Gov. Parson pledged $4.3 million to improve maternal health in December 2023. We wanted to know where that money went.
ST. LOUIS — Seventy women die each year in Missouri from complications of pregnancy or childbirth.
In December 2023, Missouri Governor Mike Parson announced a plan to improve maternal health.
5 On Your Side wanted to find out what has been done at the state level since this announcement.
We reached out to the Governor's Office, and also spoke with Dr. Karin Fowler, medical director of SSM Health's Women's and Newborn Clinical Programs, Okunsola Amadu, founder and CEO of Jamar Birth Village, Eboni Hooper Boateng, owner of Birthing You Doula Services, and Jasmine Williams, a wife, mother of five, and doula.
Through her own work and experiences, Williams has unique insight into how these joyous times can sometimes be shattered for Black, Indigenous, and other women of color (BIPOC).
“You know, the mortality rates for pregnant women, particularly Black women, are at an all-time high right now,” said Williams, who is mother to Journey, 13, DeAndre, 9, Jade, 6, Jezreel, 5, and De'Amir, 2.
She struggled with mental health issues during her previous three pregnancies.
“I don't know what it is,” Williams said, “I think after you give birth, everything goes haywire.”
Poor health and death in the first year after giving birth can be caused by a variety of health problems, from heart disease to high blood pressure.
However, mental illness accounts for 50% of maternal deaths in Missouri.
Nationwide, Missouri has one of the highest maternal mortality rates.
Research shows that over 80% of pregnancy-related deaths are preventable.
Maternal Mortality Prevention Programme
In December, Parson announced the maternal mortality prevention plan would be funded with $4.3 million and include five areas of action, ranging from changing hospital protocols to improving obstetric and postpartum training and toolkits for health care workers.
I reached out to the governor's office to find out how the money was spent.
Lisa Cox, public affairs director for the Missouri Department of Health and Senior Services, provided more details in an email. Here's a summary:
Standardized training for maternity care providers; development of a new Maternity Care Quality Plan for hospitals; and the Maternal Health Access Project, a resource for physicians and providers to connect new moms with mental health resources. DHSS contracted with the University of Missouri to establish this collaborative hub-and-spoke model, which began in April 2024. Convened a Postpartum Care Optimization Task Force to develop recommendations for an extended postpartum care pathway in Missouri. This portion of the plan will see health experts meet monthly to develop postpartum care plan templates and implementation recommendations with a special focus on reducing racial disparities. Development of a Maternal and Child Health (MCH) dashboard and a new MCH data sources webpage, both to be launched in June 2024.
Of the $4.3 million allocated, $2.8 million has been disbursed as of June 2024.
The list of organisations receiving funding is as follows:
$1,455,000 was allocated under contract to the University of Missouri. $2,425,000 was allocated under contract to the Missouri Hospital Association. $339,500 was allocated within DHSS for the creation of the MCH Dashboard. The remaining $130,500 of the $4.3 million was held in the Governor's Reserve.
Impact on patients
I asked Dr. Karin Fowler, medical director of SSM Health's Women's and Newborn Clinical Programs, if the funding is adequate.
“It's a good start,” Fowler said. “It's a good start.”
Fowler said one of the most useful new areas is the Maternal and Child Health Access Project, a new network of resources that doctors and health care workers can use to connect patients to mental health care.
“If we have a patient who tests positive for depression or anxiety and clearly needs mental health support, we have access to this network 24 hours a day,” Fowler said.
But patients must visit their health care provider to receive that help.
“There's a lot of work to be done,” Fowler said.
She also said healthier outcomes need to start before pregnancy with access to quality healthcare and healthy lifestyles.
“Being less likely to get diabetes, being physically active and healthy, managing obesity, being at a healthy weight, all of these things are available to us even before we become pregnant,” Fowler said, “and it starts with something as simple as access to healthy foods. Access to that kind of support for healthy families makes a big difference in outcomes.”
She also said Missouri needs to emulate programs in states that are doing it right.
“It's about awareness and collaboration,” Fowler said, “and even more importantly, coordination with the state. And coordination with the people who pay for health care.”
Finding help
Jasmine said her doctor prescribed the medication after she gave birth to her third baby.
“I felt like a zombie,” she recalled. “I didn't feel like a mother.”
She stopped taking it and went online.
“Facebook, obviously TikTok, everything,” Jasmine said, “and finally, I found a friend who told me I needed help with my mental health.”
Talk therapy helped Jasmine feel better, and now she's using her experience and training as a doula to make it easier for other mothers to get the help they need.
“I felt like I wasn't being listened to,” Jasmine said. “They just brushed it off and said, 'Oh, that's because you've had a baby.' But I knew people who were similar to me and helped me through the postpartum period… that helped.”
Community-Based Pioneers
I also spoke with local Black maternal health coaches and doulas.
Okunsola Amadu, founder and CEO of Jamar Birth Village, believes hospitals are just starting to get interested in serving BIPOC mothers. What's missing, she says, are midwives and doulas with a proven model of care that prevents maternal mortality.
But Amadou said “most of the money goes to hospitals.”
I also spoke with Eboni Hooper-Boateng, owner of Birthing You Doula Services, who said she would like to see more inclusive decision-making and efforts to involve doulas and midwives in grassroots-level patient care.
“I feel like there's a disconnect in terms of access to resources,” Hooper-Boateng said.
She also wants the state of Missouri to pay for doula services for patients.
