Search Results: MCHLine

Annotation: This white paper discusses the worsening maternal morbidity and mortality (MMM) rates in the United States, which continue to disproportionately affect Black/African American and American Indian/Alaska Native women. The document addresses maternal health risks, the costs associated with maternal morbidity, and four crucial delays in care identified by the World Health Organization (WHO): delays in seeking medical care, reaching a facility, diagnosis/misdiagnosis, and receiving appropriate treatment. It discusses how digital healthcare solutions can advance maternal health by closing gaps in care, diminishing these four delays, empowering women to self-monitor, and equipping providers with more patient data for timely diagnosis. The paper describes the "Happy Mama" technology platform, which is designed to guide patients from preconception through 12 months postpartum while using FHIR-based interoperability standards to connect patient data with provider Electronic Health Records (EHRs).

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Keywords: Data collection, Health care disparities, Maternal morbidity, Maternal mortality, Remote patient monitoring, Telemedicine

Annotation: This strategic plan outlines a comprehensive roadmap for the National Institutes of Health to address the unique health needs of women and girls across the life course for the years 2024 through 2028. It details five strategic goals: (1) advancing research on the intersection of biological, social, and environmental factors; (2) improving data science and management; (3) fostering career development for women scientists; (4) supporting basic and translational studies of sex influences; and (5) enhancing community-engaged science. Major topics include maternal morbidity and mortality, chronic debilitating conditions, sex and gender influences on disease pathogenesis, and the reduction of health disparities through an intersectional approach. The document describes an iterative development process that incorporated input from federal partners, scientific experts, and the public to identify high-priority research gaps. Appendices provide information on national partnerships and lists of advisory committee and working group members.

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Keywords: , Data, Maternal health, Maternal morbidity, Maternal mortality, Pregnancy, Research, Sex characteristics, Strategic plans, Women's health

Annotation: These recommendations from the American Heart Association provide a framework for enhancing postpartum systems of care to reduce maternal morbidity and mortality. The document outlines strategies for standardizing clinical education, defining the postpartum period as one year, and evaluating cardiovascular risk factors such as hypertension and diabetes. It emphasizes the importance of patient-centered holistic care through collaboration with midwives and doulas and advocates for 12 months of comprehensive health coverage for all postpartum people. Discussion also covers identifying social determinants of health and improving data collection through a national database for quality performance

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Keywords: Guidelines, Health care systems, Maternal morbidity, Maternal mortality, Postpartum care, Prevention

Annotation: This report presents a roadmap of California's Birthing Care Pathway initiative launched by the Department of Health Care Services (DHCS) to address maternal health disparities and improve outcomes for pregnant and postpartum Medi-Cal members. It describes the current state of maternal health in California, highlighting concerning trends in pregnancy-related mortality and severe maternal morbidity with significant racial disparities affecting Black, American Indian/Alaska Native, and Pacific Islander individuals. The document outlines DHCS' strategic approach to improve maternal health through policy solutions developed with input from diverse stakeholders, including Medi-Cal members. Key components include strengthening provider access, enhancing clinical care coordination, providing whole-person care, and modernizing maternity care payment systems. The report details recent Medi-Cal policy enhancements for perinatal care and describes California's participation in the federal Transforming Maternal Health Model to further strengthen delivery systems in selected Central Valley counties.

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Keywords: California, Health care disparities, Maternal health, Maternal morbidity, Maternal mortality, Model programs, Perinatal care, Policy development, Postpartum care, Quality improvement, State initiatives, Trends

Annotation: This report presents findings from the Maryland Maternal Health Innovation Program's (MDMOM) facility-based Severe Maternal Morbidity (SMM) Surveillance and Review program for 2024, analyzing 340 SMM events identified at participating hospitals following the passage of the Maternal Health Act of 2024 requiring all birthing hospitals in the state to participate in SMM surveillance beginning in 2025. The program uses a standardized case definition of intensive care unit admission and/or transfusion of four or more units of blood products for pregnant and postpartum patients up to 42 days postpartum. Hospital review committees analyzed events to determine preventability, identify contributing factors, and develop recommendations organized by the "5Rs" framework of readiness, recognition and prevention, response, reporting and system learning, and respectful care. The report documents that 32% of SMM events were potentially preventable, with obstetric hemorrhage being the most common primary cause, and includes demographic characteristics, delivery outcomes, and specific recommendations for preventing future severe maternal morbidity by cause and racial/ethnic disparities in SMM rates.

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Keywords: Maryland, Maternal morbidity, Maternal mortality, Population surveillance, Postpartum hemorrhage, Prevention, Standards

Annotation: This workbook provides guidance for implementing evidence-based practices to improve care for pregnant and postpartum individuals with cardiovascular disease (CVD). It summarizes the evidence on the significant risks of CVD in pregnancy, which can exacerbate pre-existing conditions or lead to new disorders due to the hemodynamic changes of pregnancy. The workbook presents data from Missouri's Pregnancy-Associated Mortality Review, finding that CVD accounted for 30% of pregnancy-related deaths from 2017-2021, with most deemed preventable and Black women disproportionately impacted. To address this crisis, the AIM Cardiac Conditions in Obstetric Care patient safety bundle components are provided, with detailed strategies for implementing universal cardiac risk screening, rapid response protocols, cardio-obstetric teams, care coordination, patient education, and equity-focused data monitoring. Emphasis is placed on early recognition, diagnosis, and treatment to prevent complications and death. Resources and references are included for further training and implementation.

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Keywords: Cardiovascular diseases, Evidence-based medicine, Guidelines, Maternal morbidity, Maternal mortality, Missouri, Obstetrical complications, Perinatal care, Postpartum care, Prevention, Quality improvement, Resources for professionals, State initiatives

Annotation: This website showcases the IMPROVE initiative, launched by the National Institutes of Health in 2019, to support research to reduce preventable causes of maternal deaths and improve health for women before, during, and after pregnancy. The site describes the multi-pronged research initiative, emphasizing its focus on those disproportionately affected by maternal morbidity and mortality, including African American/Black, American Indian/Alaska Native populations, people of advanced maternal age, and people with disabilities. Links to research and funding opportunities, webinars and virtual workshops, funded projects, and resources for the public and for researchers are included.

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Keywords: Federal initiatives, Grants , Maternal health, Maternal morbidity, Maternal mortality, Prevention programs, Research, Research programs

Annotation: In this podcast episode, host Christie Allen talks with renowned maternal health expert Dr. Elliott Main. A pioneering figure in maternal mortality review and quality care initiatives, Dr. Main discusses the history and evolution of the Alliance for Innovation on Maternal Health (AIM). Together, they explore the challenges and triumphs of addressing severe maternal morbidity and mortality in the U.S., the early groundwork that led to AIM, and the collaborative efforts that turned ideas into actionable tools. Dr. Main also shares his thoughts on the future of maternal health and the "one thing" he believes is critical to driving change moving forward. This episode is part of the AIM for Safer Birth series of podcasts that dive deeper into the rising severe maternal morbidity and maternal mortality rates in the United States through a data-driven, quality improvement lens.

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Keywords: Collaboration, History, Initiatives, Maternal health, Maternal morbidity, Maternal mortality, Models, Resources for professionals

Annotation: This report examines the critical impact of mental health and substance use disorders on maternal mortality and morbidity in the United States, highlighting how suicide and substance use-related overdoses account for over 20 percent of postpartum deaths. It presents promising approaches from states including Massachusetts, New Jersey, Oregon, New Hampshire, and California that integrate maternity care with behavioral health services and social supports. The report outlines six key recommendations for improving care: supporting dedicated multidisciplinary care teams, centering people with lived experience to drive health equity, normalizing substance use care, training all staff on bias and stigma, expanding the community-based workforce including doulas and peer recovery specialists, and implementing harm reduction and street medicine approaches. The authors emphasize that with nearly every state now providing 12 months of postpartum Medicaid coverage, there are unprecedented opportunities to implement integrated, trauma-informed, non-punitive care models that can significantly reduce maternal mortality and improve outcomes for families.

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Keywords: Substance abusing pregnant women, Community participation, Disorders, Health care reform, Initiatives, Maternal morbidity, Maternal mortality, Medicaid, Mental health, Model programs, Perinatal addiction, Perinatal care, Postpartum care, Quality improvement, Risk factors, Service integration, Substance use disorders

Annotation: This report provides an overview of the Maternal and Child Health Services Block Grant program authorized under Title V of the Social Security Act. The report describes the program's three main components: State MCH Block Grants (the largest component, providing formula grants to states and territories), Special Projects of Regional and National Significance (SPRANS), and Community Integrated Service Systems (CISS). It details the program's history, funding mechanisms, services provided, populations served, and reporting requirements. The report outlines how states use these funds to address the unique needs of pregnant women, infants, children, and children with special health care needs through direct health care services, enabling services, and public health services and systems. It also examines recent funding trends, highlighting shifts in allocations among the three components and changes in state expenditure patterns following the COVID-19 pandemic. The document concludes with policy considerations for Congress regarding funding allocation formulas, program coordination, and oversight accountability.

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Keywords: Block grants, Data, Funding, Initiatives, Legislation, Maternal health, Maternal morbidity, Maternal mortality, Measures, Medicaid, Prevention, Title V programs

Annotation: This report presents findings from the Maryland Maternal Health Innovation Program's (MDMOM) facility-based Severe Maternal Morbidity (SMM) Surveillance and Review program for 2023, covering 279 SMM events identified at 27 participating hospitals representing more than 80% of births in the state. The program uses a standardized case definition of intensive care unit admission and/or transfusion of four or more units of blood products for pregnant and postpartum patients up to 42 days. Hospital review committees analyzed events to determine preventability, identify contributing factors, and develop recommendations organized by the "5Rs" framework of readiness, recognition and prevention, response, reporting and system learning, and respectful care. The report documents that 34% of SMM events were potentially preventable, with obstetric hemorrhage being the most common primary cause, and includes detailed analysis of demographic characteristics, timing of events, delivery outcomes, and specific recommendations for preventing future severe maternal morbidity by cause.

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Keywords: Maryland, Maternal morbidity, Maternal mortality, Population surveillance, Postpartum hemorrhage, Prevention, Standards

Annotation: This report highlights findings from the Improving Postpartum Care Affinity Group, a quality improvement initiative convened by the Centers for Medicare & Medicaid Services from April 2021 to April 2023. Nine states participated in the affinity group to develop and test interventions addressing the high rates of preventable maternal mortality and morbidity in the United States, with nearly two-thirds of maternal deaths occurring during the postpartum period. The report describes how state teams used data-driven approaches to identify disparities and quality improvement opportunities, select measures to monitor their projects, and evaluate intervention impacts. It presents four main categories of interventions tested by participating states: targeted case management services for high-risk beneficiaries, postpartum cardiac care including blood pressure monitoring and cardiomyopathy protocols, support from doulas and community health workers with home visiting programs, and beneficiary and provider education and support tools. The document includes specific examples from states such as South Carolina's pilot addressing gaps in behavioral health screening, Georgia's work to improve provider use of postpartum visit codes, and Texas's blood pressure cuff distribution program for hypertensive beneficiaries.

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Keywords: Data analysis, Georgia, Kansas, Kentucky, Maternal morbidity, Maternal mortality, Missouri, Models, Oklahoma, Postpartum care, Prevention, Quality improvement, South Carolina, State initiatives, Texas, Wyoming

Annotation: This web content for parents describes common postpartum complications and the importance of recognizing warning signs following childbirth. It addresses life-threatening conditions such as cardiovascular diseases, sepsis, and hemorrhage while highlighting the disproportionate risks faced by Black, American Indian, and Alaska Native people. The site provides specific criteria for seeking emergency medical care and outlines recommendations for developing a postpartum care plan that includes frequent contact with healthcare professionals. Discussion also covers barriers to care for individuals with low incomes and those who lack insurance. This content is also available in Arabic, Chinese, and Spanish

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Keywords: Maternal morbidity, Maternal mortality prevention, Patient education , Postpartum care

Annotation: This is a systematic review of risk factors associated with maternal morbidity and mortality in the U.S. during the prenatal and postpartum periods, including social and structural determinants of health. The focus is primarily on research that examines factors to which pregnant and birthing people have been exposed and that may underlie poor perinatal health outcomes. The U.S. Office of Disease Prevention requested the review to inform the November 29 – December 1, 2022 Pathways to Prevention workshop cosponsored by the National Institutes of Health’s Office of Research on Women’s Health, the National Heart Lung and Blood Institute, the National Institute of Minority Health and Health Disparities, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

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Keywords: Evidence based medicine, Literature reviews, Maternal morbidity, Maternal mortality, Racism, Risk factors, Social determinants of health

Annotation: This issue brief highlights the increased risk of maternal morbidity and mortality among Black women; explores the drivers that contribute to the Black maternal health crisis, and recommends strategies to transform the delivery of Black maternal health care to improve health outcomes. Providing culturally-centered care by diverse health teams; destigmatizing and treating Black maternal mental health; protect and expand access to reproductive health care; eliminating economic inequities; and collecting and using intersectional data are among the approaches highlighted. The brief also discusses the importance of community, describing how shared resistance, resilience, and joy help define Black maternal health.

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Keywords: Blacks, Health care disparities, Health equity, Maternal health, Maternal morbidity, Maternal mortality, Prevention

Annotation: This issue brief outlines Action 2.11 from Goal 2 of the White House Blueprint for Addressing the Maternal Health Crisis, which focuses on establishing state-focused Maternal Health Task Forces (MHTFs) and improving state-level data surveillance on maternal mortality and morbidity. It describes how MHTFs can drive evidence-based decision-making to improve maternal health outcomes through data collection, analysis, and strategic planning in partnership with governmental and nongovernmental stakeholders. The document details HRSA's funding of MHTFs across 18 states through the State Maternal Health Innovation program, discusses challenges related to data collection and standardization, and presents evidence supporting the effectiveness of collaborative approaches in improving maternal health outcomes.

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Keywords: Maternal health, Maternal morbidity, Maternal mortality, Population surveillance, Public private partnerships, State initiatives, State programs, Task forces

Annotation: This issue brief highlights Action 1.15 from the White House Blueprint for Addressing the Maternal Health Crisis, focusing on integrating behavioral health supports in community settings through community health workers (CHWs) and patient navigators. The document examines the essential role of CHWs in addressing healthcare disparities and improving maternal health outcomes, presenting evidence of their effectiveness in increasing access to care and supporting positive health behaviors. It provides detailed information about the current state of the CHW workforce, including demographic data, state-level Medicaid coverage policies, and key barriers such as lack of standardized training and sustainable funding. The brief outlines specific innovations being implemented across states and offers evidence-based strategies for developing and supporting CHW programs, with particular attention to examples from state maternal health initiatives in North Carolina and Maryland.

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Keywords: Behavioral disciplines and activities, Community health workers, Community-based services, Health care disparities, Maternal health, Maternal morbidity, Service integration, State initiatives

Annotation: This issue brief highlights Action 1.7 from the White House Blueprint for Addressing the Maternal Health Crisis, which focuses on improving quality of care for pregnant and postpartum women with or at risk for hypertensive disorders of pregnancy (HDP). The document presents evidence supporting the use of self-measured blood pressure monitoring tools and resources, discussing their effectiveness in reducing maternal morbidity and addressing racial disparities in healthcare access. It examines current data on HDP prevalence and outcomes across different populations, with particular attention to racial, ethnic, and geographic disparities, and outlines specific state-level maternal health innovations and evidence-based strategies being implemented across the United States. The brief includes detailed statistics, implementation examples from states like Arizona, Illinois, and Ohio, and recommendations for strategy development at state and local levels.

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Keywords: Federal initiatives, Hypertension, Maternal health, Maternal morbidity, Model programs, Postpartum women, Pregnant women, Prevention, State initiatives

Annotation: In this podcast episode, host Christie Allen and Dr. Gillispie-Bell discuss the integration of equity and quality when addressing severe maternal morbidity and maternal mortality rates in the United States with a data-driven approach. Learn how the healthcare landscape has transformed to encompass not just clinical excellence, but also inclusive care that honors each individual's unique experiences and values. Discover the journey from recognizing racial and ethnic disparities to crafting a comprehensive approach that combines respectful, equitable, and supportive care. This episode is part of the AIM for Safer Birth series of podcasts that dive deeper into the rising severe maternal morbidity and maternal mortality rates in the United States through a data-driven, quality improvement lens.

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Keywords: Cultural sensitivity, Data, Health care disparities, Health equity, Maternal morbidity, Maternal mortality, Quality improvement, statistics

Annotation: This evidence-to-action brief focuses on Action 1.4 of the White House Blueprint for Addressing the Maternal Health Crisis, which aims to strengthen risk-appropriate care in rural and urban areas by encouraging states to implement the CDC Levels of Care Assessment Tool (LOCATe). The document explains that LOCATe is a web-based, standardized assessment of birthing facilities that allows states to see the distribution of levels of care throughout the state, supporting perinatal regionalization to ensure pregnant people receive care in facilities with appropriate capabilities. It presents maternal mortality data showing significant racial disparities, with non-Hispanic Black women being 2.6 times more likely to experience maternal death compared to non-Hispanic White women in 2021, and highlights that more than 2.2 million women of childbearing age live in maternity care deserts. The document includes examples of state maternal health innovations and evidence-based strategies, emphasizing that risk-appropriate care implementation should occur alongside efforts to address unconscious racial bias in healthcare to effectively reduce severe maternal morbidity and mortality.

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Keywords: Birthing centers, Data, Health facilities, Maternal morbidity, Maternal mortality, Perinatal care, Prevention, Regional factors, Rural health, Standards, Urban health