; Whereas indigenous women benefit from increased resources and access to community-based health care facilities, including indigenous midwives, doulas, and birth centers; Whereas the IHS, as part of the Department of Health and Human Services, operates health care facilities and administers and provides funding to health programs, including ITU facilities for American Indians and Alaska Natives, but remains severely underfunded and lacks resources to provide adequate health care services for American Indian and Alaska Native women that are culturally competent, including prenatal care, labor and delivery services, and a full range of culturally informed family planning services; Whereas the lack of funding and resources at IHS severely limits the ability of the ITU to provide health care services and administer health programs to American Indians and Alaska Natives; Whereas the United States Commission on Civil Rights found that American Indian and Alaska Native health care provided through IHS is inequitable and unequal with Federal expenditures per capita that remain well below other Federal health care programs and only cover a fraction of the health care needs for American Indians and Alaska Natives; Whereas, in 2017, IHS health care expenditures per person were $3,332, compared to $9,207 for Federal health care spending nationwide; Whereas historical trauma and gender oppression, coupled with the social determinants of health inequities experienced by indigenous women in the United States, is further perpetuated by severe underfunding of ITU facilities that continue to contribute to the disproportionately high rates of American Indian and Alaska Native maternal mortality and morbidity rates; Whereas culturally inadequate and institutionalized discrimination perpetuated by the Federal Government’s failure to uphold the trust responsibility by adequately funding health care services for American Indians and Alaska Natives continues to play a consequential role in their health care experiences and outcomes