Funded Projects

Care4Moms

Grantee: University of North Carolina at Chapel Hill
Principal Investigator: Alison Stuebe
Project Number: R40MC29455
Project Date: 04/01/2016

Age group(s)

• Women/Maternal
• Perinatal/Infancy (0-12 months)

Targeted/Underserved Population

• African American
• Asian/Pacific Islander
• Hispanic/Latino

Abstract

Mothers with hospitalized medically fragile infants are a high-risk population that may have both increased need for and barriers to accessing health care in the postpartum period. The importance of postpartum health for these mothers is amplified by increased demands of caring for a medically fragile infant and increased urgency for birth spacing and risk reduction for future pregnancies. There is limited research about the health care needs, utilization, and experience with health care services for these mothers. There is equally limited research about management of postpartum recovery in the context of mothering a fragile and/or hospitalized baby and the perspectives of OB/GYN and neonatal care providers and health system administrators as to their roles and responsibilities for the health care of these women. We will identify the challenges these mothers have in accessing care (Strategic Research Issue (SRI) #II) as well as propose recommended modifications to the current system of care (SRI #I). This will result in ensuring access to quality health care for these women (SRI #III), resulting in the healthy development of MCH populations (SRI #IV). We will conduct a mixed methods study of mothers of medically fragile infants, defined as infants admitted to the NICU for = 3 days. To quantify health needs and utilization, we will conduct a retrospective cohort study of about 7000 mothers of infants born at NC Women's Hospital over a two-year period, comparing mothers with medically fragile infants (N=1000) to those with mothers of infants in the well-baby nursery (N=6000). We will further analyze insurance claims for the one in three mothers who are covered by NC Blue Cross/Blue Shield. We will complement this cohort study with interviews with new mothers with medically fragile infants to better understand their self-described health needs, efforts to access care, experience with health services and postpartum recovery. Informed by data, we will conduct key informant interviews with members of the UNC Health Care system to increase our knowledge of the services offered to mothers, perspectives on services that should be available, opinions on the provision of dyadic maternal infant care during infant hospitalization and administrative considerations in augmenting services. Our research team, with guidance from the NCCC Family Advisory Board, will synthesize this learning into a series of recommendations for health care systems. This research will enrich the field by identifying the needs of a high-risk population of mothers and proposing recommendations for change. Given the growing national interest in postpartum care, this research will support program implementation based on well-defined maternal health needs in the context of feasible system changes.