In 2020, the national maternal mortality rate of non-Hispanic Black women was almost three times that of non-Hispanic white women.
State health officials in Connecticut reported that babies who were born to Black mothers were more likely to die before the age of one than children born to white mothers. Black mothers are twice as likely than white mothers to give birth to babies under six pounds. This can lead to serious developmental and health problems.
“In our state and in this nation, we have a maternal health crisis where Black birthing people are suffering consequences more than any other birthing population,” state Public Health Commissioner Dr. Manisha Juthani said testifying before the legislature’s Public Health Committee on Tuesday, describing the racial disparities in Connecticut’s infant and maternal mortality rates.
The hearing was held in order to discuss Gov. Ned Lamont proposed a Senate bill which would implement many statutes and programs in order to improve access to maternal health care services.
SB 968 aims to reduce these disparities by creating a category of birth centers, establishing state certification for midwives and doulas, and opening a universal program for nursing visits for new parents.
Birth centers licensed
Birth centers, unlike a hospital maternity ward, are independent healthcare facilities that can provide prenatal, labor and delivery care for low-risk pregnancies. Juthani stated that SB 986 would give birth centers across the state a new license category if it is passed.
In her testimony, she stated that this would allow birth centers to fill in any geographic gaps within the state. It will also offer lower cost options and more family-friendly opportunities to help people have fewer medically induced births in the state.
Juthani explained that birth centers provide an alternative to traditional hospital delivery care, something many women of color feel more comfortable with. You can also find alternative care providers such as midwives or doulas in the healthcare system, which makes them more accessible to wider populations.
The Connecticut Childbirth and Women’s Center, the only state-specific birthing center, is located in Danbury. The center, which is located in Danbury, is staffed with midwives and focuses primarily on natural births. Two-story clinic offers many birthing rooms equipped with queen-sized beds, a large bathroom and a Jacuzzi tub.
Its website states, “Some of the benefits of a center birth include the freedom to move freely without monitors or IVs; use of a jacuzzi tub and shower; freedom to eat and drinks as you like; unlimited number of support persons and an early discharge home.”
The state would license birthing centers, and they may be required to follow certain service guidelines. Juthani stated that certified birth centers would collaborate with local hospitals. In this way, patients would be able to access a higher level care if they had to have an emergency during birth.
You can transfer quickly to the Connecticut Birth Center by walking across the street to Danbury Hospital.
“This is a continuum. There will be a low-risk and high-risk situations for every condition. Juthani stated that having the right combination of providers and care can make the birthing person feel at ease, help them communicate, and make them feel valued.
Saud Anwar (D-South Windsor), is the Committee Co-Chair. He raised concerns about the relationship between the healthcare system and the birth centres. Anwar, who is a doctor, stated that the legislation could result in unintended selection bias, as major hospitals would be able to receive more complicated cases of pregnancy.
Anwar recalled a friend who works at a major hospital as an OB/GYN and is often involved with pregnancy-related emergencies. He explained that she is feeling overwhelmed and frustrated by all the emergency calls and was considering moving from the emergency department.
They “get disastrous things that were happening as disasters and nobody recommended them to be able to be seen at a higher level of care. He said that if a patient is bleeding out in the last-minute of an emergency room visit, then you need to rush to take care of them.”
The Connecticut Hospital Association also submitted testimony, stating that the bill’s language does not mandate regulations or protocols for the license. They instead state that the language must be updated to ensure that mandatory clinical guidelines are met.
State Rep. Liz Linehan, D-Cheshire, told the Record-Journal she fully supports birthing centers but wants to ensure that their patients receive adequate post-delivery education, such as essential screening tests for newborns and vitamin K injections for blood clots caused by vitamin K deficiency bleeding.
“There has been a movement away from these important health concerns among new mothers as of late… I do believe an education component must be included through midwives and doulas,” Linehan said. “My concerns can easily be allayed with further discussion with providers.”
Doula certification
Hafeeza, founder and host of Labors of Love podcast highlighted the importance of certifying Doulas at Tuesday’s hearing by sharing her personal journey through pregnancy. The mother of three spoke out about her “sacred” experience of giving birth. She said she didn’t need any medication and did not experience any complications.
Ture stated that her “birth team” included friends, family members, a doula, and a midwife. She added that she had all her deliveries outside a hospital setting – one in a birth center and the others at home.
She was relieved to know that someone was paying attention to her needs in the delivery area.
Ture stated that it was important to know someone knowledgeable about the vulnerable state and can convey your wishes in that space. This will help you build trust. It has a positive impact on mothers to let them relax and be involved in the process. Many of the complications and interventions would not be necessary if they felt secure and grounded in their bodies to do what we do.
A doula, a non-medical trained professional, assists a pregnant woman before, during, and after her birth. Traci McComiskey, the founder and director at Birth Support, Education and Beyond LLC, stated that they work solely to help the mother have a safe, memorable, and empowering birth experience.
SB 986 will create an optional state certification pathway to allow doulas to apply for those credentials. According to DPH’s written testimony, streamlining certification would create a path for doulas and provide insurance reimbursement opportunities.
McComiskey also testified that McComiskey believed that a voluntary certification of doulas would increase their visibility, provide more funding options, and help integrate doulas into health systems.
She stated that certification centers the voices of doulas as well as those who have lived experiences and allows for equitable access to state certification.
State Rep. Lezlye Zupkus, R-Prospect, raised concerns about cost and its affordability, but noted the importance of doula services.
“There are all kinds of people that struggle and a doula could be a great thing for them. And so I want to make sure there’s access for everybody,” she said.
Universal nursing
State Early Childhood Commissioner Beth Bye spoke on the benefits of having a nurse visit new parents after birth.
She said that the first few weeks can be stressful for both baby and parents. A nurse can help ease this transition.
She said, “You don’t need any degree to bring that child home. But a little guidance can make a big difference.”
Bye announced that the pilot program of universal nursing is scheduled to be launched in May. New parents will be paired up with a nurse based in Bridgeport. The nurse would visit their home at least three times to offer guidance and suggestions as they adjust to their new lives. After that, the nurse will connect parents to a local community worker for easy access.
Bye stated that the nursing program follows Family Connects International’s model. FCI nurses can assess families’ needs and offer services at no cost. According to their website, FCI nurses have the ability to do so. This model is also used in 19 other states.
Community health workers are a rare addition. Debbie Poerio (duringal project manager for Universal Home Nurse Visitation Program), stated that nurses are the only ones who work in other states.
She also stated that Connecticut’s program was created in collaboration between five commissioners from various state agencies.
Poerio stated that “It’s integrated” and all the services of those five agencies have been combined to create a seamless continuum of care for parents.
Bye explained that the program is supported by multiple sources including Medicaid, federal funds, CDC grants, COVID-19 aid funds, and preschool development funds. The pilot program gives them the opportunity to leverage the funds to create cost-saving programs that provide similar services at a lower cost.
“When you combine federal opportunities, looking earlier, and looking at maternal and child health, as well as safety and security, this is a homerun.”
Zupkus expressed concern about the sustainability and price of a universal nursing program, despite her support for this section of SB986. With a few more conversations and some tweaks to the bill’s language, she hopes SB 986 will have a huge positive impact.
“We need to make sure that people that need services get them, but we need to make sure that they’re stable. They’re going to continue to be there,” she said.
Cris VillalongaVivoni is the Health Equity reporter. She is a member of Report for America’s corps, which places journalists in local media outlets. Support RFA reporters at the Record-Journal through a donation at https://bit.ly/3Pdb0re. To learn more about RFA, visit www.reportforamerica.org.
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