The 2024 Advancing Health Equity Symposium featured a Maternity and Infant Health track, moderated by Erin Marshall, Esq. This comprehensive session explored various initiatives and programs dedicated to enhancing maternal and infant health outcomes in New Mexico.
The symposium began with a focus on community-based doulas in New Mexico. These doulas provide continuous support before, during, and after childbirth, improving outcomes for mothers and babies by offering physical, emotional, and informational assistance. The New Mexico Doula Association (NMDA) champions birth and reproductive justice, emphasizing equitable healthcare access through advocacy, education, and direct services. NMDA’s efforts during COVID-19, such as adapting to support out-of-hospital births and training abortion doulas, underscore their commitment. Notably, from July 2024, Medicaid will cover doula services in New Mexico, a result of NMDA’s advocacy.
The Pasteurized Human Donor Milk (PHDM) presentation outlined the mission and processes of the Human Milk Repository of New Mexico (HMRNM) in providing vital donor milk to preterm and medically fragile infants. The HMRNM supports the meticulous lifecycle of PHDM, from donor screening and milk processing to rigorous safety testing and distribution. Emphasizing the numerous benefits of human milk over bovine-based formula, including nutritional and immunological advantages, highlights include advocacy efforts of HMRNM in promoting breastfeeding and equitable access to high-quality donor milk, ultimately aiming to enhance maternal and infant health outcomes.
The New Mexico Women, Infants, and Children (WIC) program strives to enhance health equity by improving outcomes for eligible women, infants, and children through federally funded services. WIC provides nutritious food, breastfeeding support, nutrition education, and referrals to health services. Eligibility includes pregnant women, breastfeeding and non-breastfeeding postpartum women, infants, and children up to age five. Services include peer counseling, lactation consulting, nutrition education, and tailored food packages. Future initiatives by the USDA aim to streamline applications, offer virtual and in-person services, and improve access to farmers markets, thereby removing obstacles and promoting community well-being.
The University of New Mexico (UNM) also plays a pivotal role in advancing maternal health. The UNM College of Nursing received a $4 million HRSA grant to expand its midwifery program, aiming to increase the number of diverse nurse-midwives in the state. The “Advancing Midwifery Outcomes and Resiliency” project provides significant financial support to students, ensuring the continuation of high-quality care by UNM-trained midwives. UNM’s Nurse-Midwifery Program, accredited by the American College of Nurse-Midwives, integrates comprehensive training and emphasizes serving rural and underserved populations. The program boasts a high certification pass rate and a strong alumni presence, contributing significantly to New Mexico’s healthcare workforce.
The Más DULCE program, set to launch in early 2025, aims to address perinatal depression and promote health equity through a support system for postpartum families. This program includes universal screening for social needs and perinatal depression, involving Community Health Worker Family Specialists trained in Brazelton Touchpoints. Initially piloted at a UNM Family Practice clinic, Más DULCE plans to expand its reach, contingent on NIH funding.
Additionally, the UNM Health Sciences Center’s Project ECHO was highlighted for its innovative approach to improving maternal and child health outcomes. By connecting experts with local providers through tele-mentoring, the ECHO model promotes interdisciplinary collaboration and supports providers in delivering equitable healthcare.
The symposium underscored the collective efforts of various programs and initiatives in New Mexico, striving to bridge gaps in maternal and infant health and advance health equity across the state.
———————————– Program summaries follow here
New Mexico Doulas
New Mexico has a tradition of community-based doulas who offer essential support to birthing individuals. These doulas provide continuous physical, emotional, and informational support before, during, and after childbirth, helping to improve outcomes for mothers and babies. They advocate for birthing individuals, facilitate communication with healthcare providers, and assist with birth plans. Doulas also offer postpartum support, including breastfeeding assistance and emotional support during the transition to parenthood. This comprehensive care approach helps reduce stress, enhance birth experiences, and promote better health for both mother and child.
The New Mexico Doula Association (NMDA) promotes birth and reproductive justice, focusing on equitable healthcare access. Founded by community activists, NMDA provides support for pregnancy, birth, postpartum, abortion, and loss through direct services, advocacy, and education. During COVID-19, NMDA adapted to support out-of-hospital births and trained abortion doulas. Medicaid will cover doula services starting July 2024, thanks to NMDA’s advocacy. Their initiatives include developing an electronic medical record system and the Our Earth Certified Birth and Postpartum Attendant program. NMDA collaborates with various community organizations to enhance reproductive health services in New Mexico.
Visit the New Mexico Doula Association here: https://nmdoula.org/.
Human Donor Milk and the Human Milk Repository of New Mexico
The “Pasteurized Human Donor Milk (PHDM)” presentation by Lindsey Maurer, BSN RN LES, focuses on the lifecycle, benefits, and community impact of PHDM provided by the Human Milk Repository of New Mexico (HMRNM). HMRNM’s mission is to supply human milk to preterm, medically fragile, and sick infants using evidence-based techniques in line with the Human Milk Banking Association of North America guidelines. They advocate for breastfeeding and support ongoing human lactation to ensure the highest quality of donor milk is accessible to vulnerable community members.
The presentation details the comprehensive lifecycle of PHDM from donor to recipient. Donors undergo thorough screening, including health history and blood tests for infectious diseases. Donations are collected through various methods, classified, processed, and pasteurized. Rigorous bacteriological and caloric testing ensure safety and nutritional adequacy before the milk is distributed to hospitals, pediatric clinics, doulas, lactation providers, and community members.
The benefits of PHDM over bovine-based formula are highlighted, citing the American Academy of Pediatrics’ recommendation for donor milk when maternal milk is unavailable. Human milk offers numerous advantages, including immunological and nutritional benefits, reduced risk of infections and diseases in infants, and enhanced maternal mental health and lactation support.
HMRNM emphasizes the critical need for PHDM in supporting the health of infants and mothers, advocating for its use to foster better health outcomes and equity in maternal and child healthcare.
UNM Starting Midwifery Workforce Project – Applications Open Aug 2024!
The University of New Mexico College of Nursing received a $4 million grant from the Health Resources and Services Administration (HRSA) to enhance its midwifery program. The “Advancing Midwifery Outcomes and Resiliency” project aims to increase the number of diverse nurse-midwives in New Mexico, improve maternal health training, and decrease maternal mortality and morbidity risks. The grant provides up to $40,000 in financial support for up to 65 students over four years, aiding tuition and living expenses. This initiative ensures the continuation of high-quality, comprehensive care by UNM-trained midwives in New Mexico.
The University of New Mexico (UNM) College of Nursing offers a comprehensive Nurse-Midwifery Program that integrates the art and science of midwifery. Accredited by the American College of Nurse-Midwives’ Accreditation Commission for Midwifery Education, the program emphasizes care for rural and underserved populations. The curriculum spans six consecutive terms over two years, starting in the summer, and includes 55 credits, 934 clinical hours, and 116 lab hours. The program combines online and hands-on learning, with two-thirds of clinical rotations outside Albuquerque.
UNM’s Nurse-Midwifery Program is nationally recognized, ranking 11th in the nation according to U.S. News & World Report. The program boasts a 100% certification pass rate for its 2021 graduates and has a strong alumni presence, with one-third of New Mexico’s certified nurse-midwives being UNM graduates. Faculty members are experienced clinicians committed to teaching and supporting students.
The program prepares students for national certification through the American Midwifery Certification Board. UNM also provides extensive support through Student Success Coordinators and structured clinical rotations, ensuring students gain diverse and comprehensive clinical experience.
Visit UNM-HSC for more info and the Nurse Midwife Program Application link: https://hsc.unm.edu/nursing/landing-pages/midwifery-amor-digital.html
Más DULCE Pilot Program Starting in New Mexico in early 2025
The Más DULCE program, developed by the UNM Office for Community Health, addresses perinatal depression and promotes health equity through a comprehensive support system for postpartum families. It targets 10-20% of birthing people affected by perinatal depression, providing interventions during well-child visits and integrating peer support via WhatsApp and Zoom.
Key components include a dyadic treatment model (mother and baby together) that screens for health-related social needs and perinatal depression, involving a Community Health Worker (CHW) Family Specialist trained in Brazelton Touchpoints.* The program enhances access to supports, improves adherence to well-child visits and vaccines, and reduces emergency room use.
Initially piloted at one UNM Family Practice outpatient clinic, Más DULCE plans to expand to two more clinics, contingent on federal National Institutes of Health (NIH) funding. It includes universal screening for social needs in families with infants (0-12 months), open to all families.
Innovations extend the program duration from 6 to 12 months, adapt it for Family Practice settings, and incorporate virtual peer support. Funded by the Hilton Foundation through the NM Early Childhood Education and Care Dept., with potential additional NIH funding, the program aims to demonstrate a feasible clinic-community model, understand intervention dynamics, and support implementation in low-resource primary care settings.
Contact Heidi Fredine, MPH, at UNM Office for Community Health for more information: hfredine@salud.unm.edu
* Brazelton Touchpoints is a child development model focused on enhancing relationships between parents and children, as well as between parents and healthcare providers. Developed by Dr. T. Berry Brazelton, Touchpoints identifies key periods in a child’s development when they exhibit predictable regressions followed by significant developmental progress. These moments, known as “touchpoints,” help caregivers understand and anticipate changes in behavior, thereby fostering better support and engagement.
UNM Health Sciences Center Project ECHO and Maternal & Child Health
The Bridging Gaps: Gender Equity and Access in Maternal & Child Health Care program, led by Simran Priel and Clara Lopes, delves into the critical issues of maternal health disparities in the U.S. and New Mexico. The presenters emphasized the alarming rise in U.S. maternal mortality rates, which surged to 32.9 per 100,000 births in 2021. New Mexico faces specific challenges, with one-third of its counties classified as maternity care deserts, severely limiting access to prenatal care.
The presentation clarified terms such as maternal death, pregnancy-associated death, and pregnancy-related death, highlighting the nuances in maternal health outcomes. Notably, discrimination was identified as a contributing factor in nearly half of all pregnancy-related deaths between 2018 and 2020. The session underscored the need to address social determinants of health, including racial inequity, poverty, substance use disorder, and transportation barriers, as these factors are crucial in preventing maternal deaths, particularly in the late postpartum period.
A key solution proposed is the ECHO (Extension for Community Healthcare Outcomes) model, which enhances healthcare outcomes by connecting experts with local providers through tele-mentoring. The Gender Equity ECHO aims to apply a gender equity lens to maternal and child health programs, fostering interdisciplinary collaboration and support for providers. Upskilling Community Health Workers with Maternal-Child Health specialties is one way ECHO can have an impact on equity and access to care in New Mexico. The presenters called for strengthened professional and personal connections to improve maternal health care access and equity, ultimately bridging the gaps in maternal health disparities.
The Project ECHO Gender Equity Collaborative meets monthly every 3rd Wednesday at 8:30 a.m. and all interested are welcome to attend virtually via iECHO. Contact echogenderequality@salud.unm.edu for more information.
Other New Mexico Birth Companion Programs in the News
The University of New Mexico College of Nursing received a $200,000 grant from the W.K. Kellogg Foundation to support its Volunteer Birth Companion Program. This initiative offers continuous labor support to improve childbirth outcomes, particularly for BIPOC clients. Volunteers provide physical, emotional, and informational support, contributing to shorter labors, reduced pain medication, better lactation, and lower postpartum depression rates. The program, led by Katie T. Kivlighan, PhD, and colleagues, aims to enhance program sustainability and collaboration with stakeholders while diversifying the pool of birth workers in Bernalillo County.
For more details, visit UNM-HSC at https://hsc.unm.edu/news/2023/01/college-nursing-receives-kellogg-foundation-funding-volunteer-birth-companion-program.html .
New Mexico Women, Infant and Children (WIC) Program
The New Mexico Women, Infants, and Children (WIC) program aims to enhance health equity by improving health outcomes for eligible women, infants, and children. Federally funded, WIC offers nutritious food, nutrition education, breastfeeding support, and referrals to health services.
NMWIC Eligibility:
- Pregnant women (up to 6 weeks postpartum)
- Breastfeeding women (up to the infant’s first birthday)
- Non-breastfeeding postpartum women (up to 6 months postpartum)
- Infants (up to 1 year)
- Children (up to 5 years)
NMWIC Services Provided:
- Peer Counselor Program: Trained WIC mothers provide breastfeeding support and education, keeping breastfeeding rates above the national average.
- Breastfeeding Support: Certified lactation consultants assist with high-risk breastfeeding concerns.
- Nutrition Education: Free education on nutrition and health, promoting healthy choices through various formats (online, group, one-on-one).
- Nutrition Support: Monthly benefits from tailored food packages to meet specific nutritional needs.
NMWIC Initiatives: The USDA envisions a future with streamlined applications, virtual and in-person services, improved shopping experiences, and expanded access to farmers markets and culturally tailored services, enhancing convenience and access for families.
To achieve health equity, WIC removes obstacles impacting families’ well-being, providing access to nutritious foods and community resources regardless of identity, race, ability, class, or location.
For more information, visit New Mexico WIC at https://www.nmwic.org/.
