Community-based initiatives are coming to the forefront of maternal and infant health discussions in Palm Beach County (PCB). The Florida Institute for Health Innovation recently hosted a community forum featuring maternal health experts and members of the fetal infant mortality review (FIMR) program. The discussion showed the evident need for an equity and community-based lens in developing maternal health policies.
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Alina Alonso, M.D., PBC Health Department director, stated concerns over the unknown effects on children exposed to COVID in utero. A study the health department conducted from June through August 2020 found one in four participants tested positive for COVID antibodies, but were asymptomatic.
“There was a loss of zero positivity, which is very significant because that raises the concern that they had limited passive protection,” Alonso said. “In other words, people who got the natural infection lost their antibody protection long-term much faster than if you had the vaccine. With the hesitancy that we have had, especially in underserved communities, this is a big deal.
We also have shown that this zero prevalence data will also allow for better newborn follow up for the still undetermined consequences that these children may have. We don’t know if these kids that have been exposed in utero to the COVID will have any kind of consequences later on.”
Aside from COVID concerns, health leaders advocated for creating better support systems for pregnant women and mothers. Colette Brown-Graham, M.D., FACOG related that without a family member or friend advocating for these women at their doctor’s visits, they may not always receive the health services they need. Brown-Graham also emphasized Black women are disproportionately affected by lack of access to care.
“I’ve had patients come to me as an African American provider and say, ‘I’m scared to be pregnant [because] I’ve read in so many papers that my mortality rate is three to four times that of a Caucasian woman.’ I think it’s actually abysmal that in the United States, we accept that.”
Kristen Thomas, a licensed mental health counselor, underscored the importance of mental health screening for pregnant and postpartum women. According to Thomas, the pregnancy and postpartum period are the most likely times a mother could be diagnosed with a mental illness.
She added that women with mental health concerns are less compliant with prenatal care. In the postpartum period, she said mental health challenges can affect breastfeeding success and the infant’s cognitive, physical, and emotional development.
“The good thing is that these [mental health concerns] are treatable,” Thomas said, “But if they’re not treated, it can really cause some complications.”
The most successful way to address maternal health concerns in general, according to child development specialist and blogger Martine Jolicoeur, is through consistent follow up. Jolicoeur, who grew up in Haiti and now advocates for Caribbean women in the maternal and infant health space, reflected on her experiences interviewing families affected by infant deaths.
“Whenever I interview a mom who has had [community support], it seems to me that though they are going through a difficult time, there is still hope,” she said. “Whereas for the mom who does not have that kind of support, she has a harder time accepting what is going on with her. She is more confused. She is angry and deals with a lot more depression.”
The panelists agreed that community support should extend beyond pregnant women to their partners as well. The Florida Institute for Health Innovation recently surveyed 150 young men ages 18-30 across the Southeast U.S. More than half reported they were distant or not engaged with their family due to their own physical or emotional distress or disability. Thomas said paternal engagement is already a priority in the mental health space.
“[The Children’s Services Council] is also funding a program that really focuses on father engagement, providing a space for fathers to talk about and share their experience as a father, no matter what kind of level that or how old that child is.”
Panelists also reflected on successful community programs and partnerships already in place in PBC, such as the Boys & Girls Clubs of Palm Beach County and Healthy Mothers Healthy Babies.
Although Alonso acknowledged that the maternal health sphere continues to face hesitancy among Florida’s underserved communities, she emphasized the success of a coordinated, upstream approach.
“We all work together. We all worked specifically to concentrate on underserved communities. We reached out first and foremost making sure that we were testing and making everything available to our underserved community.”