When health care professionals can work with mothers-to-be throughout their pregnancy, it helps their little bundles of joy enter the world big enough for a healthy start.
Low-birth-weight infants weigh 5 pounds, 8 ounces or less at birth. They are more likely to have health problems not only at birth but also later in life. At birth, for instance, babies with a low birth weight may have breathing problems, issues with their heart or intestines, or bleeding in the brain. As they grow up, they’re more likely to develop chronic conditions like:
The good news is that research has identified several factors that can lead to a low birth weight (see sidebar), and they can be managed to reduce the risk. Getting proper prenatal care is one of the most effective ways pregnant women can prevent low birth weight.
In a recent white paper, the Highmark Foundation detailed the successes of two western Pennsylvania nonprofit organizations focused on reducing the number of low-birth-weight babies. Every Child Inc. and Butler Memorial Hospital shared a $500,000 Highmark Foundation grant that supported their maternal and child health programs.
“With this grant, we wanted to focus on overall wellness and healthiness during pregnancy,” says Palma Bennie, director at Every Child Inc. “Our staff go into the homes and work with women on healthy eating, what is appropriate weight gain, what is not, to make sure that’s clear and understood. They also talk about the importance of staying active up until the ninth month of pregnancy when they’re able to, as well as the risks of smoking, drug use, drinking alcohol and any other high-risk areas that could affect low birth weight.”
Ann Snodgrass, a nursing director at Butler Memorial Hospital, says that their Maternal Services Program launched in 1990 to meet a need in the community.
“At that time, many patients didn’t get prenatal care,” she says. “They would show up in the birthing suite here at the hospital either with very little care or, if they did receive any care, it was from a facility in the Pittsburgh area, so we’d never know how much care they’d received — if any at all — until we got their records, and that can take some time. Those patients would be at a higher risk of problems because we didn’t know any of their history.”
With the support of the Highmark Foundation grant in fiscal year 2014, 274 women received services through Butler Memorial’s Maternal Services Program, adding up to a total of 2,310 patient visits.
“We’ve been very successful in hitting a lot of our goals,” says Bennie, and she has the data to back it up.
Through the Every Child Inc. program, 100 percent of the enrolled mothers received regular prenatal care and had full-term births. More than 95 percent of the babies weighed more than 5 pounds, 8 ounces — that is, they were not considered “low birth weight.”
“Nearly 82 percent of the mothers in our program successfully initiated breastfeeding compared to Pennsylvania’s average at the time of about 70 percent,” Bennie says. “Of the mothers who started breastfeeding, 55 percent continued to breast feed six weeks after birth.”
“The grant has helped us understand the nutrition and exercise piece that I think a lot of us have taken for granted,” Bennie continues. “We’ve learned how to get creative and deliver that service so it makes sense and can apply to our moms.”
While Every Child Inc.’s program served far fewer women (24 in total) than Butler Memorial Hospital’s, keeping it small helped them personalize it for each mother-to-be — and show improvement in every aspect they measured.
Butler Memorial’s Maternal Services Program was able to reduce its low birth weights by 16 percent between 2010 and 2015 by making sure women on Medicaid or without insurance had access to three care components.
The program also encouraged new mothers not to skip their postpartum visits, typically scheduled about six weeks after they give birth.
“I think the thought was, ‘I’ve had the baby, I’m happy at home with my child, I don’t need to go back for that last visit to make sure everything is okay with me now,’” Snodgrass says. “About 55 percent of our new mothers weren’t coming back for that postpartum visit, and that’s pretty significant. We put some incentives into place for the mothers to come back, some gifts for their newborns, coupons for different things in the community, to entice them to come back so we could make sure everything was OK from a physical and psychological standpoint, and to see if they needed any resources before they go out into the world as a new mom with a new baby. Over about a 10-year period of time, we were able to drop the no-show rate down to about 10 percent.”
After 25 years serving the Butler community, the Maternal Services Program closed at the end of October, turning its mothers-to-be over to two private medical practices that will accept patients on Medicaid or without insurance. Snodgrass sees the hospital-to-practice handoff as a mark of success — and one that will make doctor’s appointments more convenient for moms.
“A big benefit now with this coordination is that women can stay in the same office for future gynecological concerns or routine exams,” she says. “Also, the private practices in the area each have three different locations, so there are six locations women can go to, where with the Maternal Services Program there was only one.”
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