How this Shively nonprofit is improving the health of new parents and their babies

Attica Scott

Opinion contributor

Sept 20, 2021

Link to article: Attica Scott Opinion Piece

This past week, I attended the grand opening of the Black Birth Justice postpartum hub in Shively. It is an amazing and much-needed resource for our community, but the facility is more than that; it is also a concrete example of what Kentucky can and should do to improve maternal health, particularly Black maternal health.

What is happening to many pregnant and postpartum people has been an epidemic of its own for years. The United States is last among wealthy nations in the percentage of people dying from childbirth-related issues; that rate has gotten progressively worse over the past decade. Kentucky’s numbers are well below our abysmal national average; and racial disparities are especially stark. 

Black women die from pregnancy-related causes at a rate four times higher than their white peers. Many factors contribute to this horrifying disparity, including chronic stress caused by racism, providers who fail to take Black women’s health concerns seriously and the lack of providers who come from communities of color.

In the United States, the postpartum period is commonly thought to be six weeks post-delivery, since most insurance coverage changes at that time. However — medically and physiologically — postpartum lasts at least a year after birth, and often well beyond that.

Studies show that Black women are more than twice as likely as white women to experience postpartum depression (PPD), while the risk for Hispanic women is almost as high. It is believed that as many as half of all women do not report PPD, indicating the problem is even worse than feared.

Although women of color may be more susceptible to postpartum depression, they are less likely to receive treatment. Research has shown troubling racial and ethnic disparities, with Black women 57% less likely than white women to start treatment for PPD and Latinas 41% less likely. 

Fixing this will take comprehensive efforts to change both our health care system and the broader society, but one thing we can do quickly is improve Medicaid’s postpartum coverage. Leveraging this multi-billion dollar program can have an outsized impact, since it pays for more than half of all births in Kentucky and is the health insurance provider for many Black and Hispanic families.

One of the first things we need to do is make sure low-income mothers who have coverage under the Medicaid expansion are not removed from the rolls after 120 days if they do not meet the income criteria for regular Medicaid. Given that postpartum depression can crop up or intensify after this period, this lack of extended coverage is significant. 

Improving pre- and post-natal health outcomes has long been a priority of mine, and one bill that I have sponsored would provide doula care similar to what is offered at Shively’s new center.

Doulas play a tremendous role when it comes to healthy childbirth and postpartum care. A 2013 study of a Greensboro, North Carolina, program found that at-risk mothers assisted by doulas were four times less likely to have a low birth-rate baby and two times less likely to experience a birth complication involving themselves or their baby; they were also significantly more likely to initiate breastfeeding.

Doula care is not free, of course, but experts from the March of Dimes, ACOG, Society for Maternal-Fetal Medicine and others agree that it is a cost-effective method that improves outcomes for parents and infants.  It is truly a win-win investment for everyone involved.

Kentucky has the potential to be a national model when it comes to improving maternal health across rural and urban populations. Just bringing our numbers up to the national average would have a profound effect on women and children, especially those from families of color.

We know what works, and we have the resources to get the job done. The only obstacle in front of us, it seems, is ourselves.