Graphic Recording for the Roundtable on Elevating Patient-Centered Strategies of Care

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Summer of 2016

• Lowest pre-term birth rates in the West of St. Louis
• Best pre-term birth rates in the North of St. Louis
• Race-based inequity
• How do we address this inequity?

Elevate:

• Hearing the voice of the patient:
  • Group-based care
  • Trauma care
  • Mental health

Pilot study:

• Group care works best for people without support
• No preterm births
• 80% postpartum visits
• More study needed for postpartum

Paradigm shift: Must consider system, not just the individual.

Impact of Maternal Fatality on Families

• There is no data to communicate impact of loss
• Hospital would not listen
• Healthy Mom

Patient Perspective with Patricia Bandettini, M.D.:

• Induction and C-section
• Went home happy
• Pale and wobbly
• Everyone afraid
• Emergency bleeding
• Able to be advocate
• Uncertainty

Shari Huskie:

• Visiting parents post birth
• Rushed to hospital
• Woke up week later
• Baby contracted RSV
• Depression one year later
• Quote from Ms. Huskie: “We are sacred but we are not treated that way.”

Maternal Morbidity and Mortality in the Indigenous Population

• Three times higher maternal mortality

• 5.2 million Indigenous people in the U.S.
• 40% in non-urban areas

Stress on Indigenous people compounded:

• Food desert
• Domestic abuse
• Remote hospital and continued care
• Mental health
• Exposure to uranium
• Lack of water access

Integrated women’s care

Gaps:

• Food deserts
• Learning barriers
• Safety bundles

Support

• Advocate
• Legislate
  • Momnibus
  • 13 bills
• Educate
• Environmental factors

One thing to improve maternal care:

• Health insurance
• Postpartum team
• Support for moms

Equitable birth care:

• Break down barriers between patient and caregiver
• Empathy and compassion
• Support system outside health system
• Equitable access to resources
• Held to highest standard