Parkland providers highlight importance of access to maternal care
Nationally recognized program expands geographic focus for postpartum patients
The first year after delivering a baby is a crucial period in a mother’s life, not only for her child’s development and well-being, but for her own health as well. According to the 2022 Texas Maternal Mortality Review 90% of maternal deaths in 2019 were preventable, further emphasizing the need for access to quality healthcare and necessary support programs during this 12-month period.
Parkland Health’s extending Maternal Care After Pregnancy (eMCAP) program, which launched in 2020, ensures women living in underserved areas of Dallas County receive postpartum follow-up care for 12 months. Additionally in 2023 the Texas Legislature passed House Bill 12, extending Medicaid coverage for mothers in Texas from 60 days to one full year after childbirth.
January 23 is designated as Maternal Health Awareness Day by The American College of Obstetricians and Gynecologists (ACOG), a leading organization representing specialists in obstetric care, aimed at increasing awareness of maternal health issues nationwide. This year’s specific focus is to highlight a growing issue many women across the nation face in accessing healthcare both during and after pregnancy.
The eMCAP program utilizes community health workers, nurse home visits, telemedicine visits, and an in-person mobile unit with medical providers, social workers, and pharmacy services deployed within the community to extend and enhance postpartum care for diabetes, hypertension, and behavioral health services.
The program is now targeting 19 ZIP Codes within Dallas County identified in the 2019 and 2022 Community Health Needs Assessments (CHNAs) as having the highest social needs indicated by poverty, income, education, unemployment, occupation, and language data, as well as a high chronic disease vulnerability index (CDVI). Since launching, the program has enrolled more than 3,400 patients living in southern Dallas County and beginning in 2024 will being to enroll patients living in eastern Dallas County. Additionally, the expansion will place an emphasis on virtual, telehealth visits. By reducing the burden of transportation to and from an appointment, attendance rates are higher helping patients maintain continuity of care.
“The eMCAP program has established a postpartum care model to replace the typically fragmented traditional care patients receive after birth, and the evidence generated from this effort can be readily adopted into other clinical practice settings targeting underserved patients with limited resources,” said David B. Nelson, MD, Medical Director of Maternal-Fetal Medicine at Parkland Health and Associate Professor in Maternal-Fetal Medicine and Dedman Family Scholar in Clinical Care at UT Southwestern Medical Center. “Compared to patients with diabetes mellitus and hypertension not enrolled in the eMCAP program, patients with diabetes mellitus had improved blood sugar measures measurements and better follow up for high blood pressure.”
In addition to ensuring health needs are met, mothers participating in the program are also connected with Dallas Healthy Start to equip them with transportation, food and housing assistance if needed, as well as parenting education and well-baby care resources.
“We know that one postpartum visit is not enough to address health concerns for these patients,” said Courtney Johnson, DNP, APRN, WHNP-BC, a nurse practitioner at Parkland. “Some of these adverse health events we are discovering at three or six-months postpartum, and if left unaddressed the outcome could be catastrophic for these women.”
“The arrival of a new baby is a busy time in a woman’s life, and often she will not prioritize her own health needs when she’s juggling the demands of parenthood,” said Christian Hobbs, APRN FNP-C, a nurse practitioner at Parkland. “Data has shown that more than half of maternal deaths in Texas occur in the first year postpartum, this program bridges the gap between obstetric care to primary care for this high-risk population.”
The eMCAP program has been recognized locally with the 2023 Leaders in Clinical Excellence Award for UT Southwestern and also nationally. The eMCAP program received the Department of Health and Human Services Racial Equity in Postpartum Care Challenge Phase 1 Award and was also recognized by The Joint Commission and National Quality Forum with the 2022 John M. Eisenberg Award.
For more information about Parkland, visit www.parklandhealth.org.
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