Mary Sherbick found out she was pregnant at the height of the pandemic in 2020. Although she and her partner had planned it, the pandemic was anxiety-inducing and isolating. While scrolling on social media, she came across online talking circles for Alaska Native women, organized by Alaska Native Birthworkers Community (ANBC), who were pregnant or postpartum. Sherbick, who is Yupik, immediately signed up.

“A lot of us were also just concerned about the way that we would be treated, and some of our concerns of pain or our birth plans within a hospital setting,” Sherbick said. “I think a lot of the women that I talked to just were aware of the history of how Indigenous women, Indigenous people in general, have been treated, and the sterilization programs that have been done unknowingly to Indigenous people.”

Growing up in foster care and losing her mother at 17, Sherbick did not have the family connection to support her in her pregnancy. And while her relatives introduced her to Yupik foods such as dry fish and agudak, she also felt removed from her culture. Her mother did not encourage Sherbick to speak the Yupik language, due to safety concerns. “There was an attitude on being Alaska Native within an urban setting, specifically within Anchorage, of animosity,” Sherbick said. Because of this, being able to have an Alaskan Native birth worker who could provide an Indigenous perspective was deeply meaningful and centered in sovereignty, she added.

Before giving birth in May 2021 at the Alaska Native Medical Center, which is where the ANBC team works primarily to support mothers, Sherbick attended one of the group’s birth preparation workshops focused on prenatal plant medicine. Participants received ingredients rooted in Indigenous knowledge, including yellow dock root, nettle leaf and red raspberry, to make herbal teas and infusions. “I can control even the potency of it,” Sherbick said. “I used the herbal iron syrup quite a bit because I was already anemic. That really helped with my blood flow and circulation.”

Sherbick’s experience of having anemia during her pregnancy is one that many Alaska Native women can relate to. According to a research study, Alaska Native pregnant or postpartum women had higher anemia prevalence than non-Native women. Anemia is far from the only pregnancy-related issue that Native Alaskans face.

In 2024, Native American and Alaska Native people had the highest pregnancy-related mortality ratio among major demographic groups, according to the Centers for Disease Control and Prevention. Alaska Native mothers also have the highest preterm birthrates in the state, with rates rising over the past decade. Native American and Alaska Native women have a higher risk of gestational diabetes mellitus and subsequent diagnosis of diabetes, compared with non-Hispanic white women.

Sherbick, who also dealt with gestational diabetes, knew that she needed a strong birth plan and support from Native birth workers. “I had specific breathing techniques. I had a whole playlist. I had a plan of walking around, and I was really doing OK until my water broke,” Sherbick explained. A partial water break increased her risk of infection and pain, so she ultimately chose an epidural, despite not wanting one at first.

The birth workers “really did a good job at breaking down the medical verbiage and making sure I truly understood what was going on and what were the next courses of action, and if that was something that I agreed to or felt that I was ready to do,” Sherbick said. “I felt really supported and honored because of that. Someone who comes from the same heritage and values as me, it just made me feel that much better.” With her birth worker’s help, she ensured skin-to-skin contact immediately, she said: “There was no wiping. I think there was no bathing for the first 24 or 48 hours. We really wanted to make sure that she felt my presence.”

Abra Patkotak, her ANBC birth worker, said she “started Alaska Native birth workers community because we saw that these families were really isolated and they needed support. It was hard for them and to be alone during the most vulnerable time in your life, that of childbirth.” Founded in 2017, ANBC has provided free birth-related services to Alaska Native women, including prenatal care, labor support, postpartum care and support during miscarriage, abortion, loss, adoption and for LGBTQ2S+ people.

Mariana Dosal, who is Mexican and a member of the Agdaagux Tribe of King Cove, Alaska, also faced birth complications while in Anchorage. Her first birth was traumatic – she hemorrhaged and nearly bled out. Fearing a similar experience, she sought help from the birth workers at ANBC. “The next time I went in, I had more experience with how to prevent that, from the native birth worker community,” Dosal said. Patkotak “being in there to advocate for what I need allowed me to not lose as much blood the second time. I didn’t go into shock, and I didn’t need blood transfusions.”

Both Sherbick and Dosal worked with Patkotak, an ANBC co-founder who is Iñupiaq from Utqiagvik. She trained to be a doula in 2010 before moving to Utqiagvik, 750 miles north of Anchorage, where she ran a pre-maternal home. There, she saw the challenges that rural Native Alaskan women faced, including having to spend large parts of their pregnancy away from home, to give birth.

Patkotak believes community support was once central to Alaska Native births. “My Amau, my great-grandfather, helped deliver babies. And this role was a role that every single community had,” she said. However, when the Community Health Aid Program started, there was a move towards more westernized healthcare, and midwives and birth workers were absorbed into that healthcare system, “and the time honored, respected role of midwifery was no longer the same”, she added.

After a generation of Native midwives passed away, the knowledge died with them. “Now, there’s this resurgence,” Patkotak said. “I think about them all the time. I call them in to support me.”

“A lot of us in my generation have been separated from that traditional knowledge just through colonization, [and] the medicalization of birth,” added Margaret David, ANBC co-founder. David is Koyukon Dene, and a mom of four, three of whom she birthed at home with support from midwives.

On a day-to-day basis, ANBC’s work ranges from birth preparation groups to on-call support. Some parents seek help during the prenatal phase, while others need labor support. ANBC also runs a 24/7 call line for referrals from the Alaska Native Medical Center for mothers in active labor. Most of the ANBC team is based in Anchorage, with a smaller team in the valley, because many rural Alaskan mothers have to travel there to give birth. A 2025 study found 43.3% of American Indian and Alaska Native births occurred in areas with low access to birthing facilities, compared with just 3.1% for white, non-Hispanic mothers.

For many mothers, traveling hundreds of miles from home is a financial, logistical and emotional nightmare.

Dosal, who lives in Dillingham, south-western Alaska, spent her last month of pregnancy in Anchorage, nearly 400 miles from home and separated from her partner. The local clinic in Dillingham lacks a birthing center, so women are sent to Anchorage about three weeks before their due date to give birth at a hospital equipped to help with labor and delivery. “That’s a really big hardship for us, because it takes a lot of money to live in Anchorage away from home,” she said. Some people have to stay even longer, depending on the complexity of their pregnancy.

While some financial support exists for mothers in this situation, it often falls short. Dosal spent $500 on groceries her first time in Anchorage just to set up a kitchen. “So it’s not really ideal for expecting mother … and then spiritually it wreaks havoc on your spirit to be in the city when you’re used to rural Alaska,” she said. But while in Anchorage, Dosal prepared for labor with ANBC’s help. “They gave me a medicinal foot bath, and gave me a pregnancy massage, and they have all these nice things for pregnant women,” she said, explaining that it provided her friendship and community that she was missing.

For the birth workers at ANBC, though, support goes beyond labor and delivery. They use a “three sisters” model, where each sister focuses on a specific layer of support to ensure a holistic approach to sovereignty from first breath. One provides free services to Native families, another grows the cohort of Indigenous birth workers and the third focuses on systemic change for better maternal health.

David explained that for years, ANBC brought other Native trainers from across the country to come and help train birth workers in Alaska. “Last year we had somebody come do a really beautiful lactation training,” she said, but, as of last year, they created their own curriculum and now train those interested in birth work.

They conduct trainings in remote regions too, including a training in Nome, Patkotak said. “We have hopes to expand … we have a lot of hopes to just increase what we’re doing, because it’s so positive, and there’s definitely a good impact.”

By expanding, and bringing birth work to other parts of Alaska, too, they hope to continue connecting birthing families with their Native roots, improving birth outcomes and expanding postpartum support.

For Sherbick, who lives in Anchorage, ANBC’s birthing circles were invaluable postpartum, for advice on colic, teething and more. “I had no idea how great … Muktuk is, which is whale blubber. It’s really good for teething babies,” said Sherbick, who had some in her freezer at the time. “And my daughter loved it.” Sherbick’s husband is Iñupiaq and Muktuk is an Iñupiaq delicacy, one which she said her husband didn’t even know of when he was her age. She thinks that being introduced to this traditional food not only helped her in the early days of being a mother, but also contributed to her daughter’s love for the food.

“And it all comes from these Indigenous women or these Indigenous people who are willing to come together to help support each other in this very sacred time in your life,” Sherbick said.