Morehouse School of Medicine’s Center for Maternal Health Equity has received a $95,000 grant to study the issue of high maternal mortality rates among women of color, especially black women earlier this month.
The study will be based on community-based participatory research (CBPR). Researchers will be conducting interviews with women who have experienced a Maternal Near Miss (MNM), this is when a woman nearly dies from a complication during pregnancy, childbirth or within 42 days of giving birth.
Dr. Natalie Hernandez is the principal investigator for the study and has over 15 years of experience with CBPR. She is an assistant professor and director of the Center for Maternal Health and Equity at Morehouse School of Medicine.
“This was something we were just going to be studying in Georgia through funds we were granted from the Governor’s office. Optum allowed for this to become a national study,” Hernandez said.
With the grant from Optum, the study will broaden to New Jersey, Louisiana and the District of Columbia. States who, along with Georgia, have some of the highest maternal mortality rates in the country.
Optum, the health services business of UnitedHealth Group, has had a long-standing relationship with Morehouse School of Medicine, said Dr. Janice Huckaby, chief medical officer of Maternal-Child health at Optum.
“We were looking at what were some things Optum could do to support work going on at the local level,” Huckaby said.
According to Dr. Hernandez, of the 700 women that die each year 50 or 60 thousand have a near miss.
“Maternal near misses are invisible experiences,” Hernandez said. “We hear about the void that is left when a mother dies but what happens when mom is alive but left with health issues postpartum.”
The study will also incorporate incarcerated women who have another barrier to accessing medical care.
According to data published in 2020 by the Women & Justice project, there are 18 states where it is legal for a pregnant woman to be shackled while she is giving birth. In 2019 Georgia outlawed shackling pregnant inmates or inmates in the immediate postpartum period.
“When it comes to addressing inequity, not having incarcerated women wouldn’t allow for a complete study,” Callie Chamberlain, Optum’s Director of Social Responsibility, said.
Chamberlain, a trained doula, added that Optum will provide a 6-week doula training program for incarcerated women and support them in starting a business when they are released from prison.
Dr. Hernandez pointed out that black researchers are regularly sidelined in a supervisory role when it comes to conducting research.
“We can lead these efforts, not just in an advisory position because we work in partnership with communities,” Hernandez said.
As a CBPR study, the interviews with women who have had an MNM are used as a data point.
“In understanding their lived experiences we can change clinical practices,” Chamberlain said.
By considering clinical and nonclinical factors in the interviews, researchers are hoping to learn how to close healthcare gaps and formulate reproducible solutions that will improve the quality of care for all women.
Drs. Hernandez and Huckaby noted that MNM’s are not isolated situations. In many cases, women have untreated conditions before pregnancy and often lack access to proper prenatal care.
“In Georgia, 20 percent of all women— pregnant and not— don’t have access to health care,” Hernandez said.
She noted that Georgia has not adopted the federal Medicaid extension.
“In many cases, pregnant women with chronic conditions are missed or receive a delayed diagnosis,” she continued.
Dr. Huckaby added that Optum’s relationship with Morehouse School of Medicine fits into their broader goals of improving maternal health overall and closing the gaps that black mothers experience in healthcare.
The partnership extends past the grant money. Optum is also helping Morehouse to craft the set of interview questions and providing a team to help conduct the interviews.
“More Black and brown providers is also a part of closing the gap,” Hernandez said. “We do training for more than just doctors. We have a physician’s assistant program, a master’s in public health program and a Ph.D. program.”
Dr. Hernandez said she is excited to start this project because unlike in other countries there haven’t been studies done at the national level into maternal near misses in the United States.