University Hospitals Secures Grant to Expand Community Support for Pregnant Mothers

Innovations in Obstetrics & Gynecology | Fall 2022

Navigating the complexities of the healthcare system can be difficult for pregnant mothers. To help overcome those challenges, the Department of Obstetrics & Gynecology at University Hospitals Cleveland Medical Center is setting out to form a stronger network for women.

Pamela Hetrick,CNM

University Hospitals received a $550,000 grant from First Year Cleveland, an organization dedicated to addressing infant mortality in Cuyahoga County. Pamela Hetrick, CNM, Division Chief, Nurse Midwifery, shares an inside look at how that funding will help UH reach the local community and improve outcomes for both mothers and their babies.

Identifying the Opportunity

The First Year Cleveland Grant will allow UH to expand and enhance the work it is already doing to help pregnant mothers get the support they need on their journeys through the health system. UH adapted the CenteringPregnancy care model in 2010, which empowers mothers with pregnancy, birth-related and breastfeeding education and combines the patient’s medical care from the Certified Nurse Midwife team all in one visit.  

This program also has two community health workers that serve as a lifeline for women, helping them navigate appointments, transportation, insurance and more. The benefits patients receive from the community health workers in the Centering Program will expand to women who are identified as facing social and economic challenges that act as a barrier to accessing prenatal care or navigating the complexity of healthcare.

“We know that healthcare can be super challenging and overwhelming. Sometimes you need an advocate,” says Hetrick. Hetrick works in the labor and delivery, where she sees firsthand how patients can struggle throughout their pregnancies without community support. “There is potential for huge gaps in their care, which can increase risk for poor maternal and fetal outcomes.”

This additional funding will help UH change the known barriers pregnant women face by expanding the community support offered through the CenteringPregnancy model to more patients who receive care at the UH Rainbow Babies & Children’s Ahuja Center for Women & Children in the Midtown neighborhood of Cleveland.

The New Program

The impact community health workers have is clearly demonstrated by the CenteringPregnancy program. Now, UH has the funding to hire and train three more community health workers at UH Rainbow Babies & Children’s Ahuja Center for Women & Children. The grant will fund this effort through July 2024, according to Hetrick. Between now and then, she will be closely monitoring patient outcomes to demonstrate the success and sustainability of the program.

The ultimate goal is to decrease length of stays, increase patient attendance at prenatal appointments, including laboratory and ultrasound testing, decrease triage visits and reduce maternal and infant morbidity and mortality. The program also hopes to increase patient satisfaction with knowing they have a community health worker to walk through their pregnancy journey right beside them.

UH providers will identify patients who could benefit from the support of a community health worker, including women who haven’t yet accessed prenatal care or those who voice concern about barriers to accessing care. Hetrick plans to have 35 patients enrolled in the new program within the first year. She and the community healthcare team will care for another group of 35 patients the next year. The team will work closely with these mothers during their pregnancies and through the first year of their babies’ lives.

Breaking Down Barriers

The CenteringPregnancy program has been making a difference in the lives of mothers and babies for years. It is a natural progression for UH to expand that community reach to more people who are at high risk medically and socially. “We know that social determinants of health are just as important for healthy outcomes as actual medical care,” says Hetrick.

Maternal and infant mortality are still a significant issue in the Cleveland community. The leadership at UH recognizes the enormous challenges pregnant mothers can face when attempting to navigate the health system. This expansion of community health worker services is another way that UH is attempting to break down those barriers to care for and connect mothers and babies with the resources they need to thrive.

“UH believes in innovation and believes in going out to the community, meeting the patient where they're at,” says Hetrick.

Reach out to Hetrick at Pamela.Hetrick@uhhospitals.org to learn more about how UH is leveraging community health workers to help pregnant mothers in the Cleveland community.

Contributing Expert:
Pamela Hetrick, CNM
Division Chief, Nurse Midwifery
UH Cleveland Medical Center