Amy Hailey knows not every new mother has a positive experience with the maternal health care system.
The vice president of professional services at Texas Health Harris Methodist Hospital Fort Worth recently met with a mother, her husband and other family members who shared their testament. They were pleased with the care, Hailey said, but not with the overall experience.
Although she was saddened to hear about their experience, she also saw it as a reflection of the need for an upcoming initiative. TeamBirth, a program designed to increase communication and improve the patient’s birthing experience, is set to launch in January 2025.
“Everything that they were telling me, I was checking the box that TeamBirth was going to help with this,” Hailey said. “I’m so excited. I think it’s going to be amazing for Tarrant County.”
Hailey’s reflections came during the Fort Worth Report’s Candid Conversation event exploring solutions for improving maternal health in Tarrant County. The Oct. 24 panel, moderated by the Report’s health reporter, David Moreno, was held at Texas Wesleyan University.
Hailey was joined by Dr. William Brian Byrd, Tarrant County Public Health director; Dr. Stephanie Carson-Henderson, chair of Women & Infants at JPS Health Network; and Dr. Shanna Combs, gynecologist with Cook Children’s Health Care System to discuss factors contributing to health disparities for mothers and what local leaders can do to address the issue.
Candid Conversation
Watch the recording of the panel discussion in full below.
The health of Tarrant County residents, and mothers in particular, “really shifted” in 2020, said Byrd.
Data revealed that Tarrant County’s maternal mortality rate is significantly higher than the national average. Black women in the county have the second-highest maternal mortality rate of any county across the state.
One of Tarrant County’s biggest challenges is access to care, said Carson-Henderson.
Underlying conditions such as hypertension and diabetes are seen at higher rates in Black and Latino mothers, she said, which can go underdiagnosed or undertreated and add additional challenges to the pregnancy.
“When they’re within our walls, we provide phenomenal care, and outcomes are better, but getting them from the home into care is one of the biggest challenges that we have faced,” Carson-Henderson said.
One of the other “bottlenecks” in the issue is access to health care providers, Byrd said. In April, state health officials proposed a $116 billion Medicaid contract proposal, excluding three hospital plans many low-income Tarrant-area residents rely on. Cook Children’s Health Plan, which covers more than 125,000 families in the Tarrant County area, was one of them. The hospital system’s legal fight against the move continues, with a judge blocking Texas Health and Human Services from finalizing its plans in October.
Other factors in the area’s high maternal mortality rates include challenges to making resources widely known and accessible, Byrd added. Transportation in areas like Arlington, the largest U.S. city without a mass public transit system, including bus or rail, can make it challenging for mothers to get to doctors appointments.
“There’s work to do on all kinds of levels, and I think transit is a place where we haven’t figured that out,” Byrd said.
Postpartum visits are one of the “most underutilized visits in health care,” Combs said, because mothers are often focused on the welfare of their newborn rather than their personal health. However, they can play a crucial role in checking on the mother’s physical and mental health.
Mental health conditions are a leading cause of prepregnancy-related deaths, according to Tarrant County Maternal & Infant Health Coalition’s presentation to Fort Worth City Council. One in seven women experience depression within six months after pregnancy.
When mothers take their kids to pediatrician visits at Cook Children’s, doctors will also screen the parent for postpartum depression as a means to target the lack of attended postpartum visits, Combs said. That way, pediatricians can offer referrals to outside resources if needed, she said.
“The mother is kind of the center of the family. So when you lose that mom, you lose that center,” Combs said. “So that has such a broad impact on the entire family.”
All the panelists represented a portion of the health organizations that make up the Tarrant County Maternal & Infant Health Coalition, a group convened in September 2022 by Fort Worth Mayor Mattie Parker. The coalition of 16 local health, education and community organizations is tasked with creating a cohesive approach to improving maternal health outcomes.
Having physicians, medical staff and even doulas of diverse backgrounds can play a role in helping a mother feel supported, Carson-Henderson said.
United Way of Tarrant County’s Maternal Health program includes community doulas, who are there to offer mothers support before, during and after the pregnancy. Families living in or who will deliver at a hospital or birth center in the 76104 ZIP code are prioritized for in-person support, according to the website.
“Having a community doula that comes from your community, that comes from your culture, that may speak the same language, if it’s not primarily English, can make a huge support difference for the mom,” Carson-Henderson said.
Looking ahead, panelists mentioned a variety of potential solutions toward improving maternal health in the county.
Some options included getting Tarrant County Public Health a seat at the county’s economic development table, Byrd said, as a means to bring more insurance providers into the community.
Continuing partnerships between Texas Christian University’s Burnett School of Medicine and UT Southwestern Medical Center to help address underlying health conditions of mothers is also part of the solution, Hailey said.
On the statewide level, potential solutions involve advocating for increased Medicaid payments in the legislature, Combs added. On a local level, she encouraged attendees to check in with the mothers in their lives — especially in the months after they give birth.
“Everybody knows somebody who’s pregnant,” Combs said. “Don’t be afraid to ask, ‘How are you doing?’ That can go a long way.”
Marissa Greene is a Report for America corps member, covering faith for the Fort Worth Report. Contact her at marissa.greene@fortworthreport.org or @marissaygreene. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.
Disclosure: JPS Health Network and Cook Children’s were sponsors of the Candid Conversation event.The North Texas Community Foundation has been a financial supporter of the Fort Worth Report. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.
This article first appeared on Fort Worth Report and is republished here under a Creative Commons license.