Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Indigenous Health

First Advisor

Andrew D. Williams


Before for the impacts of colonization, Indigenous women and birthing people were deeply cared for by their communities during pregnancy, birth, and the postpartum period.There is a serious lack of literature on perinatal mental health (PMH) for Indigenous Peoples in the US. Based on what limited data does exist, high rates of PMH complications are consistently reported for Indigenous birthing people. Exploring the unique circumstances experienced by Indigenous birthing people is crucial to addressing the PMH disparity gap. A concept map illustrating the systematic, community, and individual levels of PMH complications for Indigenous Peoples was used to organize and guide the dissertation. The process paper outlines a community asset mapping process and includes crucial considerations when engaging Tribal communities to address PMH disparities including community-based participatory approaches and mechanisms to include strengths and resources from Traditional Knowledge. A cultural safety toolkit was designed to help health providers in Montana improve care for Indigenous women and birth givers by deepening their knowledge on content related to cultural safety tenets during the perinatal period. Finally, a secondary quantitative data analysis was conducted to investigate the association between adverse childhood experiences vs. symptoms of depression and smoking postpartum using North Dakota Pregnancy Risk and Assessment Monitoring System data. The manuscript contained context was provided to emphasize the Indigenous experience of PMH complications. The work presented in this dissertation emphasized the importance of engaging Indigenous communities to address PMH disparities through strength-based approaches grounded in local cultural values.