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Some Hoosier moms live in ‘maternal care deserts’ far from pregnancy care

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New mom Briante Melton of Indianapolis met her best friend at her lowest moment.

“I just felt kind of like hopeless,” she says. “Like I was going to feel like that forever.”

After her 1-year-old son Isaiah was born, she says she suffered from post-partum depression. When she didn’t always feel like getting out, help came to her inside her home through the Nurse Family Partnership (NFP) at Goodwill Industries. 

“I can call my nurse my friend now and also a therapist as well,” Melton says of her NFP nurse Michelle Washington. 

If you want to deliver a healthy baby like Melton, the odds of doing so in the Midwest are the worst if you call Indiana home.

Chances are if you’re Black, Latina or a low-income Hoosier, you’re in one of the state’s 33 counties that lacks either a hospital or a hospital with a delivery wing. 

They’re called maternal care deserts, where just getting to a health care provider can be a barrier to healthy births.

“Some of our moms are struggling to even get their driver’s license,” said Lisa Crane, senior director of the Nurse Family Partnership at Goodwill Industries.

The partnership pairs first-time moms with a registered nurse for ongoing home visits in 30 counties around the state. During the coronavirus pandemic, most of these visits are now virtual, but Crane said access issues existed before the virus.

Support for some of the moms she serves just south of Shelbyville in Bartholomew County comes in the form of basic needs: Social workers often help moms get reliable transportation, car insurance and a driver’s license. Sometimes, the best thing nurses can provide to a new mom is a stable relationship of trust, which can help reduce stress, Crane said. 

“’My nurse has been like a mother to me in some way,’” Crane said of testimonies she’s heard from moms who’ve graduated from the program.

Melton says her Goodwill-provided nurse was a surrogate family member since most of her family lives in her hometown, Hammond. 

The partnership serves women who are covered by Medicaid, which means they live at double or below what’s federally considered poverty. 

Community-centered approaches like Goodwill’s weave a network around Indiana that seeks to fulfill a statewide mandate. 

An initiative signed into law by Gov. Eric Holcomb in 2019 launched in January to support moms and babies to create healthier outcomes for both. It’s called the OB Navigator program. The navigator also provides home visits to a woman during pregnancy and at least the first six to 12 months of her baby’s life.

The state reports more than 500 women have accepted a provider referral through the program. 

Reducing the rate at which both mothers and babies die at childbirth is among the top priorities for the state toward achieving Holcomb’s goal of having the lowest infant mortality rate in the Midwest by 2024. 

So far, Indiana’s Black infant mortality rate dropped from 15.7 per 1,000 live births in 2017 to 13.0 in 2018, the most recent year for which the state has data. 

Risë Ratney, director of maternal and child health services for the Northwest Indiana Health Department cooperative, said as both a mom and grandmother, change can’t come quickly enough.

“When you look at the health of your infants, you’re really reflecting the health of your entire community,” she says. “If you don’t get a good start in the beginning, what are your chances of having optimal health as you go along?”

In her Lake County communities, Black infants are two times more likely to have poor birth outcomes such as low birth weight, prematurity and congenital defects. 

Still, for Crane, moms often have something endearing in common.

“Every mom we meet, the very first thing she tells her nurse is, ‘I want to be the best mom I can,’” she said.

To help get prenatal care to all 92 Hoosier counties, the state health department is set to award $1.5 million in grants over the next two years to four organizations across Indiana in counties with limited or no OB services.

State health officials say the OB Navigator program is expanding ahead of schedule and will be in 22 counties by the end of October. 

Melton said the effects last longer than the program. She still has her nurse’s cell phone and sends her picture updates on Isaiah’s progress.

Ratney said success looks like babies being born full term and moms taking to breastfeeding. It also means parents know they have a support system. 

“Most of us like to have a girlfriend or somebody to be able to share experiences with,” she said. “Well, they’re getting health education, too. I love it.”

This story was reported as part of a partnership between WFYI, Side Effects Public Media and the Indianapolis Recorder.

For more information on the OB Navigator Program, contact: OBNav@isdh.in.gov

For more information on Goodwill’s Nurse-Family Partnership, click here.

To find a testing site, click here.

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