Texas is struggling with high infant and maternal mortality rates. The 2022 mortality rate for infants rose 8% to 5.75 per 1,000 births. Meanwhile, between 1999 and 2019, the state’s maternal mortality rate has more than doubled, suggesting the arrival of a full-blown health crisis for moms and babies.
Despite these worrying trends, there is hope. The vast majority of infant and maternal deaths are preventable and innovative healthcare systems are rising to meet the challenge. Harris Health, the safety-net healthcare provider in Harris County, is addressing this complex issue with a comprehensive approach that includes both preventive and curative measures.
Harris Health Tackles Rising Infant, Maternal Mortality Through Outreach and Focused Care
By StoryStudio on August 13, 2024
SPONSORED BY Harris Health
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At Ben Taub, maternal care wins awards. The hospital is a recognized leader in maternal care. It was recently ranked as a Best Maternal Care hospital by Newsweek. No one is prouder than Suzy Lundeen, administrative director, Nursing, Ben Taub Hospital.
“We were a five-ribbon awardee,” she says of the honor. “We’re honored to receive this award that recognizes the high quality of care we provide our patients.”
The distinction means Ben Taub Hospital rated highly in patient experience (the hospital is consistently in the 90th percentile for patient satisfaction), provider perception and performed highly in quality metrics in cleanliness, breastfeeding rates and lower hospital-acquired infections. The rating reflects the success of several innovative programs at the hospital. Ben Taub Hospital is the recipient of the MOM (Maternal Opioid Misuse) grant.
Partnering with Texas Department of Health and Human Services, Santa Maria and Baylor College of Medicine, the MOM grant empowers Harris Health to provide comprehensive care to pregnant women with substance use disorder particularly opioid use.
“We started our Eat Sleep Console program, a model of care for patients that supports the baby and helps identify if the baby needs a higher level of care,” Lundeen says. “And we've been very successful.”
Also, for mothers with substance use disorder, “we know that the most vulnerable time for these patients is postpartum. To address this, we have rigorous follow-up with our patients after delivery including a postpartum safety clinic,” she adds.
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“Our job is to overcome barriers in awareness, transportation, social misconception and mistrust to empower our moms and babies to live healthy lives,” she says.
Prenatal and postnatal care is vital for all women. Harris Health started the women and infant outreach program to raise awareness in vulnerable populations of the importance of such care, as well as education on breastfeeding, mental health and physical dangers that affect women postpartum.
“When it comes to prenatal care, many women begin from a place of uncertainty,” D’Souza explains. “Will I be in financial debt even before I have this baby? Or what's going to happen when I have to go back to work? The focus of our outreach is to lessen those fears and concerns.”
Kathleen Boddie, nursing outreach program manager, Women and Infant Services, LBJ Hospital, meets community members where they are with a simple message.
Maria D’Souza, administrative director, Nursing, LBJ Hospital, focuses many of her resources on addressing complications women face after delivering their babies. For example, some women experience headaches after giving birth, a sign of postpartum hypertension. Postnatal hypertension is a serious issue that can occur up to a year after giving birth and can lead to life-threatening cardiovascular issues. Postnatal mental health can be challenging, too, as can breastfeeding.
“One of the biggest challenges we face is education,” D’Souza says. She notes how many mothers don’t know that there are many factors in addition to breastfeeding a child that can significantly decrease the mortality risk for both the infant and mother. “Many moms-to-be think just because their grandmother never came into a hospital before giving birth that they don’t need to, either.” But the reality is that most of the issues D’Souza sees in infants and mothers can be solved by pre- and post-natal care.
"One of the biggest challenges we face is education. Many moms-to-be think just because their grandmother never came into a hospital before giving birth that they don’t need to, either."
“Healthy babies start with healthy moms,” she stresses. “Being healthy before pregnancy is the best starting point, along with receiving prenatal care during pregnancy and postnatal care after the baby is born—we tell moms that by meeting these three conditions, our moms have a greater chance of delivering a healthy baby.”
The outreach program uses several interventions to encourage patient participation in prenatal and postnatal healthcare. Boddie regularly visits churches, recreation centers and high schools, partnering with community organizations to spread awareness. At Ben Taub and LBJ hospitals, extensive tours are offered of the facilities to give moms-to-be an idea of what to expect when they deliver their baby. Classes are offered on prenatal and postnatal care, safety, domestic violence and mental health. The team also helps moms navigate Medicaid and addresses concerns about the support resources available to them in the community.
“The goal is to build trust,” Boddie explains. “By visiting our hospitals, we’re alleviating many anxieties they might have when they go into labor. Often, these moms even see some of the same nurses they met during their tours, which brings our moms a sense of comfort.”
It’s all part of a coordinated customer-centric approach that Boddie promotes since her arrival to Harris Health in 2023. “Treat others the way you want to be treated,” she says. This approach is evident at both Ben Taub and LBJ hospitals.
“We provide the best possible care with empathy,” D’Souza adds. “At LBJ Hospital, we have a strong lactation team, family liaison support, neonatal speech therapist and plenty of resources in hopes that moms will continue to get care after their child is born.”
"Being healthy before pregnancy is the best starting point, along with receiving prenatal care during pregnancy and postnatal care after the baby is born—we tell moms that by meeting these three conditions, our moms have a greater chance of delivering a healthy baby."
"We know that the most vulnerable time for these patients is postpartum. To address this, we have rigorous follow-up with our patients after delivery including a postpartum safety clinic,”
Birth equity is another priority for Harris Health. Research through March of Dimes suggests that overcoming bias means better outcomes for black and Hispanic moms. Lundeen’s department performs acute case reviews of every birthing experience to gather data that will lead to better outcomes. Combined with bias training for staff members, Lundeen is confident equity can be achieved.
“We put a heavy emphasis on shared decision making. We want to make sure that we get the patient's input,” she says, noting that in response to addressing equity concerns, Ben Taub Hospital is launching a program called Team Birth to better facilitate shared decision making.
When combined, Harris Health’s outreach, award-winning hospitals, and comprehensive prenatal and postnatal care create a robust response to address the health crises of rising infant and maternal mortality rates.
“We’re hopeful that these trends will turn around,” D’Souza says. “We have the resources and the will to control the morality rate and get prenatal care and education out to every mom in Harris County."
Community outreach to educate potential moms about the lifesaving benefits of prenatal and postnatal care is the preventive part of the health system’s multi-faceted approach. Harris Health’s award-winning hospitals are the curative part. Taken together, Harris Health hopes to dramatically lower the infant mortality rate in Texas.
Harris Health Ben Taub Hospital was recently named among Newsweek’s Best Maternity Hospitals, recognized for consecutive years for 2023 and 2024, while Harris Health Lyndon B. Johnson Hospital boasts a long-standing recognition as a regional high-level neonatal intensive care unit (NICU). Top level care matters, but so do all the preventive measures along the way.
Suzy Lundeen, Administrative Director, Nursing, Ben Taub Hospital
Kathleen Boddie, Nursing Outreach Program Manager, Women and Infant Services, LBJ Hospital
Maria D’Souza, Administrative Director, Nursing, LBJ Hospital