In 2018, the Montgomery County Maternal and Early Childhood Consortium (MECC), through the Office of Public Health, partnered with the Public Health Management Corporation to begin an eighteen-month Perinatal Periods of Risk (PPOR) investigation to look at disparities in infant mortality, identify significant risk factors, and develop a community action plan to improve birth outcomes.
While the infant mortality rate is decreasing across the county for all groups, racial disparities continue and are significant. The purpose of the PPOR study is to better understand the causes of poor birth outcomes in Montgomery County, specifically focusing on the fact that African American infant mortality rate (IMR) is three times the IMR for White infants.
PPOR is an analytic framework for studying racial disparities in fetal and infant mortality rates, helping community stakeholders build consensus and partnership as they work to identify and prevent risk factors during the greatest periods of risk. It is the belief of the MECC and those involved in the PPOR that if one group of babies in our county can have good outcomes, every group of babies should be able to achieve good outcomes.
The PPOR research phase, completed in February 2020 gave us crucial information from the county vital records data to show us that disparities in birth outcomes are the greatest early in pregnancy. We categorized each death by birthweight and age at death, and found that the greatest racial disparity is among very low birthweight babies (less than 3.3 pounds). To reduce the racial inequity, we need to increase babies of Black women born at healthy weights.
To learn more about what could help Black/African-American women in Montgomery County have healthy babies, we held three community focus groups. Together with the analysis of birth and death records, the focus groups revealed key action areas:
- Nutrition and weight
- Health across the life course
- Interactions with healthcare providers
- Emotional and mental health support
- Informal and formal education
- Access to services
By focusing on these areas, we can reduce the number of very low birthweight babies of Black/African–American women. This will lessen the racial gap in fetal and infant survival.
In December of 2020, MECC Member Maternity Care Coalition (MCC) received funding from HealthSpark to continue the work of PPOR, renamed “Montco Mamas”. Using Lived Experience Experts and other stakeholders, Montco Mamas met regularly to prioritize the twelve PPOR recommendations to lay the groundwork for three initiatives:
- Increase use of allied health providers: doulas, home visitors, lactation consultants, and patient advocates
- Provide targeted education about reproductive health, overall health, parenting, and other topics such as empowerment
- Increase provider’s understanding of Black women’s experiences
Work on these three initiatives continues through 2022.
To see the complete Perinatal Periods of Risk Report, click here:
To see the initial Maternity Care Coalition report, click here:
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