Bringing Attention to the Maternal Mortality Crisis

American_Delivery

Last weekend, MetroHealth had the honor of celebrating the premiere of “American Delivery” at the Cleveland International Film Festival. This powerful film examines the nation's maternal mortality crisis and the nurses working to solve it.

The documentary features MetroHealth President and CEO Airica Steed, Ed.D., RN, MBA, FACHE – a fourth-generation nurse – and the health system's innovative Nurse-Family Partnership program, which pairs nurses with pregnant patients throughout their pregnancies and until their children's second birthday.  The filmmakers also followed MetroHealth's Dionna Coleman, a registered nurse with the Nurse-Family Partnership, on her bi-weekly home visits with her patient, Jess, a first-time mom-to-be.

The film also includes stories from across the United States, from California to Kentucky to New York, and was initially inspired by the nurse leaders from the Marian K. Shaughnessy Nurse Leadership Academy at the Frances Payne Bolton School of Nursing at Case Western Reserve University.

More than 600 people attended the premiere on Saturday, April 6. Following Sunday’s encore screening, Dr. Steed joined the film’s Director Carolyn Jones, Producer Lisa Frank and other community leaders for a panel discussion.

The panel was moderated by Taylor Wizner, healthcare reporter for ideastream, and included Joyce Fitzpatrick, PhD, MBA, RN, FAAN, of the Frances Payne Bolton School of Nursing at Case Western Reserve University; and Angela Newman-White, Executive Director, First Year Cleveland.

“We know this is a crisis. Our job is to make sure everyone knows,” Dr. Steed said. “This must be a front-burner, top priority in America, but it just hasn’t been. This film will help, but it is also up to all of us to become advocates for moms and babies.”

National health statistics show that Black women are three times more likely than others to die from pregnancy-related causes. In fact, Cuyahoga County has one of the highest rates of maternal and infant mortality in the country for Black women and babies, according to the Ohio Department of Health, and those grim figures continue to rise.

Since Dr. Steed joined MetroHealth in December 2022, she has been sounding the alarm about health disparities. She aims to make MetroHealth a national model of how to end health inequity by making high-quality healthcare accessible to all and eliminating the glaring gap in life expectancies. That work includes a laser focus on eradicating the maternal health crisis.

“I easily could have been among the horrifying statistics cited in the documentary,” Dr. Steed said. “During two of my pregnancies, I nearly lost my life to pre-eclampsia, a dangerous condition that affects Black women at a higher rate than others. I survived both times, but far too many women do not.”

Building a National Model

By the time many at-risk individuals get pregnant and see a MetroHealth provider, they have already been impacted by factors beyond medical care that can affect their health and well-being. These factors – often called the social drivers of health – might include a lack of economic opportunity, food insecurity, housing instability and so much more.

MetroHealth – through its Institute for H.O.P.E.²™ – is working with organizations throughout the community to connect patients with resources that can help them overcome these obstacles. Other efforts underway include linking pregnant patients with community health workers and expanding access to prenatal and post-partum care as well as pediatric care for their babies once they are born.

“Listening – intently and intentionally – is essential,” Dr. Steed said. “A people-first culture of care means that patients are true partners. That they are treated with respect and as equals. That they feel heard and seen. That they are never talked down to, dismissed or ignored.”

She added, “I have been there. I know how it feels to be unheard, unseen, ignored, dismissed, talked over and walked over.”

Also essential is improving the representation of providers, Dr. Steed said. Research shows that patients do better – they have better outcomes, they take their medicine more regularly, they show up to appointments more often – when their providers who look them, talk like them and share the same life experiences.

“Better representation equals better health,” Dr. Steed said. “It’s that simple.”

And, of course, there’s MetroHealth’s Nurse-Family Partnership, which was featured in the film.

Through regular home nurse visits, first-time moms receive information on preventive care (prenatal care, smoking cessation, future pregnancy planning, etc.) and are connected with local health and educational resources. They also get information on improving their diets and reducing their use of cigarettes, alcohol and other substances.

These specially trained nurses check in regularly on first-time moms and mothers-to-be who live in the Cleveland neighborhoods at highest risk for preterm birth and infant mortality.

"We not only do our health assessments, but we also help them to set and meet personal goals," said Dionna Coleman, the MetroHealth nurse featured in “American Delivery. “A lot of our moms are still in school, and we want to help them finish their education. We connect them to community resources that can help with what they need to succeed. We meet the moms where they are, and earn their trust, so they feel comfortable letting us into their lives.”