BACKGROUND:
Indigenous women and girls globally face disproportionately high rates of maternal mortality and morbidity, posing a major barrier to achieving SDGs. These disparities remain largely invisible due to a persistent lack of disaggregated health data that would reveal the specific challenges experienced by Indigenous communities.

OBJECTIVES:
This analysis uncovers global disparities in maternal health outcomes between Indigenous and non-Indigenous women. It evaluates the availability and quality of ethnicity-disaggregated health data and highlights the critical role of Indigenous midwives in improving maternal health. The goal is to advocate for culturally responsive, rights-based solutions to address these gaps.

METHODS:
This analysis draws on a global health survey data review, focusing on key maternal and reproductive health indicators. Outcomes for Indigenous and non-Indigenous women and girls are compared, identifying global patterns and significant country-level variations. The availability and quality of ethnicity-disaggregated data were also critically assessed.

RESULTS:
Findings reveal stark disparities. Indigenous women and girls have lower use of modern contraception, higher rates of adolescent pregnancy, and are more likely to give birth at home without skilled health personnel compared to non-Indigenous women. Crucially, only 54% of reviewed surveys collect ethnicity data, and of those, only 63% allow for the identification of Indigenous Peoples, masking the accurate scale of the issue. Notably, the vital role of Indigenous and traditional midwives is underscored. When they are integrated into the health system, the rate of skilled birth attendance for Indigenous women increases from 55% to 62%.

CONCLUSIONS:
States must urgently address systemic barriers and discrimination that prevent Indigenous women from accessing their right to health. This requires mandating disaggregated data collection, ensuring culturally acceptable and accessible health services, and integrating Indigenous midwives into primary healthcare systems. Sustainable progress must be driven by solutions led by Indigenous women themselves.

KEY MESSAGE:
Indigenous midwives play crucial roles in improving indigenous maternal health. Marginalized - indigenous