Healthy Mothers Healthy Babies director on the future of Hawaii maternal health
Maternal and child health in Hawaii has declined over the past few years. A study by the Annie E. Casey Foundation found that low birth-weight babies and child and teen deaths per 100,000 have increased in Hawaii since 2010. Rising health disparities further inhibit strategies to reduce poor maternal health outcomes.
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Simply providing health insurance for mothers will not always ensure a healthy outcome, says Sunny Chen, executive director for Healthy Mothers Healthy Babies (HMHB), a nonprofit maternal care provider. Instead, Chen says the state should better examine the social determinants of health.
“Having insurance is not a problem, we have one of the highest rates [in the country]. But, we have really bad health outcomes. So, it tells me we have health equity, racism, and so many other things at play that have an effect on our women’s health and our infants’ health. [We’re] trying to tackle it at a macro level, top-down, bottom-up level, along with policy–tackling it at all angles we can.”
One way to ensure better maternal health outcomes is by collecting a set of data that reflects Hawaii’s diverse population and can lead to evidence-based approaches to care. Chen worked with state legislators to develop SB 900 last legislative session. The bill aimed to collect maternal morbidity data that was disaggregated by county, race, and ethnicity, as well as develop implicit bias training in perinatal facilities. Although the bill ultimately did not pass, she remains hopeful that the state will start addressing those goals.
“We do, as a state, capture [maternal] mortality, but for every death we have a hundred near death experiences. So we really wanted to start collecting that data and push the state towards doing that…It’s also important that we’re disaggregating our data because Hawaii is particularly unique, in that you can’t just lump all Asians or Pacific Islanders into groups.”
Another way to improve maternal health, according to Chen, involves reaching out and working with vulnerable communities to increase access to care. HMHB is currently partnering with the Commission on the Status of Women to provide childbirth education and other services for more vulnerable communities, such as younger parents and incarcerated women.
“It makes such a huge difference in the long term mental health of our moms, and it starts with identifying and finding clients where they’re at.”
Looking forward, Chen hopes the state will expand other forms of care, such as providing more licensure for midwives and health plan coverage for doula services. There are currently only 17 certified professional midwives licensed in Hawaii, serving the islands’ 1.36 million residents.
Kari Wheeling, HMHB’s clinical services director, says the key to moving forward on maternal health is cross-collaboration among different sectors.
“Hawaii is hopefully working more towards collaborative efforts [rather] than competitive, or trying to compete with each other. There’s a need for everyone who’s in the maternal and child health field and if we all truly work collaboratively, we can serve the women that we want to serve and need to be served. And that also stems from coming out of COVID. Everyone’s trying to survive, but if we all just took a step back and really realized what our true focus really is, and collaborated with those agencies who have their niche, who have their lane, I think people would really begin to realize the difference we can truly make with true collaboration.”
HMHB currently provides a wide range of services that encompass maternal health, including mental health counseling, food distribution, and Mana Mama, a program in partnership with non-profit health plan AlohaCare that consists of mobile vans delivering clinical services around a large part of Oahu, with plans to expand to other islands in the future.