Proposed home visit program to boost health of moms, babies stirs hope

Illustration of a pregnant couple. States are moving toward expanding Medicaid postpartum benefits in an attempt to stem high maternal mortality rates. (Dreamstime/TNS)

Credit: TNS

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Illustration of a pregnant couple. States are moving toward expanding Medicaid postpartum benefits in an attempt to stem high maternal mortality rates. (Dreamstime/TNS)

Credit: TNS

Every year in Georgia, home to one of the highest infant-mortality rates in the country, several hundred babies die before their first birthday.

In 2020, the most recent year for available data, 769 babies died in Georgia within their first year of life, according to the Centers for Disease Control and Prevention.

The number of babies born too early in Georgia has been steadily rising, a growing number of infants at risk for lifelong physical and intellectual disabilities, according to the March of Dimes.

While the situation is dire, the Georgia chapter of the nonprofit March of Dimes saw hope Wednesday in state legislation aimed at improving the health of mothers and babies, and ultimately saving lives. The measure before the state Legislature would create a home visit pilot program for pregnant women, their unborn or recently born babies and their siblings.

Such in-home help is a key priority for the March of Dimes, which recently scored Georgia with an “F” for its worsening record of maternal and infant mortality.

“These policy priorities can make a difference for moms and babies across the nation,” Shelmekia Hodo, director of maternal and infant health for the nonprofit’s Georgia chapter, told staff and volunteers in a virtual meeting.

She said the organization will meet with legislators and utilize social media to “raise awareness of the health challenges families face.”

March of Dimes staffers and volunteers joined a dozen chapters across the country Wednesday to plan for their “March for Change” day of advocacy.

The home visit pilot program is included in Georgia’s proposed budget for the 2024 fiscal year, and includes funding for home visits for at-risk and underserved pregnant women, especially those who live in rural areas and lack access to obstetrical care.

The Georgia House Appropriations Committee met Wednesday morning and included $1.7 million in the budget for the Georgia Department of Public Health to fund the program. The budget item must be approved by the Georgia Senate.

The funding would cover 11 home visiting staff (five nurses and six community health workers), two district coordinators, one DPH program lead, travel and supplies.

The program would be located mostly in the northern and southern corners of the state and in the counties of Coffee, Atkinson, Clinch, Jeff Davis, Evans, Candler, Toombs, Bulloch, Habersham, Stephens, Franklin, Hart, and Banks.

The overall goals of home visiting programs are to promote healthy pregnancies, improve parenting skills and reduce child abuse and neglect. Other support for families includes clinical services such as blood-pressure monitoring, wellness and postpartum checks. Women eligible include those at high risk of pregnancy complications and those with chronic health conditions , including HIV. Georgia has another home visiting program that is federally funded for 25 counties. The pilot program would expand to other counties.

The existing Evidence-Based Home Visiting program, is seeing positive outcomes, according to Voices for Georgia’s Children, a nonprofit advocacy organization. In 2021, 22,863 home visits were conducted for 1,925 families around the state. Outcomes reported include 99% of children visited who had no reports of maltreatment and 90% of children were screened for developmental delays. After home visits, 92% of the caregivers received postpartum care, 89% were using safe sleep practices and 94 % were screened for depression.

Also Wednesday, the March of Dimes advocates were encouraged by the progress of another priority, the extension of the Family Leave (SB 61) bill. The measure, which had been set to sunset on July 1, allows employees to use sick leave to care for immediate family members. The measure, which passed the Senate last month, has been assigned to the Industry and Labor Committee in the Georgia House.

But the third of the March of Dimes’ top three priorities — a bill aimed at ensuring workplace accommodations for pregnancy and postpartum — stalled in a House committee and failed to make it on the calendar by crossover day. The bill remains available for the next session.

Late last year, Georgia received the “F” for its preterm birth rate of 11.9% in the latest March of Dimes Report Card, which measures the state of maternal and infant health in the U.S. That means more than 1 in 10 babies born in Georgia in 2021 were delivered at least three weeks before what’s considered full term: 40 weeks of gestation. That marks a 4% increase from the previous year.

Credit: March of Dimes

Credit: March of Dimes

People of color are most at risk for premature birth. In Georgia, the preterm birth rate among Black women is 47% higher than the rate among all other women, according to the March of Dimes.

While still above the national average, Georgia’s infant mortality rate has improved in recent years. Now at 6.1 (which is 6.1 for every 1,000 live births) in 2020, that’s slightly lower than what it was in 2010, when it stood at 6.3. It’s a sharp drop from a steady uptick in recent years; it climbed up to 7.8 in 2015.

According to the CDC, the five leading causes of infant death in 2020 were birth defects, preterm and low birth weight, sudden infant death syndrome, injuries, and maternal pregnancy complications.

Quantrilla Ard's harrowing experience of giving birth to her oldest son motivated her to get involved as a volunteer. When she was close to 36 weeks, she was hospitalized and needed an emergency C-section.
“I was so nervous and didn’t feel like I had a lot of opportunity to ask questions,” said Ard. “I felt like so many things were being done to me and I was not being seen as a birthing person. . . . Again with this emergency C-section, they give you an epidural but because I wasn’t being listened to I was not actually numb enough. I felt (the doctor) cut me open.”

Credit: custom

Credit: custom

Quantrilla Ard, an adjunct professor at Morehouse School of Medicine, who lives in Fairburn, was one of the volunteers making calls to state legislators Wednesday. She eagerly advocated for funding for the home visit pilot program to help identify problems “before it’s too late.”

”I had preeclampsia before I delivered my son,” said Ard. “I have so many friends who had developed preeclampsia after they had delivered their children. They could have died or had severe health challenges because of it.”

Ard, who is Black, said she delivered her son 13 years ago by emergency C-section at a hospital in Maryland. She said she felt disregarded during her labor and delivery ordeal.

“I was terrified and so one of the reasons I share my story is I don’t want any other woman or birthing person who looks like me, who shows up as a person of color in a birthing space to be ignored, to be dismissed or overlooked, regardless of her health status, of her insurance status.”

Quantrilla Ard and her 13-year-old son, Quentin.
"It was a hard-won battle to get him here," she said.

Credit: custom

Credit: custom

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