based organizations. Through training, mentorship, research resources, and cash awards, the CCMH challenge empowered local organizations to engage in maternal health research that directly addressed the needs of their communities. By increasing access to NIH resources, the challenge positioned these organizations to contribute sustainably to improved maternal health outcomes. This article provides practical insights into how public health institutions can support community-based research and cultivate partnerships to reduce maternal health disparities. It outlines the competition’s structure, strategies, and outcomes while highlighting key implementation challenges and lessons learned.

Child and maternal health are crucial indicators of the health status of a country's population. However, there is a regional variability among health indicators and the availability of health services. Therefore, this study aims to explore the regional disparities in Bangladesh using maternal and child health indicators from the countrywide Multiple Indicator Cluster Survey (MICS) 2019, focusing on maternal and child health and related socio-demographic variables across the country's 64 districts. Using a hierarchical clustering technique with Euclidean distance, the authors identified natural clusters among districts based on selected health indicators, such as breastfeeding, nutrition, literacy, HIV/AIDS awareness, reproductive health, and access to safe environments. The findings of clustering revealed two main groups: well-performing and underperforming regions. These clusters exhibit regional variations, with underperforming areas predominantly located in Bangladesh's northern and northeastern parts. Key findings indicate that breastfeeding initiation rates are higher than global and regional averages, but significant disparities exist among districts. Underperforming districts also exhibit lower antenatal care coverage, skilled birth attendance, institutional deliveries, and a higher prevalence of undernutrition (stunting, underweight, wasting). Literacy rates and HIV/AIDS awareness are significantly lower in some districts compared to national averages. Additionally, access to clean drinking water, handwashing facilities, and sanitation services remains insufficient in certain regions. This analysis underscores the importance of addressing regional disparities to improve Bangladesh's maternal and child health outcomes. Therefore, appropriate interventions are essential to bridge the health gaps, particularly in disadvantaged areas, by improving healthcare access, quality, and infrastructure. The results give policymakers valuable insights to tailor interventions and allocate resources effectively. Overall, the study highlights the necessity for region-specific strategies to ensure equitable health outcomes across the country.

Maternal and child oral health disparities often share similar phenomena: high disease burdens, limited access to care, and insufficient preventive strategies. These systemic challenges undermine community confidence in oral health solutions. The Eastman Oral Health Institutes in the United Kingdom, Sweden, and the United States of America, through the Eastman International Alliance, facilitated critical discussions in November 2024 on this topic in international grand rounds by highlighting the need to translate research into impactful oral health policies. This special communication calls for global action to elevate maternal and child oral health into system health by leveraging policies, enhancing service integration, addressing inappropriate industry influence (particularly in terms of sugar consumption), and using digital technology. We describe the often-overlooked oral health divide in high-income countries, using the United States, United Kingdom, and Sweden as examples, to assess shared challenges, distinct obstacles, and opportunities for global collaboration. The differences between developed countries including the United States, United Kingdom, and Sweden and the challenges faced by lower-income nations underscore the need for shared learning and a global commitment to integrated oral health care. Policymakers, health care providers, and public health advocates worldwide must work together to break down barriers and strengthen services.Knowledge Transfer Statement:Improving maternal and child oral health requires a system-level approach in all countries. Integrating oral health into system health is not just an option but a necessity for building healthier communities. Leveraging partnerships between dental academic institutions and oral health delivery organizations that are embedded in medical institutions, such as the Eastman Oral Health Institutes globally, offers a powerful vehicle for identifying, sharing, and scaling effective solutions to improve system-level oral health.

The United States ranks among the worst high-income countries for maternal health outcomes, with Black women experiencing disproportionately high and alarming rates of maternal mortality and morbidity. In Los Angeles County, Black women are four times more likely to die from pregnancy-related causes than women of other racial and ethnic groups. These disparities may partially be attributed to social determinants of health, including transportation access. Lack of transportation can hinder access to healthcare, with significant consequences for reproductive health. This study investigates how transportation barriers affect Black birthing people’s access to maternal healthcare in Los Angeles. In partnership with Black Women for Wellness, we conducted a descriptive, observational study using an online survey completed by 235 respondents, all of whom self-identified as women. Findings reveal that Black women in Los Angeles face substantial transportation barriers when seeking maternal healthcare, including limited public transportation, lack of personal vehicles, and challenges in securing rides. Many participants reported that these issues caused delayed or missed prenatal appointments. These results underscore the urgent need for policy interventions and systems-level solutions to improve transportation access. Addressing these barriers is essential for reducing maternal health disparities and improving outcomes for Black women.

Examining Veterans', Doulas', and VA Maternity Care Coordinators' Perceptions and Experiences With a Community-based Doula Pilot Program.

Black-White disparities in maternal and neonatal morbidity and mortality highlight health inequities in several settings, yet such racial disparities in Canada are not well defined. Our objective was to conduct a scoping review to identify the extent of epidemiologic evidence assessing Black-White disparities in maternal and neonatal health in Canada. We included peer-reviewed epidemiologic studies which measured maternal or neonatal outcomes in Black versus White individuals in Canada. We searched OVID platforms (MEDLINE, Embase, Emcare) from inception to May 9, 2024, using keywords and controlled vocabulary terms related to race and maternal and neonatal morbidity and mortality. Results synthesis was carried out using descriptive analysis. After exclusions, six retrospective cohort studies were included in the scoping review. The majority of the included studies used data obtained from provincial datasets (n = 5), defined maternal race using self-reported race (n = 5), and were set in Ontario (n = 4). All studies reported one or more significant associations between race and adverse maternal or neonatal outcomes, with Black individuals experiencing higher rates of spontaneous fetal loss (n = 1), perinatal mortality (n = 1), preterm birth (n = 3), small for gestational age infants (n = 1), low Apgar scores (n = 2), congenital heart disease (n = 1), neonatal intensive care unit admission (n = 1), preeclampsia (n = 2), gestational diabetes (n = 1), and inadequate gestational weight gain (n = 1). Although literature on the topic is sparse, Black-White disparities in maternal and neonatal health in Canada are apparent. National, population-based data are needed to provide a comprehensive understanding of racial disparities in maternal and neonatal health and the factors driving these differences.

Purpose American Indian/Alaska Native (AI/AN) women are 2.3 times more likely than non-Hispanic white women to die from pregnancy-related causes. In addition, resilience and a strong sense of cultural identity have been linked to positive health outcomes. Therefore, the purpose of this paper is to investigate the relationship among culture, resilience and maternal health among AI/AN women and offer culturally adapted perinatal intervention recommendations for Indigenous populations around the world. Design/methodology/approach The authors conducted a narrative review using PubMed Central, Sage Journals database, NCBI, Elsevier and Wiley using the following search terms: “Indigenous,” “perinatal,” “cultural,” “intervention,” “maternal,” “pregnancy,” “health disparities” and “resilience.” Inclusion criteria consisted of peer-reviewed papers and evidence-based intervention Web pages published in English between 2000 and 2023. Findings Key intervention themes that emerged during this review included home visiting/birthing and family support; perinatal mental health; breastfeeding promotion; and Indigenous midwifery and doula services. Practical implications of culturally adapted perinatal interventions for Indigenous women include the consideration of factors that affect program implementation such as stigma and accessibility. Policymakers must confront underfunding of public health programming and work to expand programs and interventions beyond urban centers. Finally, future research should examine strengths-based public health approaches and conduct randomized controlled trials to study the effectiveness of interventions. Originality/value This research is valuable to the field of public health because it demonstrates that by using a strengths-based approach to population health, the authors may leverage the relationship among cultural practices, resiliency and health to address AI/AN maternal health disparities.