Download our Factsheet: Breastfeeding Intention

HealthConnect One aims to increase breastfeeding intention, initiation, and duration at 6 weeks for between Black, Indigenous, and other People of Color (BIPOC) and their families.Breastfeeding intention is an important predictor of breastfeeding initiation and duration as well as a measure of exclusive breastfeeding.

This fact sheet highlights the existing inequities between BIPOC families and breastfeeding ending with recommendations for centering breastfeeding promotion and education in maternal and child health.

Home Visiting Yearbook 2020

HealthConnect One is excited to be featured in the 2020 Home Visiting Yearbook by The National Home Visiting Resource Center (NHVRC). The yearbook is a nationwide and state-by-state look at early childhood home visiting. The publication presents 2019 data from evidence-based and emerging home visiting models and from state agencies to highlight the following:

-Where programs operate, the families they serve, and the families who could benefit but are not being reached

-State, tribal, and model profiles

-Services delivered by state awardees of the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV)

NHVRC is also offering a downloadable file of key home visiting service data. Visit nhvrc.org to browse these and other resources and to understand the impact of the COVID-19 pandemic on the data collection process.

You can download the HealthConnect One profile here….

You can download the full Home Visiting Yearbook here…

New Issue Brief: Maternal Health In Puerto Rico During COVID-19

Perhaps the biggest structural challenge posed by COVID-19 is the strain that the pandemic is placing on healthcare systems.

The human costs, however, are much more significant – recent data has shown that Black, Indigenous, Black Latinx and Latinx (BIPOC) populations and poorer people have higher rates of infection and are more likely to die from COVID-19.

For birthing families in Puerto Rico this could mean less attention in an already over-burdened system, a heightened susceptibility to exposure and infection, and an increase in adverse maternal health outcomes. Any public health response to COVID-19 must include a focus on birth equity work and center the needs of birthing families that are facing the greatest hardship during this pandemic.

Key components of this brief include:

  • Disparities in outcomes pre Covid-19
  • Birthing during a pandemic
  • Recommendations

For more information on this topic, please send questions or comments to Khadija Gurnah, Director of Policy and Advocacy at info@healthconnectone.org.

More: We also partnered with Alimentación Segura Infantil (ASI) in Puerto Rico (PR) to present related webinars in English and Spanish. You can view the webinars here. 

Download Maternal Health in Puerto Rico During COVID-19

Please complete the form above to download our new report. Downloadable versions are available in English and Spanish. 

Image credit: Karla Rosas / IG: @karlinche_

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Birthing Families Need Your Support – Stories from Across the U.S.

As COVID-19 strains our healthcare infrastructure, pregnant women are facing severe isolation at a time where familial and community support is critical in birth outcomes. Moms and babies of color, particularly in Black and Indigenous families, are vulnerable to adverse birth outcomes due to generations of disinvestment in the health of communities of color. Now, more than ever, birthing families need support – regardless of immigration status.

Over the past two months, we asked doulas, peer counselors and other community health workers what was happening in their communities, and now we have compiled them in the attached report. These stories highlight the extreme problems faced by birthing communities during this pandemic. You will read how families are:

  • Experiencing food insecurity, housing insecurity, job loss and having problems accessing formula and diapers.
  • Fearful of the possibility that mothers may be forced to give birth without a partner or the doulas they made birthing plans with.
  • Lacking or experiencing limited access to pre and postnatal care.
  • Afraid to seek services if they are immigrants, particularly if they are undocumented.

We’re glad to be able to share this just ahead of Mother’s Day. In this story collection you will hear voices from Alabama, Arizona, California, Florida, Georgia, Illinois, Indiana, Mississippi, New Jersey, New Mexico, Puerto Rico and Texas. We hope you will share this storybook widely, including with elected officials, to help them in their policy decisions.

This publication is available in English and Spanish. 

Download Birthing Families Need Your Support Storybook

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Changing the conversation on birth equity: issue brief 2 is on medicalization of birth

Community-Based Doula and the Medicalization of Birth is the second of five policy briefs designed to call attention to the most pressing challenges inhibiting broad adoption of community-based doula services that contribute to birth equity.

In October 2019 we released our first report, Doula Legislation-Creating Policy for Equitable Doula Access. At almost the same time last fall, the Centers for Disease Control and Prevention reported that Black, American Indian, and Alaska Native (AI/AN) women are two to three times more likely to die from pregnancy-related causes than white women 

Key components of this report include:

  • A historical context that shows how the medical profession in the 20th century sidelined traditional birthing experts who supported pregnant and birthing women. 
  • Not only are  maternal mortality rates unacceptably high, women who experience severe maternal morbidity – which can be defined as “near misses” for women of color — number in the tens of thousands.
  • The report highlights how community-based doulas support women through the perinatal period and addresses how doulas and medical professionals such as nurses can team up to protect pregnant women.

We issue these briefs to reinvigorate the conversation around birth equity through home-visiting perinatal support services including how to integrate this support in the health care system and its ability to impact health outcomes for every woman touched, but especially U.S. women of color and indigenous women. 

We welcome the opportunity to engage with you about this topic or hear suggestions for future briefs, please send questions or comments to Sadie Wych, our Evaluation and Learning lead at swych@healthconnectone.org or 815-382-3382.

Download Community Based Doula and the Medicalization of the Birth

Honoring Black Birth Workers of the Past

by Olivia Dockery

Black History Month is the time when we honor, reflect and learn about elders who have impacted Black culture and how their legacy is continued. This Black History Month, HealthConnect One wants to honor the legacies of Black birth workers who have played critical roles in improving the health outcomes of Black mothers, babies, and families. Today, Black women are three to four times more likely to die due to pregnancy-related causes than white women. Most of these deaths are preventable, so why does this disparity exist?

The 15th century marked the beginning of the transatlantic slave trade. Africans were enslaved and brought over to the Americas to provide labor in order to secure and build European settlements and wealth. To resist one of society’s most dehumanizing atrocities, enslaved Africans preserved traditions and customs. One of those customs were traditional birth practices. Traditional birth workers were vital to the survival of Black people. These birth workers, also known as “granny” midwives, were viewed as trusted community members with the ability to heal, care, and assist others. They were taught through practice and would pass down their knowledge from generation to generation.

Black birth workers were known as more than midwives; they were postpartum doulas, lactation consultants, family counselors, health educators, and so much more. The post- Emancipation period did not improve the quality of life for formerly enslaved Blacks. They had to succumb to working and living conditions similar to those on plantations. Black birth workers traveled all over the south to make sure that Black families received the care that was needed regardless of their geographic location or ability to pay. They bridged the gap between disenfranchised communities and the health care system. Advancement in medicine, systemic racism, and patriarchy pushed Black midwives out and provided space for the white, male doctors that conquered U.S. medical institutions. Midwifery began to be regarded as an unsafe, outdated model of childbirth and “by the 20th century, 50% of births were attended by a midwife.”

According to ProPublica,  “only 10% of all births were attended by a midwife,”  and 2% of midwives in the U.S. are Black, noted the American College of Nurse-Midwives.” Multiple studies have shown that midwives and doulas can improve the health outcomes of mothers and babies. It is clear that community-based birth workers can lead successful interventions to combat the racial disparities that exist within maternal and child health. While we encourage Black health professionals to enter the birthing field, we must continue to challenge and dismantle the systems of racism and patriarchy. Black birth workers of the past did just that, today we honor them.

Spotlight On Historical Black Birth Workers

Bridget “Biddy” Mason was born enslaved in Georgia during the early 19th century. She was not only a midwife, but an advocate for other enslaved Black people. Her last owner moved west to California and there she petitioned for her and her family’s freedom. Once she was free, she began to save money from her midwifery practice. She founded the first African Methodist Episcopal Church in L.A. Through Mason’s acquired wealth, she became known as a local philanthropist. She donated to many charities, fed and housed low-income families, and visited prisoners. She also founded an elementary school for Black children. Bridget “Biddy” Mason’s contribution to improving the lives of Black families will not be forgotten.

Margaret Charles Smith didn’t start practicing midwifery until her late 30s. She was one of Greene County, Alabama’s first official midwives in 1949. Her career spanned over 35 years and she delivered over 3,000 babies. Smith worked mostly in the rural, Jim Crow South where there was little to no care for Black mothers and their families; whether there were no accessible health facilities or the health facilities refused to treat Black patients. In 1996, Smith wrote a book about her life as a midwife, Listen to Me Good: The Life Story of an Alabama Midwife. In 2010, she was inducted into the Alabama Women’s Hall of Fame. Margaret Charles Smith’s legacy of caring for marginalized and underserved communities lives on through the contemporary work of Black birth workers.

Mary Francis Hill Coley also known as Miss Mary was a midwife that practiced in Georgia for more than three decades. She trained under another great, Black midwife, Onnie Lee Logan. Miss Mary was a pillar of her community. Along with her midwifery practice, she became a health advocate for rural Black families. In 1952, Miss Mary was asked to do a training video for the Georgia Health Department. It was clear that Miss Mary was an expert at her craft, her patients and community loved her. The documentary, All My Babies: A Midwife’s Own Story, received critical acclaim and was used by the World Health Organization and United Nations to train midwives across the globe. We honor Miss Mary and the work she has done to improve the health outcomes of Black moms, babies, and families.

This month, HealthConnect One will be publishing our latest  in-depth brief “Community-Based Doulas and the Medicalization of Birth.” Stay tuned!!!

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New: HC One Issue Brief: Creating Policy for Equitable Doula Access

We are thrilled to announce the release of the HealthConnect One (HC One) Issue Brief: Creating Policy for Equitable Doula Access. It’s very exciting that communities and states across the country are looking at doula access. We  think it’s really important that we talk about what is a doula and what’s a community-based doula and how they are different. This issue brief also covers processes and approaches to setting up policy that will provide equitable doula access.

The purpose of this high-level brief is to help states think about how they are going to move forward on creating policy for equitable doula access. As we know, with communities across the country, we can work with our public departments of health and other entities that want to address this issue. Please download and read our policy brief and share with your networks.

Download:  HC One Issue Brief: Creating Policy for Equitable Doula Access

Download: Executive Summary of  Creating Policy for Equitable Doula Access

If you have questions about the brief or need assistance and support on this issue please reach out to us at 312-243-4772 or email us at info@healthconnectone.org.

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Building for Birth Equity: Lessons from the Field

HealthConnect One (HC One) launched the Birth Equity Leadership Academy (BELA) in the spring of 2017, to develop effective and authentic leadership on maternal and child health within communities that are often marginalized, and to amplify the voices of these leaders through a coordinated national network.

BELA is the first national network focused on birth equity.

After approximately 18 months of implementation, we have identified six key lessons learned:

  1. Community and connection break the isolation of individual birth workers
  2. Modeling, support and mentorship impact how individuals work with families and community
  3. Seed grants paired with mentorship launch innovative, expansive ideas
  4. Developing leadership in communities means supporting both professional and personal growth
  5. Focusing on equity requires a significant time investment
  6. Time, capacity and process are crucial elements of success


For details, please download the full brief here:

LESSONS FROM THE FIELD:
BUILDING A NATIONAL BIRTH EQUITY NETWORK

A vital part of BELA is the community projects initiative, which provides mini grants and technical support in order to increase capacity for serving vulnerable and marginalized communities around maternal and child health.

HealthConnect One is currently supporting community demonstration projects from BELA leaders across the country in the form of $80,000 in mini grants. The overarching goals of these mini grants are to foster collaboration, share learning, and support new or current work in underserved communities and communities of color.

For a summary of lessons learned in launching this mini grant funding strategy, please download the full brief here:

LESSONS FROM THE FIELD:
BUILDING A COMMUNITY ROOTED SMALL PROJECTS FUNDING STRATEGY

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Read Sustainable Funding for Doula Programs: A Study

Community-based doulas have been increasingly recognized in recent years for improving health, reducing costs, and effectively addressing health disparities. However, their services have continued to be underfunded, which has plagued the ability to make them available on a broad scale.

In light of this potential to positively impact health and the existing barriers to sustainable funding, HealthConnect One (HC One) commissioned TRP Health Policy (TRP), a nationally recognized bipartisan policy firm, to research potential sustainable funding streams, policy opportunities, and strategies for sustaining community-based doula services.

This publication is a summary of that research, which focused on doulas but is also applicable to breastfeeding peer counselors, community health workers, and others working to improve maternal, infant, and family health outcomes.

Download Sustainable Funding for Doula Programs

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Read The Perinatal Revolution report (2014)

The Community-Based Doula Program provides low-income mothers with someone from their community who can help make breastfeeding easier, and guide them toward a healthy pregnancy and a baby who has the ultimate nutritional advantage. This study shows that community-based doulas can change the way our country cares for our most vulnerable moms and babies, and it can save taxpayer dollars.

Download a one-page summary of the Perinatal Revolution

U.S. breastfeeding rates are particularly low in disadvantaged communities, where babies are more likely to face health problems. The World Health Statistics in 2010 revealed that 40 countries had better neonatal mortality rates than the United States and 32 had higher rates of exclusive breastfeeding at six months. Furthermore, according to the CDC1, Non-Hispanic Black babies were almost twice as likely as Non-Hispanic white babies to be born at low birth weight, and Black babies were twice as likely as white babies to die before their first birthday.

Community-based doulas change this trajectory, with an approach that consistently results in high breastfeeding rates and low c-section rates. A community-based doula is a woman of and from the same community who provides emotional and physical support to a woman during pregnancy, birth and the first months of parenting, through home visits and center-based activities. The effectiveness of the program emerges out of the trusting relationship between a community-based doula and her participant, the duration of their relationship, and the continuous presence of the doula during labor and birth.

The study, supported jointly by the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC), looked at 8 community-based doula sites around the country assisted by HealthConnect One, and found that 87% of community-based doula clients were breastfeeding at 6 weeks, as compared to 61% of a similar sample. Even at 3 months, 72% of community-based doula clients were still breastfeeding, as compared to 48% of the broader sample.

The Community-Based Doula program has since been adopted by multiple organizations and was named a best practice by AMCHP’s Innovation Station in 2015.

Download The Perinatal Revolution