A team of providers and researchers at the University of Kentucky is working with community and government leaders across the state to address a pressing issue facing the Commonwealth: the maternal morbidity and mortality rate.
"Kentucky has one of the highest maternal mortality rates in the country. Lowering the proportion of women dying during or after childbirth in our state is not just a goal, but a necessity to safeguard the health and futures of both mothers and their children," said John O'Brien, M.D., director of the Division of Maternal Fetal Medicine at UK HealthCare, a professor in the Department of Obstetrics and Gynecology in the College of Medicine, and the appointed chair of the Kentucky Maternal Morbidity and Mortality Task Force within the state's Cabinet for Health and Family Services.
The project titled "The Kentucky Severe Maternal Morbidity and Mortality Task Force: State Maternal Health Innovation Program" is funded by a $5.2 million grant over five years from the Health Resources and Service Administration (HRSA) of the U.S. Department of Health and Human Services. It's part of HRSA's State Maternal Health Innovation (SMHI) Program.
The Kentucky Maternal Mortality Review Committee (KyMMRC) meets to determine the causes of maternal deaths in the state and to identify opportunities for preventing future deaths, through policy or practice. KyMMRC has documented substance use, injury and behavioral health conditions are all common contributing factors.
"In Kentucky, the study of severe maternal morbidities reveals a stark reality that these outcomes are deeply intertwined with healthcare disparities," said O'Brien. "Rural communities and people of color bear a disproportionate burden, highlighting the urgent need to address systemic inequalities in maternal healthcare access and quality."
Together with hospitals, providers, community partners and state governmental agency supporters, the Kentucky Maternal Morbidity and Mortality (KyMMM) Task Force will work to implement and promote best practices to make birth safer, improve maternal health outcomes and, ultimately, save lives.
The initiative draws on expertise from the Alliance for Innovation on Maternal Health (AIM) and the Kentucky Perinatal Quality Collaborative (KyPQC).
As part of the project, the KyMMM Task Force will work with state agencies to develop a scorecard to track severe maternal health issues using hospital records. The team will also create a data surveillance system to monitor maternal deaths and injuries, with a goal of making this information publicly available.
"Our team also wants to be able to provide critically important hands-on learning opportunities for smaller hospitals to be prepared to handle pregnancy-related complications," said O'Brien. "We also want to extend and assist coordination of telehealth services to birthing facilities throughout the state as we have shown reduction of severe morbidity in rural communities is possible through telehealth availability."
Another innovation within this award will also include bystander-informed, violence intervention and prevention training specifically for obstetric healthcare providers to address maternal health related to violence.
"In Kentucky, the majority of pregnancy-associated maternal deaths stem from partner or family violence, substance use and anxiety or depression," said Dana Quesinberry, J.D., Dr.P.H., the associate director of the Kentucky Injury and Prevention Research Center (KIPRC) and an assistant professor in the Department of Health Management and Policy in the UK College of Public Health (CPH). "Our goal is to leverage our collective expertise to share violence intervention and prevention training models statewide to make a targeted effort to reduce these types of death."
"The majority of violence-related maternal deaths ARE preventable. We are firm in our belief that this proactive approach will offer hope to mothers in our state and make a measurable difference in health outcomes," said Ann Coker, Ph.D., one of the team leaders on the project. She is the Verizon Wireless Endowed Chair in the Center for Research on Violence Against Women (CRVAW) and a professor of epidemiology in the Department of Obstetrics and Gynecology in the College of Medicine.
In addition to receiving funds for the SMHI Program, HRSA provided an additional $170,233 to be utilized for Medicaid redetermination and postpartum care coverage navigation for pregnant and postpartum individuals and their families.
"We have utilized these funds to establish a Perinatal Community Health Worker Program whose mission is to provide culturally and linguistically matched services to pregnant and postpartum persons in the state," said Cynthia Cockerham, community program and research director for UK HealthCare's Division of Maternal Fetal Medicine and the SMHI operations director.
"This task force is a comprehensive project involving multiple stakeholders and a crucial step for Kentucky moving forward," said O'Brien. "By uniting expertise, resources and advocacy, our goal is to ensure every mother receives care and support."
The study team covers an array of medical expertise including: Linda Berry, a registered nurse and perinatal substance use coordinator at UK HealthCare; College of Public Health Dean Heather Bush, Ph.D., professor of biostatistics and Kate Spade & Company Endowed Professor in CRVAW; and Barbara Parilla, M.D., the medical director of the UK HealthCare Perinatal Assistance and Treatment Home (PATHways) program and a professor in the Department of Obstetrics and Gynecology.
