MCAH NEWSLETTER

This months newsletter takes a deeper dive into perinatal health, the disparities that exist amongst the Black, Native American, and Asian Pacific Islander populations and explores realistic solutions to address them. Information on local resources are also included.

Please also read on afterwards as we share photos from our Birthing Justice event earlier this month.

Photo by Mustafa Omar on Unsplash

Gestational Diabetes (High blood sugar during pregnancy)

• Increase from 2018-2020 across nearly all racial/ethnicity groups, age groups
• Overall rate from 2019-2021 for Sonoma County= 11.9, vs. California= 10.8
• Higher rate among Medi-Cal users (13.9) vs. private insurance users (10.6)
• Disparities exist by race/ethnicity (see table below)

Severe Maternal Morbidity is defined as unexpected and potentially life-threatening complications. The graph below shows that rates (both within Sonoma County as well as in the State as a whole) are increasing over time. Sonoma County's rate is in green, California's rate is dark blue.

Disparities for Black Birthing People in Sonoma County

• For 2020-2022 the infant mortality rate among Black birthing people was 8 times higher than the overall Sonoma County infant mortality rate (24.1/1,000 live births compared to 3.1/1,000 live births)
• Black birthing people had among the lowest rates of early (first trimester) entry into prenatal care
• Births to Black birthing people were more likely to be low birthweight (less than about 5.5 pounds) than Sonoma County births overall

If you are interested in learning more about Sonoma County's health data, check out the two resources below:

The Sonoma County Community Dashboard is an interactive platform that provides regularly updated data from 2016 to the present.

The California Department of Public Health's Data Dashboards allow you to look at State and County Data (when available) among the following domains: Women/Maternal, Perinatal/Infant, Child, Children and Youth with Special Healthcare Needs, and Adolescents.



What can providers do? What can Health Systems Do?

Healthcare providers can:

• Ask questions to better understand their patient and things that may be affecting their lives.
• Help patients, and those accompanying them, understand the urgent maternal warning signs and when to seek medical attention right away.
• Help patients manage chronic conditions or conditions that may arise during pregnancy like hypertension, diabetes, or depression.
• Recognize and work to eliminate unconscious bias in themselves and in their office on an ongoing basis.
• Respond to any concerns patients may have.
• Provide all patients with respectful quality care.



Hospitals and healthcare systems can:

• Identify and address unconscious bias in healthcare.. (CMQCC)
• Standardize coordination of care and response to emergencies.
• Improve delivery of quality prenatal and postpartum care.
• Train non-obstetric care providers to ask about pregnancy history in the preceding year.

For patients/clients:

• Talk to a healthcare provider if anything doesn’t feel right or is concerning.
• Know and seek immediate care if experiencing any of the urgent maternal warning signs, including severe headache, extreme swelling of hands or face, trouble breathing, heavy vaginal bleeding or discharge, overwhelming tiredness, and more. These symptoms could indicate a potentially life-threatening complication.
• Share recent pregnancy history during each medical care visit for up to one year after delivery.
• Connect with healthcare and social support systems before, during, and after pregnancy.

See Below for Tools and Resources

Toolkits and Resources related to

Health Equity and Perinatal Health:

The Black Mamas Matter Toolkit "is a resource for advocates who are concerned about the health and well-being of black women and girls. It takes a human rights based approach to maternal health, identifying the rights of pregnant and birthing parents and the corresponding role of government to ensure safe and respectful maternal health care for all. First released in June 2016, the toolkit was produced by the Center for Reproductive Rights in partnership with members of the Black Mamas Matter Alliance."

Mental Health America’s 2023 BIPOC Mental Health Toolkit "provides free, practical resources, including information about how an individual’s environment impacts their mental health, suggestions for making changes to improve and maintain mental well-being, and how to seek help for mental health challenges."

UCSF's Motivating Interdisciplinary Lactation Knowledge (MILK) Research Lab has two NICU Toolkits- One for Hospitals and one for Black Famlies. Access them here.

California Maternal Quality Care Collaborative (CMQCC) has resources for hospitals and hospital staff with a focus on improving Maternal Health and Equity. See their Quality Improvement Initiatives here. They also have recordings of previous webinars posted here.

Reproductive Justice also includes Abortion Access

From the Black Mamas Matter Alliance:



The BMHC24 theme, “Our Bodies STILL Belong to Us: Reproductive Justice NOW!” highlighted the widespread restrictions on abortion care access coupled with rising cases of criminalization due to pregnancy loss which continues to widen the gaps of adverse maternal and birth outcomes in the U.S. Many of the states with the most restrictive abortion bans have the worst maternal and child health outcomes and the least supportive social welfare and family support programs, particularly for Black women and birthing people. 

Click here for local abortion providers.

We recognize that in Sonoma County, access to Abortion services is limited. Individuals are often having to make the decision to travel farther to obtain the services they need. Partnership is aiming to mitigate this barrier by covering travel and hotel stays to obtain services outside of the county if necessary. Please read below:

Partnership Health Plan is now arranging all transportation and lodging services in-house when needed by plan members to access Medi-Cal-covered benefits, including prenatal or other pregnancy-related care. Plan members or their providers can call the following number to get transportation and lodging set up:

(866) 828-2303. Callers will be referred directly to a Transportation/Lodging Specialist.

Birthing Justice Film Screening April 11, 2024

What was the purpose of this screening?

• 
  
• In the United States Black women are 2-3 times more likely to die from pregnancy complications compared to White women. (Birthing Justice Film)
• The Unites States ranks 23^rd in maternal and infant mortality among developed nations. (Birthing Justice Film)

During the Birthing Justice Event we asked everyone in attendance to commit to dismantling the racist structures that continue to harm and kill Black birthing people The first step was to engage in self reflection to see how we all contribute to this biased narrative.

Here are some examples of what was expressed:

• Cradle Black and Brown birthing mothers with love, and compassion, and trust them
• Be strong enough to be vocal against injustice.
• Advocate for patients under all circumstances.
• Speaking for Women of color - Let our voices be heard. Talk to us! Tell us what is happening.
• Even with call bells ringing and multiple patients to care for, I will take the time to connect with my patients and hear what they need from me to make their experience a positive one.
•  I will do my best to manage my time differently and not compromise my awareness and consideration of my patient's needs.
• We need to have less of the medical chaos when emergencies arise.
• Have more patience with the mother/birthing person and empathy towards them.
• Don't instill more fear into the birthing person.



Everyone one deserves Birthing Justice, Reproductive Justice and Joy!

YPhoto by Eye for Ebony on Unsplash

Thank you for taking the time to read through this entire Newsletter. Your partnership is so important to us and the communities we serve!

Sonoma County MCAH