Health workers say at-risk Missouri mothers need help during and after pregnancy
Health workers say at-risk Missouri mothers need help during and after pregnancy

Doctors and health workers in St. Louis say getting maternal care earlier and more consistently is essential to reducing the state’s high maternal and newborn mortality rates.

Pregnancy and maternal health experts at a panel convened by the St. Louis Department of Health on Thursday said quality prenatal and postpartum health care provided by workers outside clinical health care settings is essential to reducing rates of maternal and child mortality.

“No one person can be the be-all and end-all,” said Dr. Matti Hlatshwayo Davis, St. Louis’ health director. “I as a doctor can’t, and a nurse can’t, and a [community health worker] I can’t, but together understanding the work we do is critical to each other, we can do this.”

About six babies per 1,000 births die each year in Missouri, and more than 30 women for every 100,000 people die in the state during pregnancy or within a year of giving birth. Death rates for black mothers and infants are higher than for their white counterparts.

According to the state Department of Health and Senior Services, black women were three times more likely to die during pregnancy or in the year after giving birth than white women.

Panelists advocated increasing the use of doulas, community health workers, and midwives and integrating them into existing clinical settings.

“We have not integrated [midwives and doulas] in the health systems that other countries have, said Okunsola Amadu, a midwife and founder of Jamaa Birth Village, which provides doula services to people of color in St. Louis. “Social workers, community health workers, these are people who are with pregnant women all the time.”

Support at the beginning and throughout the pregnancy provides emotional support to mothers-to-be. It also facilitates the integration of screenings for potential problems, including congenital syphilis, and provides an easy way for women to manage health problems.

“It doesn’t matter if your doctor is sympathetic if the person who answers the phone and checks you in at the hospital or the nurse who delivers with you isn’t,” said Dr. Dineo Habele, head of obstetrics and gynecology at Washington University. “We need everyone in health care to think about how we approach individual patients.”

About 30 percent of black pregnant women in St. Louis do not receive adequate prenatal care, compared with about 13 percent of white pregnant women, said Yolanda Lawson, president of the National Medical Association, which represents African American doctors.

Only about half of black pregnant people in the city received prenatal care early in their pregnancies, she said.

Post-pregnancy care is just as important, the panelists said. Mental health problems, suicide and substance use are among the most common reasons mothers die within a year of giving birth.

“The moment someone decides to commit suicide, complete despair sets in. And there’s a huge correlation between that and a lack of social connection,” said Ronke Falletti, founder of Korede House, a women’s social club in the Central West End.

The space, which offers membership on a sliding scale, will soon host peer support groups for mothers, she said.

“Engineering that social connection and building trust … that’s our solution,” she said. “That way we can identify early, intervene early and provide that support for whatever that temporary social situation is, rather than having a permanent solution to it.”

Copyright 2024 St. Louis Public Radio. To see more, visit St. Louis Public Radio.

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