Each session has been uploaded to our YouTube Channel and linked below. Be sure to subscribe!
|Leveraging Policy to Achieve Maternal Health Equity ||Jamila Taylor, Breana Lipscomb, Kichelle Webster||Policies in the U.S. have caused and exacerbated racial inequities in maternal health outcomes. With intention, policy can be leveraged to counter structural racism and achieve maternal health equity. Some examples of federal and state policy approaches that would help the U.S. achieve maternal health equity include passage of the Black Maternal Health Momnibus Act and the extension of Medicaid coverage to 12 months postpartum.|
|Male Engagement to Improve Maternal Health||Wesley Bugg|
|Men have great potential to proactively support and improve maternal health. Join this panel of male maternal health advocates as they provide concrete examples of male engagement in pregnancy and postpartum support, including challenges and inspiring successes.|
|Building More Equitable Organizations to Support Maternal Health||Stacy Scott|
|With data consistently showing that Black and Indigenous women are 2-3 times more likely to die due to pregnancy-related complications compared to White women, addressing health disparities in maternal health is an essential component of our collective work. Can we truly expect to address the inequities in health outcomes if we don’t fix the inequities within our own organizations? During this panel presentation, speakers will share challenges and opportunities for health organizations to truly become equity aligned organizations and why this is a necessary step for improving maternal health outcomes. Speakers will share specific tools they’ve developed to support organizations in their work toward equity alignment, as well as lessons learned from their own organizational journeys.|
|Learning from Local Initiatives to Improve Maternal Health||David Fakuhnle|
|Improving maternal health outcomes requires investment and action at many different levels, including at the local level. In this opening session, panelists from the host city of the National Maternal Health Innovation Symposium, Baltimore, Maryland, will discuss challenges and community-informed solutions to support maternal health.|
Workshops – View the full playlist on YouTube.
|A Focus on Indigenous Birth Work||Nicolle L. Gonzales||An overview of indigenous birthworkers and the movement to reclaim sovereignty for birth and reproductive health.|
|A Holistic Approach to Maternal Health in Rural Indiana||Heather M. Grable|
|The Indiana Rural Health Association (IRHA) has implemented Healthy Start Communities that C.A.R.E. (HSCC) into four rural Indiana counties. Through this grant from HRSA, we have placed family nurse practitioners (FNP) and a licensed clinical social worker (LCSW) to serve pregnant women, postpartum women, and women of child-bearing age. By taking a holistic approach to maternal health through behavioral, mental, and clinical services, there has been an increase in access to care through these providers to provide an enhanced level of healthcare services. FNP and LCSW services are of no cost to women in the targeted geographic area, eliminating previous barriers to health insurance and access to care. HSCC has improved health literacy to Spanish-speaking populations through bilingual providers to assure quality of care and health care services and overcome language barriers. HSCC’s LCSW has supported and continues to support women, addressing behavioral/mental health concerns by providing trauma-informed care and identifying impacts of COVID-19 on overall maternal mental health. This presentation will give an overview of the implementation of these providers into HSCC, the barriers encountered, and accomplishments achieved.|
|Addressing Maternal Mortality and Morbidity through Father Engagement||Latrice Rollins||Georgia has one of the highest mortality rates among Black mothers and infants in the nation. Despite extensive practice guidance and research evidence on the positive impact of father involvement on perinatal health disparities, involving fathers, specifically Black fathers, is one of the least explored, articulated, and therefore implemented, aspects of maternal/child health services. Additionally, the health and social services system as a whole is currently not equipped to involve Black fathers in a way that is supportive to the fathers themselves, which in turn impacts their ability to support mothers’ and children’s health and well-being. This session will describe strategies and lessons learned from two community-based participatory research projects to address the high rates of Black maternal morbidity and mortality in Georgia through father engagement in maternal and child health services. Using a community-based participatory research approach through a collective impact framework, we assessed the father-friendliness of 4 diverse, maternal and child health providers, identified father-specific programs and resources in Georgia, and implemented breastfeeding and nutrition education for expectant mothers and fathers in the Healthy Start Programs in Georgia.|
|Addressing postpartum behavioral health needs in an innovative Two-Generation Primary Care Clinic||Anne Elizabeth Glassgow||Primary care clinics often offer limited behavioral health care, particularly for postpartum women. In October 2020, we opened an innovative Two-Generation Clinic that integrates behavioral health and primary care for postpartum women and their infants. The Two-Generation Clinic is located at UI Health, an urban safety net healthcare system that serves many of the poorest communities in Chicago. Providing integrated care for postpartum women in an urban area with limited behavioral health resources increases access to care and utilization. The multidisciplinary team includes primary care physicians, psychiatrists, obstetricians, bilingual social workers, advance practice nurses, and community health workers. Primary care is provided to women and their infants by the physician and team simultaneously. All women receive comprehensive behavioral health screening (mental health, trauma/PTSD, substance use, violence, and social determinants of health) and are offered social work support, counseling, and psychiatry services. All women in the clinic receive at least one contact with a social worker and a psychiatrist reviews all behavioral health screenings. The model includes weekly multidisciplinary team meetings to review all patients and develop care recommendations. We will present the Two-Generation Clinic model of care, describe the implementation of the model, and provide case presentations. |
|Careers in Maternal Health||Siani Antoine|
|Learn about the various career paths in maternal health in a moderated panel discussion. This workshop will highlight the career paths of three panelists. Panelists represent a range of careers including health communications/media, public policy and government affairs, community engagement, and project evaluation/ monitoring. Our unique panel will expose you to numerous careers in maternal health outside of the hospital setting with an open Q&A at the end.|
|Centering Women’s Voices in Maternity Care Quality Improvement||Kuann Fawkes|
|Charting the Course for Equity and Innovation in Maternal Health and Families in the Workplace||Averjill Rookwood||The workplace has historically required that employees function in a manner that does not acknowledge their parenthood and any challenges that present themselves at any point in the journey. In the modern workplace an overwhelming majority of employees are parents and yet women specifically are forced to navigate inequitable and impractical policies, benefit practices and cultural norms. These practices impede upon their overall health and well-being while trying to form and sustain families at work. |
Workplace practices, policies and benefits are often constructed in a silo that ignores the specific needs of the employee population at large and instead focuses on risk aversion and cost containment without digging deeper for root cause. This workshop will highlight the ways that maternal health, family forming and family sustaining at work is currently steeped in implicit bias and explore paths forward that require a strategic approach to create and protect maternal health and balance at any point in the continuum.
|Compensating Hospitals for Work on Quality Improvement Initiatives: Who, How, and When?||Andreea Creanga|
|This workshop will discuss ways in which hospitals and obstetric providers can be compensated for participation in quality improvement (QI) initiatives and adoption of evidence-based practices to prevent adverse maternal outcomes and reduce outcome disparities in the US. Dr. Andreea Creanga will introduce the topic and presenters and moderate the discussion. Building on his experience with hospital QI and state- based quality collaboratives in California, Dr. Main will discuss compensation mechanisms like Medicaid waivers and health plan incentives. Ms. Allison Lorenz will use examples from her work in Ohio (e.g. GDM Collaborative, implementation of the severe hypertension AIM bundle) to describe modalities to motivate the long-term participation of obstetric providers and hospitals in statewide QI projects by offering financial support to clinician champions and using technical assistance funding to enhance collection and use of implementation process and outcome data. Ms. Diane Feeney will share experience with Maryland’s Health Services Cost Review Commission use of financial incentives for hospitals, including a hybrid reward/penalty model for reducing preventable readmissions in Maryland hospitals – the model takes into consideration both hospital improvement year-to-year by measuring intra-hospital readmissions and hospital attainment or “relative performance” by measuring inter-hospital performance. A 20-min Q&A session will follow.|
|Conversational Capacity: A Simple Communication Technique to Improve Conversations and Deepen Understanding||Amy Mullenix||In any communication exchange there is the potential to hit a ‘sweet spot’ where conversations are balanced, open, and non-defensive. These are the most productive conversations. This session is about how to achieve this sweet spot. This skill-building workshop will enhance participants’ communication skills by deepening understanding of traditional “winning-minimizing” communication behaviors, followed by brief exercises that illustrate how participants can actively employ “candor-curiosity” behaviors in order to reduce unproductive behaviors and increase engagement during difficult conversations. The use of the “candor-curiosity” approach to ensure equity is centered and all voices are heard will be discussed. As time and format allows, participants will practice the “Advocate-Explain-Test-Inquire” conversation cycle with partners or in small groups. Participants in this session should experience more success in challenging conversations as they continue to practice this skill, and correspondingly enhanced effectiveness, higher job satisfaction, lower stress, and more energy for creatively fulfilling their maternal health mission. Content for this workshop is based on the book Conversational Capacity (Weber, 2013).|
|Coordination of Federal Programs to Maximize Maternal Health Improvement Initiatives across the United States||Kimberly Sherman|
|This workshop will provide an overview of current federal maternal health programs supported by the Department of Health and Human Services Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC). Specifically, staff from the HRSA/Maternal and Child Health Bureau (MCHB) and CDC/Division of Reproductive Health (DRH) will discuss efforts to coordinate federal programs to maximize impact across the United States. Presenters will provide specific examples of coordination efforts, shared program measures approaches, and aligned goals. Participants will be provided an opportunity to provide feedback on how further alignment nationally could support alignment of initiatives at the state and local levels. High level, emerging program priorities will also be shared and there will be an opportunity for participants to provide feedback and suggestions for consideration related to future program enhancements and new program development.|
|COVID Response Sessions Going Virtual with the Maternal Telehealth Access Project||Juan Michelle Martin|
|Emergency Relief Efforts to Support Maternal Health in Home Visiting||Anne Peterson|
|This session will highlight innovative strategies employed by Nurse-Family Partnership (NFP), an evidence-based community health program focused on improving maternal and child health outcomes, to address the digital divide and economic implications of the COVID-19 pandemic among clients. In March 2020, in response to the COVID-19 pandemic NFP began delivering its nurse home visitation model exclusively via telehealth. With the transition to telehealth and the economic downturn during the pandemic, a gap in NFP’s ability to fully meet client needs emerged.|
First, NFP identified approximately 10% of clients – about 3,800 first-time mothers – who lacked access to technology needed to stay connected to the NFP program. Additionally, NFP clients experienced high rates of job and income loss due to COVID-19. To mediate these impacts, NFP, in partnership with corporate, philanthropic and nonprofit partners, provided two forms of emergency relief – cell phones with data service provided at no cost to 3,000+ moms , as well as direct cash assistance to 4,000+ families to support economic stability. Presenters will share how NFP operationalized these two innovations, lessons learned from these expanded emergency relief efforts, and ongoing evaluations of the innovations’ impact on families – highlighting the connection between social determinants and maternal health and wellbeing.
|Engaging a lived experience advisory group in a maternal telehealth program evaluation||Deitre Epps|
|The Maternal Telehealth Access Project aimed to increase access to virtual perinatal services and supports to women at greatest risk of maternal mortality and morbidity, including women of color and women who live in rural and frontier communities during COVID-19. |
The lead evaluator, RACE for Equity, developed an equitable, results-based evaluation approach incorporating the Results Based Accountability framework and principles of Culturally Responsive Evaluation to understand how well MTAP funding met the needs of intended communities. A critical part of the approach included engaging community members in the Lived Experience Advisory Group (LEAG). The LEAG provided recommendations and key information to the evaluation team to ensure quality, useful, and credible evaluation findings.
In this workshop, select members of the LEAG and the LEAG planning team will describe the importance and feasibility of the LEAG, including the process of engaging 13 LEAG members in monthly meetings, the importance of building an evaluation team that has a meaningful connection to the lived experience of the stakeholder community, and key lessons learned to inform future engagement opportunities.
LEAG members will share their experiences as LEAG members, parents, doulas, community health workers and advocates from communities impacted by maternal health inequities.
|Engaging Level I Hospitals in a Pandemic: How Iowa Recruited Hospitals to Join AIM||Debra Kane|
|Amidst a pandemic that had hospitals stretched thin and over capacity, Iowa joined the AIM program and began to recruit hospitals to participate in the first safety bundle: Reducing Primary Cesarean Births. Despite the challenges faced by hospitals across the state, 43 of 57 birthing hospitals in Iowa agreed to participate in our first safety bundle! This level of participation accounts for over 93% of all Iowa births. This session will outline specific strategies employed by the Iowa AIM team to engage hospitals, and an overview of our brand new maternal health data center.|
|Engaging Providers to Improve Maternal Health||David C. Lagrew Jr.||Successful engagement of providers in adopting best practices in care often is the most common reason for quality improvement failures. We will explore the most common causes of poor engagement leading to these results. The importance of supporting efforts with the correct selection and sharing of clinical data will be emphasized. Methods for persuading physicians to become champions and join team based care and quality improvement efforts, will be specifically addressed.|
|Improving the quality and expanding the delivery of warning signs education for pregnant and postpartum patients and their families: Innovations from four states||Jennifer Callaghan-Koru|
|Patient education on the warning signs of maternal complications is a recommended strategy to reduce preventable maternal deaths. During this session, four states with Maternal Health Innovation awards (Arizona, Illinois, Maryland, and Ohio) will present their warning signs education programs. The workshop will address considerations for selecting and adapting educational materials, multi-level delivery strategies for warning signs education, equity considerations including health literacy and cultural competency, and evaluation approaches. This workshop will highlight the unique program components of each state, providing a “landscape” of innovations for other states and organizations to consider adapting for their own programs.|
|Leading with Race: Shifting Gears in Community Engagement||Karinda Roebuck|
|The health care system continues to struggle to overcome disparate maternal health outcomes as there is not a human rights based approach to health care. Equity for Moms and Babies Realized Across Chatham (EMBRACe) is a grant-funded project that aims to achieve equitable birth outcomes for women through the alignment of systems and services across five local health and social services institutions. EMBRACe partnered with a local racial equity organization, Chatham Organizing for Racial Equity (CORE) to center racial equity in all aspects of the project’s work. We will focus on how this partnership reimagined equity and community engagement for EMBRACe partner organizations. CORE helped to create a learning community grounded in Reproductive Justice and human-rights principles. Within this framework, EMBRACe now leads with race and has redefine community engagement to be community-led rather than community informed enacting the liberating theory of relational power through Story Circles. Sharing personal stories addresses the unreconciled and unaddressed racial trauma experienced throughout the entire perinatal experience. There is strength and power in the collective stories and showing women that collective power and how to harness that power is a step towards shifting power dynamics from institutions to the women themselves. Relational power is trusting Black and Brown women to know what is best for themselves and following their lead in how our institutions are constructed. We believe that communities of color in Chatham County hold the key to a maternal health policy and practice agenda that honors and exemplifies the human right of all women to achieve the best possible reproductive health outcomes.|
|Moving Upstream: Strategies for Improving Maternal Health Before Pregnancy||Sarah Verbiest|
Omar M. Young
|Maternal mortality review committee findings as well as the U.S. Surgeon General’s Office continue to identify improving women’s health before pregnancy as a key area of intervention in maternal mortality prevention. Panelists will share strategies for addressing this important and yet neglected area of focus. Speakers will share their experiences working on several projects focused on improving health care during the preconception and interconception periods. This includes discussion of the HRSA MCHB-funded Preconception Collaborative Innovation and Improvement project which worked to develop, implement, and disseminate a woman-centered, clinician-engaged, community-involved approach to the well-woman visit to improve the preconception health status of women of reproductive age, particularly low-income women and women of color. This initiative included both local clinical sites and state-level teams including Oklahoma and North Carolina (2 MHI states). The presenters will discuss the work of a new collaborative funded by WK Kellogg Foundation focused on improving care for women of reproductive age living with chronic conditions as well as insights from focus groups with this population funded by a PCORI engagement study. Presenters will discuss on-going challenges and opportunities in this space, and engage participants in a discussion of how to move further upstream to improve maternal health.|
|Opportunities to advanced maternal health equity through patient-centered systems design||M. Kathryn Menard|
Velma V. Taormina
|In 2011, North Carolina Medicaid partnered with Community Care of NC, a provider-led entity with decades of experience supporting community-based|
health care delivery systems, to design and launch the NC Pregnancy Medical Home (PMH) program. The aim of this public/private partnership was to
improve the quality of care for pregnant Medicaid beneficiaries, improve birth outcomes and reduce healthcare costs. Working in collaboration with the
Department of Public Health, the PMH program engages maternity care providers in quality improvement efforts and provides community-based care
management focusing services with those most likely to benefit. The PMH program has received much national attention as the largest and longestrunning
program of its kind for its potential to advance health equity and improve maternal outcomes. Ten years later, the PMH program will be retired as
NC Medicaid transitions from a statewide fee-for-service system to delivery of service through five prepaid health plans. There was an abundance of
lessons learned during the design and implementation of the PMH program. The focus of this presentation will be sharing what we would do differently if
we were to design the program today, particularly as it relates to community engagement and opportunities to advance health equity.
|Prioritizing Mental Health to Better Serve Black Mothers: A Call to Action||Courtnie Carter|
|During this session, presenter Courtnie Carter will discuss her lived experience as a Black mother of two boys living in North Carolina. During the COVID-19 pandemic, Black women and mothers in her community were especially vulnerable to mental health concerns and crises. Carter will share her experiences with the lack of mental health services during her own birth journey in the weeks before COVID-19 shut down. To address these challenges, we must find innovative ways to screen Black women for mental health distress, elevate the voices of Black women when they share their mental health concerns, and provide special attention to Black women’s mental health prior, during, and after birth. In this session, Carter will share some approaches that maternal health providers might use to implement more culturally competent care in their practice by sharing her own perspective and lived experience. |
After hearing the Call to Action, presenters and attendees will have a chance to discuss challenges to supporting maternal mental health in their own communities, especially among Black mothers, and begin to discuss ways to respond to the Call to Action.
|Social Determinants of Health in perinatal care: Leading with resources||Kristin Tully|
Fernanda Maria Ochoa Toro
|Alongside the opportunity for promoting and protecting health, there are challenges and potential harms of engaging patients around Social Determinants of Health (SDoH). This study identified patient and clinician perspectives on how assessment might best be conducted in maternity care and how needs might be most effectively addressed. The setting for this research was a prenatal clinic and in the surrounding community of a University teaching hospital in the Southeastern United States. Data were collected through semi-structured interviews, focus groups, and a workshop with a total of 19 English- and Spanish-speaking maternal patients and 13 clinicians between March 2019 and February 2020. Participants suggested that SDoH resources are available, all patients should be screened as part of integrated health assessments, early in care and periodically. Screening should not be conducted for issues that clinicians are not prepared to respond to with empathy and with protocols for addressing urgent, immediate needs and with details on how patients can connect to sustained programs. Patients desire for SDoH strengths and challenges to be normalized by their clinicians, including affirmed awareness that circumstances may change. Patients want clinicians to be proactively transparent with the purpose/s of SDoH screening.|
|The EMPATHS Perinatal Substance Use Pilot Study||C.H. Tersh McCracken|
|In this session, we will outline the lessons we have learned implementing universal screening, brief intervention, and referral to treatment (SBIRT) for pregnant women struggling with substance use in an OB/GYN setting. For this presentation, we will first provide an overview of the impact of perinatal substance use. We will then present the evidence supporting universal screening for substance use via a standardized self-report assessment tool in pregnancy. We will discuss the process of program design and the barriers and facilitators of implementing the program and the process of collaborating with community partners. Finally, we will discuss the process of working directly with patients participating in this program. Those who attend this presentation will leave with key takeaways they can apply when considering implementing SBIRT in their clinical settings.|
|Toward Precision Maternal Health: The U.S. Maternal Vulnerability Index||Jordan Downey|
Valerie C. Valerio
|Maternal mortality is unacceptably high in the U.S., and disproportionately impacts Black women at 2-4 times the rate of White women. To improve outcomes, we must better understand why mothers are dying. Structural and environmental factors that influence maternal health contribute to what we call maternal vulnerability. The Maternal Vulnerability Index (MVI) is the first county-level open-source tool to identify not only where, but why mothers in the U.S. are vulnerable to poor outcomes.|
The MVI consists of six themes built with over 40 county- and state-level indicators associated with maternal health outcomes. Stakeholders can use the MVI to pinpoint vulnerable communities and target interventions to reach each population. The index’s modular themes contextualize which factors matter most in each county. Using the MVI, we found that vulnerability is highest in the South, for rural communities, and for Black women. We analyzed individual-level maternal mortality data to validate the index and further understand racial inequity in maternal outcomes. We found that even Black women in the least vulnerable counties are at higher risk of mortality than White women in the most vulnerable counties, highlighting the need for interventions targeted towards improving the perinatal experience for Black women.
|Using Whole-System Maps to Deepen Understanding of Maternal Health Services in a Complex System||Amy Mullenix|
|This workshop will provide an overview of systems thinking, then describe how maternal health leaders can engage with stakeholders using a simple tool that can deepen understanding of service provision in a given area. This allows regional or state-level multi-sector collaboratives to visualize the current range of services available. It positions stakeholders to see complementary system components as well as identify service gaps and duplications. One benefit of this mapping technique is that it is a low-tech activity that can easily be facilitated without advanced software (whole-system maps are most often created in Excel or MS Word). The session will walk through a sample whole system map, illustrating how each partner/stakeholder fills out one row of table for a clearly identified target population, answering questions such as: What happens for this population in my agency? For whom exactly do we provide these services? Where are the services provided? When? (What triggers entry, frequency, exit, etc.) The map “maker”/maternal health leader then takes additional steps to aggregate all data and provide a completed map back to the stakeholders, and can also provide a series of “next step” facilitation questions for discussion and action.|
|“The Centering Pregnancy Telehealth Group Care Model” Guidance for Adapting in Person Prenatal Groups to a Virtual Group||Lynn Scheidenhelm||This presentation will discuss creative, engaging and fun ways to adapt pregnancy medical group care to a virtual format based on the Centering model of group care. The Centering model is based on facilitative rather than a didactic model of medical care. We will walk through ideas for facilitating engaging groups with welcoming openings, how to create a safe and inclusive space, interactive learning activities, mindfulness, community building, the private 1:1 clinical assessment time and a closing. Virtual group care is a way to help manage social determinants of health, such as transportation and childcare, as well as social isolation during pregnancy that have impacted health access for patients in both urban and rural settings.|
Spark Sessions – View the full playlist on YouTube.
Implementation of Severe Maternal Morbidity Surveillance and Review Pilot Program in Maryland with Carrie Wolfson, MPA and Gunes Koru, PhD, Maryland Health Innovation Program (MDMOM), Johns Hopkins University
Incorporating Geospatial Social Determinants of Health Data into Maternal Mortality Review with Katharine (Kayla) Bruce, MPH, Louisiana Department of Health, Office of Public Health, Bureau of Family Health
Cooperativa Raíces para el Cambio / Roots4Change Co-op: Creating equitable, sustainable, and culturally relevant approaches to maternal & child health care before, during, and post COVID-19 with Nikki Prado Solano, BS, Roots4Change Co-Op & The University of Wisconsin-Madison
Telling the Whole Story: Integration of Informant Interviews and Perinatal Risk Assessment Data into New Jersey Maternal Mortality Review Committee Case Summaries with Renee Kraus, MPH, BSN, RN, New Jersey Department of Health