A Raleigh-based community health center that low-income and uninsured people have relied on for decades is opening an OBGYN clinic with the intention of addressing, head-on, the factors that have Black mothers and babies dying at higher rates than white mothers and infants.
Services for expectant parents at Advance Community Health will feature a type of group prenatal care that’s been credited with reducing rates of preterm births. The center is also starting a parenting program for fathers.
Dr. Lisa Vendeland, the director Obstetrics, Gynecology & Women’s Services at Advance, is heading up OBGYN service with a team that includes a nurse, nurse practitioners, a dietician, and social workers.
Offering expansive prenatal services and parent support is a deliberate effort to lower rates of infant and maternal death in communities of color.
These deaths “just shouldn’t be happening,” Vendeland said.
State healthcare leaders, providers, and community health groups have been talking for years about the state’s high infant and maternal mortality rates and how Black people are hit the hardest. Reducing infant mortality rates and reducing the gap between Black and white survival were some of the reasons behind the early push to expand Medicaid in the state. North Carolina expanded Medicaid last year.
At a celebration of the center’s maternity health launch, Advance CEO Scot McCray said starting the service was a goal he set when he arrived to lead the center three years ago.
Advance Community Health is one of 42 Community Health Centers in the state aimed at providing care to rural and underserved communities. Community health centers treat patients with and without insurance and offer sliding-scale discounts based on income. Advance has offices in Wake and Franklin counties. The Southeast Raleigh headquarters offers the widest array of health services.
McCray said he didn’t want to just start another service, but wanted to build a healthcare program that would decrease infant mortality in communities of color, have more women of color start prenatal care in their first trimester, reduce instances of low birth-weight babies, and tackle high maternal mortality rates.
“We wanted to make sure we’re doing something different. Something that can make an impact,” he said.
North Carolina’s infant mortality rate improved slightly from 2021 to 2022, the CDC reported last year, but Black babies here are still more than twice as likely to die before their first birthdays than white babies.
The maternal mortality rate in North Carolina more than doubled between 2019 and 2021, NC Newsline reported, rising much faster than the national rate. While 22% of North Carolina’s population is Black, 43% of the women who died from pregnancy-related causes between 2020 and 2022 were Black, the investigative news site MuckRock reported.
Mothers are more likely to die of a pregnancy-related condition than they were a decade ago, said Dr. Betsey Tilson, state health director and chief medical officer at the North Carolina Department of Health and Human Services. “The tragedy of the infant and maternal deaths is that about 85% of them are preventable,” she said. “We can prevent these deaths. We can lower the disparity.”
Black and Latinx women tend to start prenatal care later in their pregnancies than white women. The OBGYN service at Advance will help address problems of access, Tilson said.
Central to the effort to improve infant and maternal health will be CenteringPregnancy, a type of group prenatal care that melds checkups with education and discussion groups composed of women with approximately the same due dates. These longer sessions replace the typical 15-minute prenatal checkups.
CenteringPregnancy reduces rates of preterm and low-weight births, said Sarah Hornung, CenteringPregnancy coordinator.
“It’s not just a prenatal care program,” she said. “It’s creating supportive communities.”
In the health center’s program for fathers called Parenting Poppas, men will lead lessons on hands-on baby care. The center will also provide a psychological and social support group for men, Vendeland said. Men who participate in the direct care of their children are more satisfied parents, participate more actively in their communities, and raise stronger, healthier kids, she said.
By working harder to change maternity care and paternal care “we can decrease how many moms and babies die,” Vendeland said. “This is our best hope for this program.”
