The United States Breastfeeding Committee officially designates August as National Breastfeeding Month (NBM) to identify and implement policy and systems changes needed to ensure that every family who chooses to breastfeed has the support and resources they need. In addition, Black Breastfeeding Week, to be held Aug. 25 through 31 in 2020, recognizes that women of color have historically experienced more adverse events related to maternal health and emphasizes safe, reliable and equitable care and increased awareness for disparities that are still prevalent.
The American Academy of Pediatrics recommends that infants be exclusively breastfed for about the first six months of life, with continued breastfeeding alongside introduction of complementary foods for at least one year. Despite this recommendation, a recent study revealed that less than 44.1% of infants in Michigan were exclusively breastfed through three months, and about 23.9% were exclusively breastfed through six months. These rates suggest that mothers may not be getting the support they need from healthcare providers, family members and employers to meet their breastfeeding goals.
Improving the health of mothers and infants is a priority for the MHA Keystone Center and the state of Michigan, as Gov. Gretchen Whitmer shared in her State of the State address earlier this year.
To strengthen ongoing efforts to reduce harm and improve quality for mothers and infants, the MHA Keystone Center partnered with the Michigan Department of Health and Human Services (MDHHS) to provide educational webinars and collaborative safety sessions for birthing hospitals across the state of Michigan.
The next webinar is scheduled from noon to 1 p.m. July 17 and is geared toward birthing hospitals in Northern Michigan and the Upper Peninsula. June Murphy, DO, a maternal-fetal medicine specialist at Munson Medical Center in Traverse City, will provide insight on maternal hypertension.
During the safety sessions, participants will discuss implementing the Michigan Alliance for Innovation on Maternal Health (MI AIM) safety bundles, which equip hospitals with influential protocols, necessary equipment, employee education and drills to prevent and adequately treat severe maternal events. This peer-learning format allows participants to discuss barriers and successes of identifying and treating obstetric hemorrhage and severe hypertension.
As Governor Whitmer shared in her State of the State address, improving the health of mothers and babies is a priority for the state of Michigan. Specifically, the governor’s plan will extend postpartum Medicaid benefits for a full year for mothers, increase access to treatment for substance abuse and mental health services for mothers and expand access to home visiting programs. The full care continuum reaches outside the four walls of a hospital, and these initiatives can make a significant impact in ensuring all mothers and babies remain healthy. The MHA Keystone Center supports the governor’s stance and remains dedicated to supporting the efforts of providers by partnering with organizations that are at the forefront of improving maternal health in Michigan.
Through a new partnership with the Michigan Department of Health & Human Services (MDHHS), the MHA Keystone Center will offer several maternal health regional safety sessions in 2020. The MHA Keystone Center and the Regional Perinatal Quality Collaborative (RPQC) leaders are planning each session to ensure they meet the needs of providers in the local area. The nine RPQCs that represent Michigan’s 10 prosperity regions include diverse, cross-sector stakeholders that focus on improving birth outcomes and authentically engaging families and community members in their region. More information on the safety sessions will be available in the upcoming months.
Since 2016, the MHA Keystone Center has partnered with the Michigan Alliance for Innovation on Maternal Health (MI AIM) to bring together resources to help reduce morbidity and mortality for moms and babies across the state. Between 2014 and 2017, complications from hemorrhage have declined by 19.6% and maternal hypertension complications have decreased by 19% in Michigan birthing hospitals. In alignment with these efforts, the MHA Keystone Center recently released a new, interactive dashboard for Michigan birthing hospitals to track their performance on the MI AIM safety bundles. Safety bundles equip hospitals with actionable protocols, necessary equipment, staff education and staff drills to prevent and adequately treat severe maternal events. Hospitals may use the dashboard to compare their progress on the safety bundles with other organizations in their region and across the state.
MI AIM, in conjunction with MDHHS and the Maternal Infant Health Strategy Group, is hosting the third annual Michigan Maternal Infant Health Summit March 30 and 31 in Lansing. Professionals across the healthcare community will gather together to support the collective goal of ensuring health equity to all Michigan mothers and babies. The summit will feature nationally-recognized speakers and focus on aligning priorities between public and private organizations while offering education on the latest developments in the field.
At the summit, the following Michigan birthing hospitals will be recognized for their achievements in 2019 to implement the MI AIM safety bundles and improve health outcomes for mothers in their care. The 50 recipients – a number that has grown each time the designations have been awarded – engage in collaborative quality improvement activities through MI AIM and the Obstetrics Initiative and submit data indicating the adoption of the AIM safety bundles practices. The organizations also demonstrate improvement and share lessons learned with other participating hospitals in an “All Teach, All Learn” approach. The MHA Keystone Center is proud to be a sponsor of this event and join more than 550 individuals that are registered to attend.
Henry Ford Allegiance Health
Henry Ford West Bloomfield Hospital
Henry Ford Wyandotte Hospital
Hurley Medical Center
McLaren Central Michigan
Munson Healthcare Cadillac Hospital
St. Joseph Mercy Ann Arbor
Spectrum Health – Grand Rapids
Spectrum Health Lakeland Hospital Niles
Spectrum Health Lakeland Saint Joseph
Spectrum Health Pennock
Spectrum Health Zeeland Community Hospital
Bronson Battle Creek Hospital
Bronson Methodist Hospital
Henry Ford Hospital
Henry Ford Macomb Hospital
McLaren Bay Region
McLaren Greater Lansing
McLaren Lapeer Region
McLaren Northern Michigan
MidMichigan Medical Center – Midland
Munson Medical Center
North Ottawa Community Hospital
Spectrum Health Big Rapids Hospital
Spectrum Health United Hospital
Metro Health-University of Michigan Health
University of Michigan Hospitals & Health Centers
Dickinson County Healthcare System
Munson Healthcare Charlevoix Hospital
ProMedica Coldwater Regional Hospital
Spectrum Health Ludington Hospital
Ascension St. John Hospital
Beaumont Hospital, Dearborn
Beaumont Hospital, Farmington Hills
Beaumont Hospital, Grosse Pointe
Beaumont Hospital, Royal Oak
Beaumont Hospital, Trenton
Beaumont Hospital, Troy
Beaumont Hospital, Wayne
McLaren Port Huron
McLaren Thumb Region
MidMichigan Medical Center – Alpena
Munson Healthcare Grayling Hospital
Munson Healthcare Otsego Memorial Hospital
ProMedica Monroe Regional Hospital
Three Rivers Health
The MHA Keystone Center will continue to strive to improve maternal and infant health in a statewide approach by training our current and future physicians, nurses and healthcare professionals to establish acceptable treatment and practices for our hospital community.
Brittany Bogan, FACHE, CPPS, is the senior vice president of safety and quality at the MHA and the executive director of the MHA Keystone Center.
“I realized when you look at your mother, you are looking at the purest love you will ever know.” ― Mitch Albom
Last week Gov. Gretchen Whitmer presented her State of the State address, establishing her priorities for the upcoming year. A considerable portion included a focus on healthcare, particularly maternal health. In Michigan, 52.5% of maternal deaths caused by cardiomyopathy, infection/sepsis and hemorrhage are determined to be preventable. Whenever we see statistics in healthcare, we can always have a discussion about methodology, but frankly, any preventable death is unacceptable and deserves our full attention.
In pursuit of our association’s mission to advance the health of individuals and communities, we commend Gov. Whitmer for taking a leadership role on this issue and bringing needed attention to a topic that affects us all. Michigan’s birthing hospitals play a key role in welcoming new life to Michigan’s families and must do everything in their power to protect the health of a mother and baby during their most vulnerable time. It is our sincere belief that the governor’s plan will provide much needed support to the efforts that the MHA Keystone Center and our member hospitals have already undertaken to ensure health equity by addressing disparities and social determinants of health.
Specifically, the governor’s plan will extend postpartum Medicaid benefits for a full year for mothers, increase access to treatment for substance abuse and mental health services for mothers and expand access to home visiting programs. The full care continuum reaches outside the four walls of a hospital, and these initiatives can make a large impact in ensuring all mothers and babies remain healthy.
Training our future physicians, nurses and healthcare professionals in implicit bias will also go a long way in establishing acceptable treatment and practices for our hospital community. I’m excited to see Randolph Rasch, dean of the Michigan State University College of Nursing and Dr. Audrey Gregory, CEO of the Detroit Medical Center, have been identified by Gov. Whitmer to lead this important effort.
The MHA Keystone Center has been actively working to address this issue since 2009, when the MHA Keystone: Obstetrics collaborative was established. Several years ago, the work of the collaborative merged into the Michigan Alliance for Innovation in Maternal Health (MI AIM), with recent data showing encouraging results from our efforts. Between 2014 and 2017 in Michigan:
Severe maternal morbidity decreased by 10.5%.
Complications from hemorrhage decreased by 19.6%
Maternal hypertension complications decreased by 19%
The MHA Keystone Center is also involved in the Obstetrics Initiative (OBI), an interdisciplinary quality initiative funded by Blue Cross Blue Shield of Michigan that engages maternity care providers and hospitals in a collaborative effort to safely reduce the use of primary cesarean deliveries for low-risk pregnancies.
In addition, I’m proud to have 48 of Michigan’s birthing hospitals engaged in providing process and outcome data to the MHA Keystone Center. However, more work can be done. We’d love to see full participation and encourage all of our members offering obstetrical services to submit this data. For those birthing hospitals that are participating, the MHA Keystone Center is debuting a new MI AIM dashboard later this month.
I also encourage our members to join the MHA Keystone Center at this year’s Maternal Infant Health Summit, March 30 and 31 in Lansing. Hosted by the Michigan Department of Health and Human Services, MI AIM and the Maternal Infant Health Strategy Group, professionals from across the healthcare community will come together to support our shared goal of ensuring health equity to all Michigan mothers and babies.
Lastly, the pressing need to improve maternal health is not limited to Michigan, and it has drawn the attention of the U.S. House Education and Labor Committee at the federal level. Two observations from members of our own congressional delegation at a recent hearing of that committee:
“The United States has one of the highest maternal mortality rates in the developed countries, and deaths among women of color is fueling that growth.” – U.S. Rep. Brenda Lawrence (D-Southfield), Black Maternal Mortality Caucus co-chairwoman.
“We have an emergency going on in America right now, and I cannot think of a better instance of the sanctity and preciousness of life than this, than the life of the mother.” – U.S. Rep. Haley Stevens (D-Rochester Hills).
Over the past 100 years, the MHA has been involved in many efforts to improve care and quality. As we embark on a new calendar year, I can think of few causes worthier of our attention and efforts. I hope you will join Gov. Whitmer, the MHA Keystone Center, our member hospitals, and all of our maternal health partners in this critical endeavor.