Encouraging Maternal and Birthing people through Resources, Access, Coordination and Education (EMBRACE)




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Purpose: According to Commonwealth Fund, 2023 Scorecard on State Health Performance, Texas ranks 51 of 51 in Access & Affordability, 49 of 51 in Reproductive & Women’s Health, 48 of 51 in Prevention & Treatment and 38 in Racial & Ethnic Health Equity. In this report, 29% of birthing individuals did not receive prenatal care in the first trimester and one-third of women, 18-44 years old, did not a consistent source of health care. Not only does Texas not have a system of care in place, it has decided not to expand Medicaid through the Affordable Care Act (ACA). This further makes pregnant and postpartum people, especially the uninsured, most vulnerable to tragic maternal and birth outcomes. There’s significant racial disparities between Black and hispanic women vs. non-hispanic white women as they are two to three times more likely to die from pregnancy related complications. Postpartum period must be addressed as well because one in three pregnancy related deaths happen one week after birth to one year. We propose the Encouraging Maternal and Birthday people through Resources, Access, Coordination and Education (EMBRACE) program to address these health disparities through an integrated care model. This model will integrate doulas, highly trained individuals who provide community based maternal support services during pregnancy, labor, delivery, and after delivery to improve pregnant & postpartum health outcomes.

Methods: We will work with community stakeholders invested in maternal health that have authority to make change. Then discover potential challenges and needs for the development and implementation of EMBRACE after reviewing our current resources. Furthermore, we will learn about diverse perspectives, inclusion voices, and expertise in development and implementation of community programs serving disadvantaged communities (Healthy Start, etc). The Healthy Equity principles will then be embedded into every aspect of the project model guided by the CMS Framework for Health Equity.

Results: Once the grant is approved, we can communicate with hospital and clinic administration to smoothly incorporate COMSS into their system.

Conclusion: In recent years, the infant mortality rate has improved. However, the maternal mortality rate is still rising, especially in minority populations such as black and hispanic. Studies have shown significant improvement in maternal mortality rate when doulas and community health workers are involved. We have created a model that incorporates them into the public system in areas where these populations are the most affected.