Search Results: MCHLine

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

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 report presents the results of the Levels of Care Assessment Tool (LOCATe) implemented in Montana in 2021 to assess maternal and neonatal care capabilities in birthing facilities and support strategies to improve risk-appropriate care. LOCATe aligns with guidelines from the Society for Maternal-Fetal Medicine, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatricsto match hospital capabilities with patient risk. The report summarizes Montana's LOCATe results, with 96% of birthing facilities participating. Key findings include: 80% of facilities assessed at Level I or II for neonatal care; 68% assessed at Level I or lower for maternal care; facilities had discrepancies between self-reported and assessed levels; 44% lacked maternal transport plans; and protocols existed for maternal emergencies but drills were lacking. The report provides five recommendations to improve risk-appropriate care: 1) Develop perinatal regionalization through stakeholder coordination; 2) Cultivate relationships between facilities through education and learning collaboratives; 3) Establish maternal transport plans and agreements; 4) Enhance care through evidence-based practices and statewide safety bundles; 5) Measure impact through data and review committees.

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Keywords: Gestational age, High risk pregnancy, Montana , Perinatal care, Reproductive health, Risk appropriate care, Rural health, State initiatives, Statistical data

Annotation: This toolkit is designed to assist state health officials in advancing policy initiatives to strengthen perinatal systems of care, improve maternal and infant health outcomes, and address health disparities amid the maternal health crisis. The resource provides key strategies for states using Medicaid policy levers, including policy considerations for strengthening postpartum care coordination under Medicaid, implementing Medicaid coverage of doula and midwifery services to expand the perinatal workforce, and guidelines for optimizing the extension of Medicaid postpartum coverage.

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Keywords: Health care systems, Medicaid, Perinatal care, Postpartum care, State MCH programs, policy development

Annotation: This Clinical Practice Guideline includes recommendations on the screening and diagnosis of perinatal mental health conditions including depression, anxiety, bipolar disorder, acute postpartum psychosis, and the symptom of suicidality. Recommendations are classified by strength and evidence quality.

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Keywords: Annxiety, Depression, Diagnosis, Guidelines, Mental health, Mood disorders, Perinatal care, Screening

Annotation: This Clinical Practice Guideline includes recommendations on treatment and management of perinatal mental health conditions including depression, anxiety, bipolar disorders, and acute postpartum psychosis, with a focus on psychopharmacotherapy.

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Keywords: Annxiety, Depression, Disease management, Mental health, Mood disorders, Perinatal care, Postpartum care, Prenatal care, Psychotropic drugs, Therapeutics, Therapy