AMNA NAWAZ: A recent study found a disturbing rise in the number of deaths among pregnant women and new mothers during the pandemic, and not just because of complications from pregnancy and childbirth.

The report by "The Journal of the American Medical Association" found that, from 2019 to 2020, there were 4,535 deaths among pregnant women and new mothers.

That was up from 1,588 deaths pre-pandemic.

Native American women faced the greatest risk by far during this period.

They were three-and-a-half times more likely to die than white women.

To better understand what's driving this increase, I recently spoke with Jessica Whitehawk, the founder of the Ttawaxt Birth Justice Center on the Yakama Nation Reservation in Washington state.

Jessica Whitehawk, welcome to the "NewsHour."

And thank you for joining us.

Let's just begin with, knowing what about maternal care for Native women going into the pandemic, did you expect to see these kinds of increases?

JESSICA WHITEHAWK, President and Founder, Ttawaxt Birth Justice Center: Yes, when we went into the pandemic, our team knew that there was going to be a lot of issues that were going to be revealed and intensified.

But we didn't quite understand until it started -- until we started seeing it now, what it actually was going to be.

But we did anticipate it, yes.

AMNA NAWAZ: Tell me why.

Why did you anticipate that increase going in?

JESSICA WHITEHAWK: For many years, and, historically, we have had really high infant and maternal mortality rates.

And as public health crisis such as a pandemic happens, we know that, in general, that the populations that are already struggling were going to struggle even more.

And so that's -- that was a fear that we had when the pandemic began.

AMNA NAWAZ: So tell us about those struggles.

What does prenatal and postnatal care look like for most of the women that you serve?

JESSICA WHITEHAWK: For most of the women that we serve, they are experiencing health care through federally qualified health care systems, which have very limited office visit time, and the care that's provided is subpar.

During a prenatal visit, they often only have three to seven minutes per visit, which isn't enough time to be able to ask questions and understand what's going on with your body or even for a doctor to understand what complications or what additional things are needed beyond prenatal care.

AMNA NAWAZ: And, Jessica, I found it interesting, in the report, they found pregnant and recently pregnant Black women also faced an increased risk.

Their odds of death were double those of white women in this period they were looking at.

When you look back to the pandemic, it really laid bare a lot of the structural racism that exists in our health care system.

Did you see that among the population of Native women you serve as well?

JESSICA WHITEHAWK: Absolutely.

There was structural racism there before.

And, as the pandemic began, it really opened those cracks in a way that revealed numbers that cannot be ignored.

AMNA NAWAZ: We know pregnancy is a time of enormous stress on the body.

But there were all these other causes of death not linked to pregnancy or complications from that itself, Native women five times as likely to die in car accidents during or after the pregnancy, three times as likely to die of drug overdoses or homicide, four times as likely to die by suicide.

In your role trying to support these women, where do you even begin?

How do you address all this?

JESSICA WHITEHAWK: A lot of the reasons why this is happening is very historical.

Violence against Native American women has taken place since the inception of America.

This has not changed over time.We still have very high missing and murdered indigenous people rates.We are in -- still in a battle with this type of violence.

What our organization does and what we believe are the values is that, when you rebuild community and support for each other and start getting access to high-quality care, support through other women, support through culture, support through language and rebuilding our nationhood, that that's the way that we want to address all of these numbers and the things that we're seeing.

AMNA NAWAZ: Jessica, as you know, maternal health is really a mix of social factors, economic factors, a lot of things.

But it's widely seen as a key indicator in overall social well-being.

When you look at these latest numbers, what does that say to you about that?

JESSICA WHITEHAWK: It's scary.

I feel -- I feel that this is -- it is absolutely our life givers are the people that determine the foundation for our future.

As we continue to build these systems that are grounded in community and continue to support through culture and healing, that these numbers will improve.

But this is going to take a long time to fix.

It's taken a long time to get here, and it's going to take a lot of work and a long time to fix.

AMNA NAWAZ: That is Jessica Whitehawk of the Ttawaxt Birth Justice Center in Washington state.

Jessica, thank you for your time.

JESSICA WHITEHAWK: Thank you.