Scot McCray remembers viewing grim statistics about maternal and infant health in North Carolina a few years ago. “How do we turn the tide?” he asked himself.
As the CEO of Advance Community Health in Raleigh, he felt frustrated by the lack of progress in reducing infant mortality, especially among low-income and minority patients. “We have failed. We’ve been having the same conversation for 30 years,” McCray said.
But tackling high rates of infant mortality is becoming a national priority, and McCray hopes to see positive changes nationally. Work is well underway locally.
Dr. Lisa Vendeland joined the health center in late 2023 as director of obstetrics, gynecology and women’s services. In spring 2024, she helped launch a comprehensive care model that includes a “Centering Pregnancy” approach. “It’s a full year of wrap-around care,” she said.
Vendeland said North Carolina historically had high rates of maternal morbidity and mortality, and those rates were 15 times higher for Black women than for other groups. Comprehensive care is the only way to correct the problems that lead to the loss of so many moms and babies.
Centering Pregnancy involves getting moms in the door very early in a pregnancy and then grouping mothers who are due around the same time. Most patients choose to opt in to this voluntary program, and the experience builds camaraderie among patients.
The health center offers programming in English and Spanish. The program features individual meetings with providers and group sessions on pregnancy and infant care topics such as breastfeeding. Once the baby arrives, moms come in one-week postpartum, and staff arrange the first pediatric visit as well.
Advance Community Health has a parallel program for that oft-overlooked group: fathers. Families do better when both parents take part in prenatal care, and the benefits extend to others, according to Vendeland. “Dads who are involved become more involved in the community as well,” she said.
Vendeland said the health center will assess the results of the program as time goes on. She expects to see improvements such as fewer trips to the ER and fewer pre-term births. Meanwhile, some results are already in. “We’ve had our first two mommas deliver.”
HRSA recently awarded nearly $19 million to 15 states to identify and implement innovative strategies to address the maternal health crisis.