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Birth Equity Education Project
The Michigan Council for Maternal and Child Health, supported by a team from the Institute for Health Policy at Michigan State University, is working to produce a series of knowledge products to promote policy improvements in specific areas of maternal and infant health. Titled the Birth Equity Education Project (BEEP), our primary goal is lifting efforts and policy strategies that can impact health inequities for black and indigenous women and babies.
This report explores the history and current work of doulas, the lack of recognition many face in clinical settings and the structures they operate within, including community-based doula programs. Doulas have shown to be an empowering and effective resource to reduce racial disparities in birth outcomes.
MCMCH has an accompanying policy guidance document--Advancing Doulas in Michigan--that outlines several policy considerations to enhance the availability and viability of doulas.
Here 'dyad' refers to the complex relationship between mother or caregiver and an infant, discussing the needed measures to help address mental health while highlighting some solutions currently in place, including MC3 Perinatal, Infant Mental Health Home Visiting (IMH-HV) and integrated infant mental health services where trained staff is embedded in pediatric and OB/GYN settings. The accompanying policy recommendations outline the need for funding and reimbursement for additional maternal mental health (depression) screenings, utilizing incentives to encourage patient participation and to improve referral follow-up practices and expanded use of innovative screening tools like High Tech, High Touch (HT2) that provide prompt referral and follow-up to identified needs with sustainable funding.
This report examines the role perinatal health care--the care a woman receives before, during and after delivery--has in health equity and birth outcomes. While standard prenatal care delivery has not changed substantially since the 1930s, there are innovative care delivery systems that are demonstrating improved outcomes by focusing on equity, providing patient and relationship-centered care and empowering families with education.
Making Perinatal Care Work in Michigan outlines several policy considerations for perinatal care to strengthen our state’s focus on promoting birth equity and preventing poor maternal/infant outcomes.
This report explores how a racially and ethnically diverse maternal and child health care workforce remains a distant goal that is contingent on improving the educational pipeline from elementary to advanced education, the reduction of financial barriers, as well as psychological and skill building services from mentorship programs. The policy recommendations on this issue include incorporating measures of workforce diversity into system performance metrics, such as hospital community needs assessments; increasing and enhancing educational loan repayment programs by examining barriers to participation by underrepresented populations; and having insurers provide incentive payments to provider organizations that demonstrate workforce diversity, as well as concordance with patient population.
Finance & Payment Innovation: Improving Equity in Perinatal Care and Maternal and Infant Outcomes
This brief explores the strengths and weaknesses of payment reforms in relation to improving maternal and infant health outcomes and reducing racial disparities. Payment reforms for maternity or perinatal care, costs, and outcomes are discussed, along with the the role of Medicaid and the beneficiaries it covers, including Michigan data and examples from other states’ efforts.
The accompanying policy guidance document calls for stakeholders in Michigan to come together to discuss, inform and guide decisions on how payment approaches for perinatal care can be improved through legislative action, administrative policy, contracting and health plan payment design to advance equitable birth outcomes.
Breastfeeding: Removing Barriers and Supporting Equitable Outcomes
This brief discusses the root causes of the disparities in breastfeeding initiation and duration rates for Black and Indigenous families--including unconscious biases and systemic racism--and where opportunities exist to improve the systems that are intended to serve families. Community-based programs that are successfully reaching women of color to provide breastfeeding support are also discussed.
The accompanying policy guidance document calls for embedded lactation support in obstetric and pediatric primary care settings; building more robust breastfeeding education and specific indicators into the state’s Quality Rating Improvement System (QRIS) for child care providers; and requiring hospitals to have lactation support available for every birthing individual during their stay, regardless of day of week or time of day, and to give each family a referral to locally available, culturally congruent lactation services during discharge planning.
A Crossroads: Substance Use Disorder During Pregnancy and Postpartum
In this brief, the public health concern of substance use during pregnancy is discussed, with examination of both the history of treating substance use and the stigma attached. It highlights the need for comprehensive healthcare that combines substance use and mental health care in the context of maternity care.
The accompanying policy guidance document includes recommendations for enhancing services and supports to individuals dealing with substance use during the perinatal period, and preserving the critical bonding time between parent and child.
