The Indian Health Service and ACOG Committee Observes 50 Year Collaboration

Monday, April 20, marks 50 years since ACOG's American Indian/Alaska Native Women's Health Committee and HHS's Indian Health Service (IHS) began its partnership. Dr. J. Chris Carey, FACOG, past member of the American Indian/Alaska Native Women's Health Committee, reflects on the impact the ACOG and IHS partnership has had supporting and improving the lives of AI/AN women and their children for over 50 years.

In 1970, ACOG formed the Committee on American Indian/Alaska Native Women’s Health (AI/AN). At that time, maternal mortality in AI/AN women was two and a half times that of women in the rest of the country.  

The committee was formed in large part due to the efforts of Beryl Blue Spruce, MD (1934-1973), an obstetrician-gynecologist who was the first Pueblo Indian physician. Dr. Blue Spruce was a remarkable man who went from the Pueblo to Stanford University, the medical school at the University of Southern California, an internship at Albert Einstein in Philadelphia, residency in obstetrics and gynecology at Pennsylvania Hospital, and then a MPH from the University of Michigan. He was an advocate for Indian Health who suffered from lung disease as a child and as a young man. He tragically died in 1973 from a respiratory infection and respiratory failure¹.  

To me, Dr. Blue Spruce exemplifies Indian Health and ACOG’s involvement with Indian Health. He started from the Pueblo and rose to excel at some of the highest academic institutions in the country, despite his own poor health.  

He advocated tirelessly for Indian Health and was able to influence the health of AI/AN women with very limited resources. ACOG recognized the need for improvements in AI/AN women’s health, and was able to significantly improve health through advocacy and volunteers.  

I am a member of the Muscogee (Creek) Nation. I first joined the Committee in 2000 and was privileged to serve through 2006. I count my service on the Committee as one of the greatest privileges of my life. 

The Committee allowed me to give back to the people of my heritage. Like many native people, and like Dr. Blue Spruce, I was torn between two worlds. How can you advance as a scholar and academic physician, and stay with your people? How can you stay with your people and develop the skills you need to advance their care? 

Through the Committee, I was able to meet a great many people, native and not, who were able to blend these two worlds. I met many dedicated physicians and other providers who spent all or part of their lives in service to Indian Health, and native people who were able to study and advance skills that benefited native people and others. I learned how ACOG could advance women’s health in native communities by sharing the knowledge and talents of people in the communities, in the IHS, and in the greater community of obstetrician-gynecologists. The experience helped me grow as a physician and as a person. When I was in a personal and professional crisis, the Committee and its staff helped me immeasurably.  

In my time on the Committee and as ACOG’s representative to the CONACH, I had the opportunity to visit almost every region and area in Indian Health. I saw everything from wonderfully organized and functioning health systems, to sites that were in crisis. All of them were dedicated to providing the best care that they could give under the circumstances, and I think that we were able to offer something to each site. I left some sites with a great feeling about the care, and others with the sick feeling that I had not been able to do what needed to be done. But I now think that we were able to do at least something at every site. Sometimes the good we do is not immediately obvious, and maybe not seen for years.  

To me, the Committee exemplifies what ACOG does best. It exemplifies the core values of ACOG. The tireless support of ACOG and its staff make a huge difference in the health of AI/AN women, and in future generations of native people. The next Beryl Blue Spruce is out there, and I hope the Committee will help that person become an obstetrician-gynecologist that can contribute as much as he did.

I know that the Committee helped me more than I contributed to the Committee, and my service benefited me in ways that I did not see until later. That is the nature of service – the good you do for others, does you good as well.

¹Minority Contributions to Science, Engineering, and Medicine.  Funches, Peggy; and others,  San Diego Public Schools, San Diego, 1978