Search Results: MCHLine

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 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 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 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

Annotation: This patient safety bundle provides actionable steps that can be adapted to a variety of health care facilities and resource levels to improve the quality of care and outcomes for patients with perinatal mental health conditions. It provides broad direction for incorporating perinatal mood and anxiety disorder screening, intervention, referral, and follow-up into maternity care practice across health care settings. Components include implementation details and resources, a data collection plan, an evidence-informed "change package," and learning modules.

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Keywords: Data collection, Evidence-based medicine, Health care quality indicators, Health metrics, Maternal morbidity, Maternal mortality, Measures, Mental health, Perinatal care, Postpartum care, Prevention, Protocols, Quality improvement, Resources for professionals, Safety

Annotation: This evidence review addresses racial inequities in the maternal health care and outlines evidence-informed approaches that address gaps in access to care; adopt and incentivize high-value models of care; diversity the perinatal workforce; and invest in community-based organizations.

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Keywords: Health equity, Health status disparities, Maternal Morbidity, Maternal Mortality, Maternal health, Perinatal care, Policy, Postpartum care, Prevention

Annotation: This toolkit, which incorporates policies and tools used at U.S. hospitals, outlines best practices and provides support materials and guidance for implementing a quality-improvement project focused on reducing elective deliveries before 39 weeks' gestation. The toolkit also provides methods to identify improvement opportunities and outlines techniques for measuring process and outcome improvements. Topics include the importance of eliminating deliveries before 39 weeks, implementation, data collection and quality improvement, and clinician and patient education.

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Keywords: Cesarean section, Child morbidity, Childbirth, Education, Guidelines, Infant morbidity, Maternal morbidity, Outcome evaluation, Perinatal morbidity, Prevention, Process evaluation, Programs, Resource materials, Trends

Annotation: The purpose of this project was to test the hypothesis that low-risk mothers and newborns will be at reduced risk of adverse health outcome if assigned to receive a home visit rather than a group clinic visit on the third postpartum day. Low-risk mothers and newborns were identified prior to hospital discharge. These study subjects were enrolled, interviewed, and randomized to a home visit (intervention) or a group clinic visit (usual care) on the third postpartum day. Outcome data were obtained from telephone interviews with mothers from computerized utilization databases at Kaiser Permanente. An adverse health outcome was defined as any of the following during the first 14 postpartum days: an urgent clinic visit by the newborn or mother, breastfeeding discontinuation, maternal depressive symptoms, or rehospitalization of the newborn and/or the mother. [Funded by the Maternal and Child Health Bureau]

Keywords: Home Visiting Programs, Home Visiting Services, Infant Health Care, Infant Morbidity, Infants, Infants, MCH Research, Neonates, Newborn infants, Perinatal Health, Postpartum Women, Postpartum Women, Research, Standards of Care

Annotation: This compendium contains entries about volunteer initiatives aimed at improving prenatal care or reducing infant mortality. [Funded by the Maternal and Child Health Bureau]

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Keywords: Clergy, Health promotion, Infant mortality, Infants, Morbidity, Perinatal health, Pregnant women, Prenatal care, Prevention programs, Religious organizations, Southern United States

Annotation: This report focuses on two subjects: delivery of health care to children, and infant and perinatal mortality and morbidity. Suggestions are included for further research in maternal and child health. A retrospective report on the Rochester Neighborhood Health Center is provided. And a report of delivery of health care for children is also included. Reports of discussion on the conference topics conclude the report. [Funded by the Maternal and Child Health Service]

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Keywords: Child health, Child health services, Conferences, Maternal health, Morbidity, Perinatal mortality, Research

Annotation: This report discusses the extent of the problem of perinatal morbidity and mortality, factors influencing the outcome of pregnancy, long term sequelae, health services for mothers and children, standards of related care, the role of the midwife, related educational needs, and research needs.

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Keywords: Children, Education, Fetal morbidity, Midwives, Mothers, Perinatal mortality, Pregnancy, Research

Annotation: These patient safety bundles are the core building blocks of the AIM program’s efforts to address the leading known causes of preventable severe maternal morbidity and mortality in the United States. Supported by quality metrics and measures through the AIM Data Center, each bundle provides actionable steps that can be adapted to a variety of facilities and resource levels to improve quality of care and outcomes for patients. Individual safety bundles cover the following: obstetric hemorrhage, severe hypertension in pregnancy, safe reduction of primary cesarean birth, cardiac conditions in obstetric care, care for pregnant and postpartum people with substance use disorder, perinatal mental health conditions, postpartum discharge transition, and sepsis in obstetric care. Some materials are available in English, Spanish, and French.

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Keywords: Evidence based medicine, Health care quality indicators, Health metrics, Maternal health, Maternal morbidity, Maternal mortality, Measures, Perinatal care, Postpartum care, Protocols, Quality improvement, Resources for professionals , Safety, prevention programs