Search Results: MCHLine

Annotation: These perinatal clinical care guidelines for the general population include guidelines for the first prenatal visit (6–12 weeks) and each subsequent prenatal visit (13–42 weeks). Topics include initial and interval history; psychosocial assessment; physical examinations; immunizations; laboratory evaluation and additional testing; oral health; genetic counseling, screening, and testing; general counseling, education, and discussion; and the postpartum visit.

• 2024 Guidelines
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Keywords: Guidelines, Perinatal health, Perinatal services, Postpartum care, Pregnant women, Prenatal care, Preventive health services

Annotation: This website explains how Perinatal Quality Collaboratives (PQCs) work to improve the quality of healthcare for mothers and babies. PCQs are networks of perinatal health care providers that include hospitals, clinicians, and public health professionals working to improve pregnancy outcomes through quality improvement initiatives and use of best available evidence-based strategies. The site includes a video introduction to PQCs; a webinar series; a guide to help states developed PQCs, success stories, journal articles, and links to additional resources.

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Keywords: Collaboration, Infant health, Maternal health, Model programs, Perinatal care, Perinatal services, Quality assurance, Regional programs, State initiatives

Annotation: This article examines lessons learned from California's experience with perinatal community health workers (CHWs) and provides recommendations for policy makers designing similar programs. It discusses how perinatal CHWs can help address disparities in maternal health outcomes by providing culturally appropriate support throughout pregnancy and postpartum periods. The authors, drawing from 15 years of experience in California's Medicaid system, outline key considerations including adequate reimbursement rates, payment flexibility for services provided in both clinical and community settings, program coordination to prevent inefficiencies, standardized data collection methods, and support systems to prevent CHW burnout. The document includes specific examples from programs at San Francisco General Hospital and Los Angeles County, and discusses implications for state Medicaid programs participating in CMS's new Transforming Maternal Health Model.

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Keywords: Barriers, California, Community health workers, Maternal health, Models, Payment, Perinatal care, Policy development, Postpartum care, Reimbursement, State programs

Annotation: This report outlines findings and recommendations from a survey assessing equity practices within Perinatal Quality Collaboratives (PQCs). It presents survey results from the Maternal Child Health Systems Assessment Tool (MSAT), which evaluated how PQC leadership perceives and experiences equity within their work environments. The document examines key findings in demographics, attitudes, behaviors, knowledge, perceptions, characteristics, and experiences of PQC staff, revealing that while most PQCs operate within an ally-designed system, they face challenges in leadership diversity and implementing equity-based approaches. It provides seven major recommendations for improving health equity in PQCs, including increasing leadership diversity, moving beyond basic DEI training to action planning, enhancing community engagement, securing leadership buy-in, strengthening organizational culture, addressing socio-political barriers, and ensuring sustainable funding support. The report includes specific implementation strategies for each recommendation and incorporates visual aids such as a community engagement spectrum diagram and a table of authentic community engagement practices.

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Keywords: Collaboration, Cultural diversity, Health equity, Perinatal health, Quality assurance, Surveys, Work force

Annotation: In this podcast episode, host Christie Allen sits down with Dr. Andrea Greiner, a maternal-fetal medicine specialist at the University of Iowa, to discuss the unique challenges of rural maternity care. Dr. Greiner shares her experiences working at a perinatal regional center, offering insight into how larger facilities can support rural hospitals and providers. Together, they explore the importance of individualized care, the complexities of coordinating care across diverse healthcare settings, and the logistical hurdles rural patients face. The 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: Access to health care, Barriers, Coordination, History, Maternal health, Perinatal health, Regional factors, Regional medical centers, Rural health, Safety

Annotation: in this podcast episode, host Christie Allen talks with Audra Summers and Ashley Rainey about Indiana's innovative use of the AIM Patient Safety Bundles to drive sustainable change in maternal care. Audra and Ashley share their experiences implementing and maintaining quality improvements across Indiana's 75 delivery facilities. They discuss the importance of collaboration, the integration of safety measures into daily practices, and how sustainability is achieved through data-driven methods and cultural shifts. The 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: Indiana, Maternal health, Perinatal care, Resources for professionals, Safety, 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 issue brief discusses the extension of postpartum Medicaid coverage from 60 days to 12 months following birth, which states have been able to implement since April 2022. It examines how this extension supports improved access to perinatal and postpartum care but requires complementary state actions to be fully effective. The brief highlights key challenges in postpartum care, including care fragmentation, workforce shortages, and barriers to implementation at system, community, and individual levels. It outlines four solution areas: developing comprehensive standards of care, expanding dyadic care models, increasing workforce support, and providing education and technical assistance. The document concludes with specific recommendations for funders to support implementation efforts at local, state, and national levels to improve maternal health outcomes and advance health equity.

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Keywords: Barriers, Financing, Health care reform, Initiatives, Maternal health, Medicaid, Model programs, Perinatal care, Postpartum care, Resources for professionals, patient education materials

Annotation: This thesis presents a research study examining birthing people's experiences with the health care system during prenatal, intrapartum, and postpartum periods. The study used patient journey mapping, surveys, and interviews to capture experiences at multiple time points. Participants included six prenatal and four postpartum patients, with a focus on Black birthing people. Key findings revealed challenges with insurance access, getting questions answered between appointments, and a lack of racial concordance with health care workers. Participants also reported feeling unprepared for unexpected events, accepting care that did not align with their needs, and inconsistent mental health and intimate partner violence screenings. The thesis discusses implications for improving maternal care, such as offering low-cost services, implementing telehealth, ensuring universal screenings, and increasing workforce diversity.

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Keywords: Access to care, Barriers, Blacks, Childbirth, Health care systems, Interviews, Perinatal care, Postpartum care, Pregnant women, Prenatal care, Surveys, Toronto Canada

Annotation: This resource workbook for healthcare providers addresses integrating mental health care into obstetric settings to improve outcomes for pregnant and postpartum people. It presents evidence-based guidance including universal screening recommendations for depression, anxiety, bipolar disorder, and post-traumatic stress disorder at multiple points during the perinatal period, with particular emphasis on screening for bipolar disorder prior to initiating antidepressant treatment due to risks of mania, psychosis, and suicide. The workbook advocates for behavioral health therapy as the priority treatment for mild to moderate conditions and stresses the importance of trauma-informed care, anti-racism training, and addressing social drivers of health to create safe environments for disclosure and treatment. It includes the Alliance for Innovation on Maternal Health Perinatal Mental Health Conditions patient safety bundle components organized into readiness, recognition and prevention, response, reporting and systems learning, and respectful care categories. The publication highlights Missouri data showing mental health conditions as the leading cause of pregnancy-related deaths from 2018 to 2020, with suicide deaths doubling and all mental health-related deaths found to be preventable. Resources include screening tools, provider toolkits, educational materials, and information about the Missouri Maternal Health Access Project, a statewide perinatal psychiatry access program.

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Keywords: Mental health, Missouri, Obstetrical care, Perinatal care, Service integration, State Initiatives

Annotation: This workbook provides guidance for implementing the Alliance for Innovation on Maternal Health (AIM) patient safety bundle on severe hypertension in pregnancy. It summarizes the evidence on hypertensive disorders of pregnancy, including classifications, diagnostic criteria, and treatment recommendations from ACOG, with a focus on timely treatment of severe hypertension (≥160/110 mm Hg) with first-line antihypertensive medications within 30-60 minutes to prevent maternal stroke. The workbook discusses considerations in diagnosing and managing preeclampsia, which can progress rapidly and become life-threatening without prompt intervention. It highlights data on hypertensive disorders from the Missouri Pregnancy-Associated Mortality Review and provides action steps for implementation of the AIM bundle among Missouri maternal health stakeholders. Resources and references are included for further education and training.

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Keywords: Guidelines, Hypertension, Maternal health, Missouri, Perinatal care, Pregnancy induced hypertension, Prenatal care, Resources for professionals, State initiatives

Annotation: This blog post details policy and programmatic strategies states are implementing to strengthen the perinatal health care system, improve maternal health outcomes, and address disparities, particularly noting that Black women are 2.6 times more likely to die from pregnancy-related causes than White women. Based on an analysis of states’ strategic plans, the key priorities for supporting pregnant and postpartum women include (1) ensuring access to timely and high-quality care, citing examples such as Iowa’s Obstetrics Mobile Simulation Training Program and North Carolina’s Region IV Provider Support Network; (2) developing and sustaining the perinatal workforce, citing examples such as Illinois DocAssist, a free statewide psychiatric access program, and New Jersey’s Maternal and Infant Health Innovation Center; and (3) supporting high-quality care coordination, citing examples such as California’s Enhanced Care Management Birth Equity Population of Focus under CalAIM and Texas’s High-Risk Maternal Care Coordination Services Program.

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Keywords: Access to care, Blacks, California, Healthcare disparities, Illinois, Iowa, Maternal health, New Jersey, North Carolina, Perinatal care, Policy, State initiatives, Strategic plans, Texas

Annotation: This action brief discusses the importance of prioritizing respectful maternity care, calling attention to the need to support dignity, autonomy, and companionship in pregnancy, birth, and postpartum care. The brief highlights five anti-discriminatory action steps highlighted in the White House blueprint for addressing the maternal crisis and links to a wide variety of programs and resources aimed at improving maternal health outcomes. Statistical data related to maternal maltreatment and a description of factors affecting progress are included

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Keywords: , Barriers, Federal programs, Health care disparities, Health equity, Initiatives, Maternal health, Models, Perinatal care, Quality improvement, Racial discrimination

Annotation: This toolkit provides actionable information, algorithms, and clinical guidance to support detection, assessment, and treatment of perinatal mood and anxiety disorders. Included is a summary of perinatal mental health conditions; patient screening and treatment guidance; a how-to guide on integrating mental health care into obstetric practice; and educational resources for providers, patients, and families. The toolkit was developed by the UMass Chan Medical School and reviewed by members of the American College of Obstetricians and Gynecologists' Maternal Mental Health Expert Work Group.

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Keywords: Mental health, Obstetrical care, Perinatal care, Service integration

Annotation: [This issue brief explains how expanding the role of midwives in the U.S. health care system could reduce perinatal health disparities and help address provider workforce shortages. It provides an overview of the midwifery model of care and describes how the integration of midwifery as a standard feature of maternity care varies dramatically across states. It also examines racial/ethnic disparities in midwifery access and use and examines barriers, including inequitable Medicaid reimbursement rates that limit broad access to midwifery care.

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Keywords: Access to health, Barriers, Midwives, Perinatal care, Trends, Work force

Annotation: This brief highlights goal 1 of the White House blueprint for addressing the maternal health crisis, which is to increase access to and coverage of comprehensive high-quality maternal health services, including behavioral health services. The brief outlines the need to strengthen risk-appropriate care in rural and urban areas; improve quality of care provided to pregnant and postpartum women with or at risk for hypertensive disorders of pregnancy; expand capacity to screen, assess, treat, and refer for maternal depression and related behavioral disorders; and Integrate behavioral health supports in community settings. Evidence-informed strategies for improvement, criteria for states to consider when developing strategies, and additional resources are included. Statistics on the percentage of women ages 15-49 with health insurance (by source of coverage); percent of Medicaid coverage by race/ethnicity; and births covered by Medicaid are also provided.

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Keywords: Access to care, Barriers, Health insurance, Initiatives, Maternal health, Medicaid, Mental health services, Perinatal care, Service integration

Annotation: This action brief describes the need to expand and diversify the perinatal workforce to meet the nation's health care needs. Compounding the limited access to maternal health care professionals, the brief highlights the lack of racial and ethnic diversity in the workforce and recommends increasing the number of nurses, health aids, midwives, doulas, lactation consultants, and community health workers to help bridge the gap. Statistics on maternity care desserts and employment of obstetricians and gynecologists by state are included The brief also describes the numerous factors that influence the lack of maternal health care practitioners in the U.S. and includes a list of innovative projects and programs aimed at addressing the issue.

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Keywords: Access to care, Barriers, Healtah equity, Initiatives, Maternal health, Perinatal care, Statistics, Work force

Annotation: This report synthesizes key learnings from an 8-session virtual learning series held between December 2022 and July 2023 focused on implementing Medicaid coverage for doula and perinatal community health worker services. It presents findings in four main areas: partnerships between payers and providers, administrative supports, training and certification requirements, and workforce development. The document outlines specific recommendations for state Medicaid agencies and managed care organizations to create sustainable benefits that center community-based perinatal support providers' needs and advance birth equity. The report includes detailed speaker quotes, examples from multiple states' implementation efforts, and links to full session materials and recordings from the learning series.

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Keywords: Community health workers, Doulas, Medicaid, Perinatal services, Professional education, State agencies

Annotation: This issue brief highlights Action 2.6 from the White House Blueprint for Addressing the Maternal Health Crisis, focusing on training healthcare providers on implicit biases, culturally and linguistically appropriate care, and behavioral health needs of pregnant and postpartum women. The document examines how racism, bias, and structural inequities contribute to maternal health disparities, particularly for people of color, and presents evidence about the effectiveness of different approaches to addressing implicit bias and providing respectful maternity care. It outlines specific state-level innovations and evidence-based strategies being implemented across the United States, including mandated training programs, cultural competency initiatives, and tools for measuring and evaluating bias reduction efforts. The brief includes data on racial disparities in maternal health outcomes and provider-patient racial concordance, while providing recommendations for developing more equitable and culturally responsive care systems.

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Keywords: Cultural competency, Health care disparities, Implicit bias, Maternal health, Perinatal care, Racial factors, State initiatives, health equity

Annotation: This report examines innovative approaches to perinatal and child health services within Medicaid programs to support communities and advance health equity. The document profiles various initiatives focused on improving maternal and child health outcomes through the prenatal-to-three framework. Key areas covered include advancing a culturally congruent perinatal workforce through doula programs, partnering with maternal and child home visiting programs, integrating community input in program design, coordinating care for mothers with opioid use disorder, and investing in high-quality perinatal and child healthcare services. The research was supported by the Pritzker Children's Initiative and developed with input from a national advisory committee comprising clinical, scientific, and policy experts representing diverse healthcare organizations, academic institutions, and policy centers.

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Keywords: Child health services, Community based services, Health equity, Initiatives, Medicaid, Outreach, Perinatal care, Perinatal services, Research