On this Indigenous Peoples’ Day we welcome a guest post from Brianna Theobald, author of Reproduction on the Reservation: Pregnancy, Childbirth, and Colonialism in the Long Twentieth Century, published this month by UNC Press.
This pathbreaking book documents the transformation of reproductive practices and politics on Indian reservations from the late nineteenth century to the present, integrating a localized history of childbearing, motherhood, and activism on the Crow Reservation in Montana with an analysis of trends affecting Indigenous women more broadly. As Brianna Theobald illustrates, the federal government and local authorities have long sought to control Indigenous families and women’s reproduction, using tactics such as coercive sterilization and removal of Indigenous children into the white foster care system. But Theobald examines women’s resistance, showing how they have worked within families, tribal networks, and activist groups to confront these issues.
The History-Making Work of Native American Nurses
When I began researching the history of pregnancy and childbirth on Indian reservations, Native American nurses were not on my radar. Years later, I have concluded that these women—for most of the twentieth century, nurses on reservations were almost entirely women—were key historical figures in the evolution of Native women’s reproductive experiences over the course of the twentieth century. Through their presence and their labor, Native nurses helped shape patients’ experiences of government hospitals. They served as cultural mediators and often as patient advocates and watchdogs. At key moments in Native American history, their status as “insiders” within the federal medical apparatus spurred Native nurses to activism.
Throughout the nineteenth century, Native women as well as men played important roles as healers in Native communities. A woman, particularly an older woman, might have been regarded as having particular knowledge regarding plant-based medicines, for example, and women performed vital work as midwives, a role that often extended beyond assistance during childbirth. As the federal government implemented its assimilation agenda in the last decades of the century, however, policymakers and local authorities viewed health and medicine as a crucial site for transformation. The Bureau of Indian Affairs criminalized the work of male healers and disparaged Native women’s healing knowledge.
But some government employees and missionaries also recognized that Native women could potentially facilitate the assimilation process through medicine, while also providing basic care that was so urgently needed in many communities. Boarding schools often provided female students with rudimentary nursing training, and in the 1930s the BIA established a nurse-training course at the Kiowa Indian Hospital in Oklahoma. The course lacked accreditation, however, and effectively prepared students to work as aides in government hospitals, where they remained near the bottom of hospital hierarchies.
Nevertheless, small but growing numbers of Native women became registered nurses before World War II, with or without government assistance. Susie Walking Bear (Yellowtail) became the first Crow registered nurse in 1927. Within a few years, she was working at the government hospital on her reservation. She quickly began speaking up about the institution’s inadequacies and the mistreatment of Crow patients, especially women. Although she did not remain employed at the hospital long—she resigned out of frustration after a few months—Yellowtail advocated for the removal of physicians with whom she and others were dissatisfied.
As Susie Yellowtail’s story suggests, Native nurses could be disruptive forces within government hospitals. Partly for this reason, for decades the BIA preferred not to assign Native nurses within their home communities and instead to send them to hospitals on other reservations. In doing so, the BIA was increasingly at odds with the demands of tribal leaders, who viewed the employment of tribal members at local hospitals as a matter of self-determination.
By the early 1970s, there were enough Native American nurses to form a professional organization, the American Indian Nurses Association (AINA). AINA raised awareness of health disparities; sensitized non-Native medical providers to tribal histories and cultures; and advocated greater openness to Native healing practices. In these same years, some Native nurses adopted more explicitly activist roles in the context of growing concerns of coercive sterilization in government hospitals. In 1973, Connie Pinkerton-Uri, a Choctaw and Cherokee physician, visited the government hospital in Claremore, Oklahoma, at the invitation of more than a dozen Native nurses who were protesting discriminatory labor practices and poor patient care. During her visit, the nurses made her aware of what she referred to as a “sterilization factory” at Claremore. While some Native nurses would ultimately become frustrated by the politicization of reproductive health care, Pinkerton-Uri regularly credited Native nurses with leading the “revolt” against unethical sterilization practices.
During the last years of Susie Yellowtail’s life—she died on Christmas Day 1981—she, other members of AINA, and Connie Pinkerton-Uri, among others, shared at least one conviction: the future of Native health and well-being depended on the recruitment of more Native nurses.
Brianna Theobald is assistant professor of history at the University of Rochester. Follow her on Twitter.