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As maternal and infant mortality affects families across the District, Medstar Washington Hospital Center has been working to not only improve health outcomes, but address disparities.
Recently, Medstar Washington Hospital Center received the 2024 Gage Award for Population Health, for their dedication to combating maternal and infant mortality, particularly in Wards 7 and 8, where the city’s average almost doubles.
“We are so grateful for the generous gift from the A. James & Alice B. Clark Foundation that has enabled us to do this great work together,” Dr. Tamika Auguste, chair of Women’s and Infants Services at MedStar Washington Hospital Center, said in a statement. “We’ve enjoyed collaborating with our community partners to make differences in the outcome and lives of our maternal and newborn populations in the District of Columbia. Our team is dedicated to making these improvements and continuing to make a difference.”
While serving maternal and infant patients across D.C. has been important, special attention has been needed for some residents east of the Anacostia River.
“Mothers who resided in Wards 7 and 8 were 1.5 to 2 times more likely to have low birthweight births than mothers residing in any other ward, except Ward 5,” according to DC Health’s Perinatal Health and Infant Mortality Report 2022, between 2019-2020. “Mothers whose births were Medicaid financed were almost two times more likely than mothers with private insurance to have a low birthweight baby.”
Low birthweight infants are estimated to be about 20 times more likely to die than heavier infants.
Through MedStar Health’s D.C. Safe Babies Safe Moms initiative, Dr. Melissa Fries, high-risk obstetrician at MedStar Washington Hospital Center, works in partnership with Community of Hope to serve residents east of the River. The purpose of the partnership is alleviating common restrictions of access to medical care while addressing cardinal maternal health concerns.
“The things that I see the most frequently that I am concerned for, are concerns both for maternal diet, both over- and under-nutrition, that leads then to either poor baby growth or maternal diabetes. We talk about food and availability, frequently,” Dr. Fries told The Informer. “The other things that I’m concerned [about] are the conditions of their possible hypertension.”
Hypertension is a chronic problem, often related to family history, with similar connections to obesity or being overweight. Fries highlighted that these issues are often aligned with nutritional concerns. Rates of food insecurity across Wards 7 and 8 make for a host of barriers to proper nutrition and nourishment amid pregnancy.
The struggle to balance one’s health while seeking access to quality prenatal care can also weigh on the mental health of an expecting mother. Among her patients, Fries sees overwhelming concerns of maternal anxiety and depression.
“One of the things that has happened as we become aware of the challenges for maternal health in pregnancy, is an escalation of people’s anxiety about, ‘Will this be me? Is this something that is going to happen to me?’” Dr. Fries explained. “So with the awareness comes anxiety, and that’s important so that people are on track and taking care of their own bodies, but at the same time, it heightens that sense of being sort of in the target zone for that.”
Coming Together to Improve Birth Outcomes
As a Certified Nurse-Midwife and Women’s Health Nurse Practitioner at Community of Hope, a local nonprofit providing quality healthcare and resources to help end family homelessness, Bayyinah Muhammad, knows firsthand the needs and hardships that many District mothers face, including maternal mental health and housing insecurity.
“Some of the things that we run across with our pregnant folks who live in Ward 7 or 8, [and] across the district, but definitely exacerbated in those area [is] homelessness or housing insecurity,” said Muhammad. “We have a lot of perinatal mental health issues, and then your normal comorbidities, [such as] asthma exacerbations, food insecurity, those types of things.”
In an effort to relieve patients from the mental stressors that come with pregnancy, Community of Hope offers wraparound services to provide mothers and infants with medical needs, and an additional team of support to help balance personal issues that may arise beyond the pressures of pregnancy.
“Whether you’re a first-time parent or this is baby number three or four, there is some anxiety[or] fear of the unknown that exists there and then,” Muhammad explained. “Our patients are very transparent with us about what their concerns are. They are very vocal about appreciating that we give culturally congruent care when we’re telling them that things are not looking well or we have concerns, really delving into what that means and explaining it in a way that helps them to understand.”
Muhammad emphasized the positive impact of support beyond providing medical resources for their patients. The combined effort with MedStar Health has helped further eliminate barriers to accessing care, while improving birth outcomes for some of the city’s most vulnerable demographics.
“We are very grateful for this partnership and the ability that it gives us to keep the continuity of care for our patients,” she told The Informer. “I think a lot of times frustrations throughout someone’s prenatal and postpartum period can be exacerbated when trying to access all the pieces you need to get good care throughout your prepping. Our partnership with Safe Babies Safe Moms, allows us to give some cushion in those spaces where we may not be able to do that otherwise.”
