Maternal and Child Health Resources: 2023 Synopsis

Explore AHA’s Better Health for Mothers and Babies initiative resources, highlighting hospitals and health systems improving maternal and child health outcomes, produced in 2023. 

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Download the Maternal and Child Health Resources: 2023 Synopsis

Addressing Disparities in Maternal Health

PODCAST: Improving Maternity Care for Indigenous Populations

Indian Health Services and Sanford Bemidji Medical Center, Minnesota

American Indian and Alaska Native people are twice as likely to experience pregnancy-related death as their white counterparts. Additionally, historic trauma, systemic racism and societal factors, such as inadequate transportation, housing or access to electricity or clean running water contribute to inequities. High rates of co-morbidities during pregnancy, including mental health conditions and substance use, also contribute to disparate pregnancy outcomes among Indigenous women.

Minnesota’s Sanford Bemidji Medical Center and other partners formed Families First to address these challenges in the Indigenous communities they serve. Through this Health Resources and Services Administration (HRSA)-funded-program, Sanford embedded high-risk obstetrics care coordinators in a regional network partner clinics to help identify and address patient barriers to prenatal care or manage complications in pregnancy, such as high blood pressure and diabetes. Following staff education on trauma stewardship, trauma informed care, cultural awareness and neonatal abstinence syndrome, Sanford saw a 77% decline in Child Protection Services holds for babies with neonatal abstinence syndrome, a decrease in neonatal length of stay, and an increase in referrals and use of drug and alcohol treatment programs and medication assisted therapy programs.

The Indian Health Services (IHS) developed Obstetric Readiness in the Emergency Department (ObRED) in response to the closure of rural labor and delivery units and the decline in national birth volumes. ObRED provides sites in maternity care deserts — where obstetric care is not readily available — with readiness checklists, quick reference protocols, and training curriculum for safe triage, stabilization and transfer of pregnant patients and newborns. ObRED has been introduced in three IHS Areas with over 225 providers and staff participating in hands-on simulation training. IHS is also piloting a postpartum program to offer patients care and services via telehealth and home visitation support.

Both IHS and Sanford are working on weaving culturally competent practices in perinatal care, offering transportation services to appointments, and establishing infrastructure to increase broadband access.

Tina Pattara-Lau, M.D., maternal child health consultant with the IHS Office of Clinical and Preventive Services suggested, “[Providers should] acknowledge the trauma and the bias across generations, along with resiliency of cultural practices to help build trust and provide culturally safe care. [Look within and ask], am I elevating Indigenous leaders, elders, members of the community to create systems by the people for the people they serve?”

PODCAST: Improving Maternal and Infant Services in Rural Iowa

Saint Anthony Regional Hospital, Carroll, Iowa

The Center of Excellence at Saint Anthony Regional Hospital in Carroll, Iowa, seeks to increase access to obstetrics care, improve health outcomes for moms and enhance the patient experience. In its first year, the center focused on building relationships and partnerships with communities. It also connected with federal and local leaders to understand the impact of policies on maternal health in communities and down to the bedside. To address workforce challenges, the center conducted outreach activities to encourage health workers and ignite a passion for health care among local students.

Now, in its second year, the center focuses on enhancing patient engagement by offering educational classes and postpartum support groups. “We see moms coming [to support group] through their entire maternity leave, building a community of peers, and then carrying those relationships with them as they return to work,” said Ashleigh Wiederin, OB outreach coordinator.

Additional Resources

ISSUE BRIEFS

  • Best Practices for Equitable Maternal Care
    This resource shares ways health care organizations can foster equitable practices in maternal care, individually and systemically. Case examples from The University of Chicago, NYC Health + Hospitals and Providence Swedish Hospital highlight strategies their maternal hypertension and doulas programs, respectively, are utilizing to serve diverse women better. The AHA-led discussion, Examining Best Practices for Equitable Care, with health care leaders from the CDC’s Division of Reproductive Health, National Urban League and UNC Rockingham Healthcare informed this resource. 
  • Understanding Bias in Black Maternal Health with “Toxic”
    Collected from multiple screenings of the educational film, “Toxic: A Black Woman’s Story,” AHA shares considerations for leadership engagement, systemic and personal behavior changes health care organizations can explore to provide more equitable maternal health care. Additionally, this resource shares best practices and tips for screening the film, along with case examples from Atrium Health Navicent, Colorado Hospital Association and Summa Health on their use of the film. 
  • COVID-19 Vaccination During Pregnancy: Barriers and Best Practices
    Informed by focus groups conducted by AHA’s The Living Learning Network, in partnership with the CDC and AHA’s Vaccine Confidence team, this report shares existing barriers, best practices and unique solutions in providing the COVID-19 vaccination in pregnancy. 
  • Federal Public Policy and Legislative Solutions
    for Improving Maternal Health A summary of AHA-supported federal public policy and legislative actions, including Medicaid expansion, telemedicine, maternal mental health, access and coverage, social needs and more, for enhancing maternal health in the U.S.

PODCASTS

BLOGS

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Social and Emotional Health of New Parents

HOTLINE: You’re Not Alone: Supporting New Moms With the National Maternal Mental Health Hotline

In May 2022, the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA) launched its National Maternal Mental Health Hotline. Following a full year of operations, the agency revamped the hotline in 2023 with a new easier-to remember phone number and more tools for promotion and outreach. The hotline provides 24/7, free, confidential, perinatal mental health support and resources that are accessible via call or text at 1-833-TLC-MAMA. Hotline counselors provide real-time emotional support and information on educational resources and referrals to local and telehealth providers and support groups. The hotline offers culturally and linguistically competent assistance, featuring interpreter services in 60 languages and an experienced, racially and culturally diverse hotline staff that includes licensed and trained providers such as physicians, nurses, mental health clinicians, doulas and peer support specialists.

The hotline receives over 1,600 calls and texts each month. HRSA reports that most users call when they or a loved one are feeling anxious, overwhelmed or depressed. Dr. Michael Warren, associate administrator of HRSA’s Maternal and Child Health Bureau, described the hotline’s impact on an AHA podcast this way, “Counselors will tell you sometimes moms call while pumping because it’s the only time they have a moment to themselves. They are doing this work on behalf of their child, but also taking time to engage in this self-care at the same time. Some pregnant women decided to leave their abusive partner after seeking help from the hotline.”

To raise awareness about the hotline’s services, HRSA has developed a Partner Toolkit featuring free promotional materials such as ready-made images, marketing text, posters, wallet cards and a magnet. All materials are available in English and Spanish, and HRSA has made them available for use by various health care organizations and other community partners. The AHA is pleased to partner with HRSA to promote the hotline to our member hospitals and health systems and to the patients and communities they serve.

PODCAST SERIES

Beyond Birth

A narrative podcast series on how health care organizations can support the needs of pregnant people and new parents.

Beyond Birth: The Social Needs of New Mothers with Ascension

Ascension SE Wisconsin Hospital - St. Joseph Campus, Milwaukee Ascension Providence Hospital - Southfield (MI) Campus Ascension Sacred Heart Pensacola (FL)

Ascension’s Maternal Health Social Initiative addresses the health-related social needs that prevent women from having healthy pregnancies. The initiative is staffed by ethnically diverse providers and maternal health navigators who are trained to build an open and safe environment based on compassionate listening and trusting relationships. At each visit, Ascension helps to screen and identify a patient’s social needs. Providers start each visit by conversing with patients about their social needs before diving into their clinical care. Based on the need, Ascension offers education and assistance with transportation and housing, along with food specific to those with anemia, hypertension and diabetes.

Maternal health navigators and community health workers close the loop on referrals via phone calls, clinic visits or home visits and ensure patients’ social needs are met. Since July 2022, Ascension has expanded the Maternal Health Social Initiative to five locations within the health system. There are now navigators in Wisconsin, Florida, Michigan, Tennessee and Texas. Overall, postpartum visit completion rates increased from 22% to nearly 73%, and prenatal visit completions increased by 10%. The hospitals also report giving out more referrals, decreases in missed appointments, increases in infants born at full term and at a healthy birth weight, as well as a reduction in neonatal ICU stays. A patient who participated in the program in Ascension Sacred Heart in Pensacola, shared, “Don’t be afraid to accept help when offered or ask for help. Even after my pregnancy, I still get transportation services for me and my son’s appointments.”

Beyond Birth: Understanding Perinatal Depression

With UMass Memorial Health UMass Memorial Health, MA

Universal screening at designated touch points is a necessary first step in identifying those with perinatal mental health conditions. However, those who screen positive must be supported in receiving further assessment, diagnosis and appropriate treatment to symptom remission, with access to perinatal mental health resources and professionals. The Massachusetts Child Psychiatry Access Program (MCPAP) for Moms, a program funded by the Massachusetts Department of Mental Health and developed by faculty at UMass Chan Medical School and UMass Memorial Health, helps increase the capacity of clinicians like obstetricians and nurse midwives to better address the mental health needs of individuals who are pregnant, postpartum, lactating, or thinking about conceiving. To reduce the stigma around expressing mental health needs, MCPAP for Moms developed clinical guidance, recommendations and actual verbiage for sensitive conversations with patients. Additionally, it provides technical assistance for obstetric practices in developing and embedding workflows to identify, detect and treat perinatal mental health conditions.

“It is really about building capacity so that an expanded workforce is able to address mental health conditions, and importantly, perinatal individuals get the care they need and deserve,” shared Tiffany Moore Simas, M.D., chair of obstetrics and gynecology. The program has served more than 10,000 patients to date. Clinicians who utilize MCPAP for Moms are able to address perinatal mental health conditions, including more severe mental health illnesses such as bipolar disorder.

Additional Resources

INFOGRAPHICS

BLOG

  • Supporting Families Experiencing Infant Illness or Loss
    Dell Children’s Medical Center and Hand to Hold partnered to provide early intervention support via an integrated mental health team, for parents with infants in the neonatal ICU. Northwest Community Healthcare shares the importance of building a trusting, unjudgmental relationship between patient and providers, in a vulnerable time.

PODCAST

  • The Role of Fathers in Maternal and Child Health
    Leaders from the University of Rochester Medical Center and the Association of Women’s Health, Obstetric and Neonatal Nurses examine the important role of fathers in maternal and child health and how addressing fathers’ needs can improve family well-being and create better outcomes for mother and child.

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Child Health

For Our Kids: Pediatric Behavioral Health Needs

UMass Memorial Health, MA

Since the pandemic, UMass Memorial Health has seen a rise in ED admissions in pediatric patients with mental health conditions. To address the shortage of beds and outpatient providers, leading to a 50% increase in ED boarding time, UMass Memorial implemented several processes to send kids home safer and faster. The hospital’s child psychiatrists see youths that have been awaiting a placement for more than 48 hours, and those recommended by the pediatric social worker who need a change in medications or evaluation to decrease length of stay. The child psychiatrists also refer youth to community-based care when needed. The staff is also educated in trauma-responsive care and workplace violence to reduce triggers and incidents of aggression among pediatric patients.

UMass Memorial finds value in collaboration, within and outside hospital walls, to effectively improve outcomes. They partner with the Massachusetts Department of Mental Health’s Intercept program to provide intensive home-based services and support the mental health needs of youth, outside the ED. A family behavioral intervention specialist visits the patient multiple times a week to assess the patient’s progress, connect them with additional resources and education, if needed. A 24/7 crisis line is also available for patients or their family members to call for assistance. To date, 470 youth have been connected to the Intercept program, and 91% have not been readmitted. “Whether it is a primary care provider, pediatrician, child psychiatrist or community organization, there needs to be handoff, and we must analyze the data to see the power of our interventions,” shared Brian Skehan, M.D., director of Pediatric Emergency Mental Health Services.

PODCAST SERIES

Pediatric Vaccine Confidence

The AHA developed podcasts to raise awareness about pediatric COVID-19 vaccines, for a CDC-funded project.

Additional Resources

BLOGS

WEBINAR

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Maternal and Child Health Resources: 2023 Synopsis page 1.

 

Key Resources