Maternal Health Research Collaborative for Minority-Serving Institutions Research Centers

Maternal mortality is a silent public health crisis in the United States with Non-Hispanic Black women (hereinafter Black) and birthing persons experiencing significant health inequities throughout their childbearing experience. The CDC has determined that four in five pregnancy-related deaths in the U.S. are preventable. Reducing these shameful rates requires a reduction in health disparities and access to high quality care. While there is a plethora of health inequities experienced at the national state and local levels there is simultaneously reliable research showing that community-based doula and midwifery care is a high-value care model that improves childbirth outcomes increases care quality and holds the potential to achieve cost savings in all perinatal care. Few studies of community-based care among Black women and birthing persons exist despite the public health crisis of disparities in Black maternal health and several studies pointing to the fact that Black women have unmet maternal health needs. Community based care recognizes that doulas and midwives can shift the experience of birthing persons in ways that qualitatively and quantitatively improve health outcomes by interrupting the structures and too common procedures that underserve and harm Black women. The project goal is to conduct applied community engaged research in partnership with community-based organizations to assess the impact of a mobile and household-centered care model for improving Black maternal health outcomes and experiences in Miami FL. The objectives are: 1)to examine the connections and pathways for mothers and families to connect with community-based doula/ midwifery services and education by developing community-based solutions that increase equitable access 2)to provide Black expectant and postpartum mothers and their families with access to equitable and respectful care 3)to provide non-clinical and social determinants of health-related educational services through the workforce development of community-based providers 4)to utilize project findings to advance maternal health disparity research at FIU and other Minority-Serving Institutions 5)to ensure the translation implementation and dissemination of project data that is reproducible and scalable in similar communities This research uses mixed methodologies including surveys focus groups with community members and practicing birth workers client reports produced by participating doulas and midwives and comparative analysis of maternal indicators among our study population and the county and state data available from the Florida Department of Health. Review of health outcome indicators among study participants alongside patient-reported data using validated scientific tools allows for comprehensive analysis of the qualitative and quantitative impact of mobile community-based care. Outcomes will be disseminated to community stakeholders through social media posts blog posts and community newsletters. Peer-review publications white papers briefs and academic conference presentations will all contribute to the research community and evidence best practices. Quantitative and qualitative evaluative methods will be conducted to describe the patient experience and patient-reported outcomes with doulas and midwives in the community care model to show the impact of project activities on the quality of care for maternal services and education during the perinatal period. Systems and ethnographic mapping with an equity lens ensures that evaluation captures voices perspectives and values of vulnerable communities. Policy Systems and Environmental (PSE) Change Reproductive Justice and Rapid Cycle Quality Improvement help us better understand how doula and midwife networks arise and how current and prospective doulas and midwives access patients.