The AHA has created an Action Plan that describes four steps to help meet the goal of eliminating maternal mortality and reducing severe morbidity:
- Evaluate and act on your data
- Examine disparities
- Engage mothers and families
- Partner with clinicians and stakeholders in your community
This Action Plan incorporates feedback from hundreds of hospital and clinical leaders who serve on AHA’s councils, committees and regional policy boards. The member case studies below highlight how our member hospitals and health systems have worked to implement these actions.
Evaluate and Act On Your Data
Penn Medicine Addresses Pregnancy-related Hypertension with Home Monitoring Digital Technology (January 2019)
Philadelphia-based Penn Medicine improved the health outcomes of postpartum women with hypertension through its Heart Safe Motherhood program by enabling women whose pregnancies were complicated by high blood pressure to take their own blood pressure readings using a cuff provided by Penn as well as a mobile app. As a result, no women enrolled in the program were readmitted to the hospital within seven days of giving birth, compared to a 5 percent readmission rate among women monitored through in-person visits, and 60 percent of participating women reported their blood pressure readings while enrolled.
Services specific to perinatal mental health are sparse in Maryland, and those that exist are often difficult to access. In 2003, Sinai Hospital of Baltimore launched the Perinatal Depression Outreach Program to improve infant and maternal well-being through the identification and treatment of maternal mental health struggles.
Perinatal Addiction Treatment Program – Dartmouth-Hitchcock Medical Center, Lebanon, N.H. (February 2017)
The number of infants born with neonatal abstinence syndrome (NAS) has increased as opioid use skyrocketed in the region. Keeping mothers and babies safe in the midst of the opioid crisis in northern New England is the goal of a new online toolkit being tested in eight regional hospitals.
In May 2014, the Ohio Governor’s Office of Health Transformation awarded MetroHealth Medical Center in Cleveland $395,170 in grant funding to reduce lengthy hospital stays and promote improved health outcomes for opiate-dependent mothers and their newborn babies. The funding was a part of a joint partnership between the Ohio Departments of Medicaid and Mental Health and Addiction Services called the Maternal Opiate Medical Support (MOMS) Project.
In 2001, a Samaritan Health Services (SHS) physician, Dr. Richard Wopat, recognized the need to improve birth outcomes of high-risk pregnant women in the region. In collaboration with various community and state partners, he started a pilot program in 2002 at Good Samaritan Regional Medical Center to ensure that the most vulnerable pregnant women had access to care and to screenings for special issues including medical, obstetrical, and psychosocial concerns. Today, the Samaritan Maternity Connection (MC) program is now implemented at all five of the SHS hospitals and the three county health departments.
Institute for Diversity and Health Equity Case Study
The Women in Neighborhood Network – Henry Ford Health System, Detroit
The Institute for Diversity and Health Equity, an affiliate of the American Hospital Association, works closely with health services organizations to advance health equity for all and to expand leadership opportunities for ethnic minorities in health management. We have long believed that promoting diversity within health care leadership and tackling health disparities is critical to ensuring the highest quality of care for everyone.
The Women in Neighborhood Network empowers mothers and their support partners to help thrive along with their babies during the first year. This program piloted an enhanced model of group prenatal care with CHWs and Certified Nurse Midwivers.
Engage Mothers & Families
The Welcome Baby Program is part of a community network of programs that work together to provide supportive services to families with newborns. Developed in partnership with First5LA, it is a voluntary, universally provided hospital and home-visitation program offered at no cost to pregnant and postpartum women.
Creating a Community Net for Vulnerable Women and Children – Mercy Health Fort Smith (Ark.) (October 2018)
Mercy Health Fort Smith delivers approximately 2,500 babies annually. In this organization’s region, drug addiction, domestic violence and post-partum depression are a significant struggle among pregnant women, so the hospital’s leaders decided to address those issues directly.
Yale-New Haven Hospital (YNHH) demonstrates its longtime commitment to families – especially mothers and children – by providing a variety of wide-ranging programs. Working within its diverse urban surroundings, YNHH partners with parents to support healthy children through initiatives both within the hospital and out in the community.
A Multi-Pronged Approach to the Opioid Crisis – Catholic Medical Center, Manchester, N.H. (February 2017)
In Catholic Medical Center’s Mom’s Place obstetrical unit, there has been almost a doubling in the percentage of babies born with neonatal abstinence syndrome (NAS) since 2011. In the hospital’s Pregnancy Care Center, an innovative program named Roots was developed to engage pregnant mothers suffering from SUD so that they can have a safe pregnancy and ultimately deliver an infant who is not addicted.
Partner with Clinicians and Community Stakeholders
Reducing Infant Mortality: Maternal and Infant Outreach – Parkview Health, Fort Wayne, Ind. (December 2018)
The Maternal and Infant Outreach initiative is offered in partnership with multiple social services agencies aimed at reducing infant mortality by providing resources to expectant and new mothers, including Healthy Families, Associated Churches, A Hope Pregnancy Center, Beds and Britches, Etc., SCAN, and the Neighborhood Health Clinic.
The Healthy Beginnings program, in partnership with the Delaware Division of Public Health, brings together preconception care, which identifies and addresses risks to future pregnancy; pregnancy planning to guide women through the critical first steps that can set the stage for a healthy pregnancy; and prenatal care that promotes the well-being of mother and baby from conception to childbirth.
Northern New England Perinatal Quality Improvement Network – Dartmouth-Hitchcock Medical Center, Lebanon, N.H. (November 2018)
Sixteen years ago, Victoria Flanagan, R.N., M.S., and Michele Lauria, M.D., M.S., became increasingly alarmed as provider after provider closed vaginal-birth-after-a-caesarean (VBAC) programs across northern New England. In their clinical work, Flanagan and Lauria witnessed the burden such closures placed on women. Thus, what began as a collaborative project to investigate the VBAC issue for their master’s degree program evolved into what is now known as the Northern New England Perinatal Quality Improvement Network (NNEPQIN). Today, NNEPQIN consists of 43 organizations throughout New Hampshire, Vermont, and Maine involved in perinatal care, including hospitals, state health departments, professional midwifery organizations, and the March of Dimes.
Community Efforts to Decrease Infant Mortality – Aultman Health Foundation, Canton, Ohio (October 2018)
Ohio is ranked 48th in the nation in overall infant mortality and 49th in infant mortality for African-American babies. Aultman has collaborated with the Canton-Stark County THRIVE initiative to reduce the infant mortality rate and the disparity rate.
South Carolina suffers from a high rate of preterm birth, with 11.1 percent of women delivering prior to 37 weeks gestational age. There is also a racial disparity in rates of prematurity, with 14.1 percent of African-American women in South Carolina delivering preterm. To address these issues, Greenville Health System (GHS) partnered with the March of Dimes and the South Carolina Department of Health and Human Services to start implementing CenteringPregnancy group prenatal care at GHS and across the state.