Meeting Challenges To Improve W.Va. Infant And Maternal Mortality Rates

Addressing the West Virginia Legislative Interim Committee on Health Monday, Dr. Angela Cherry is with the West Virginia Perinatal Partnership Advisory Council, a public private collaborative dedicated to improving health outcomes among pregnant women and babies.

Cherry first laid out the medical and social challenges, beginning with where West Virginia stands on a national scale.

“We have the fourth highest low birth weight, the tenth highest very low birth weight, the fourteenth highest teen birth rate, the eighth highest infant mortality and twentieth highest maternal mortality rate.” Cherry said. “We are having an increase in our maternal deaths according to accidental drug overdoses, which I’m sure everyone knows.”

Cherry pointed out racial disparities with a significantly higher infant mortality rate for Blacks and Hispanics. She also noted the birthing center ‘deserts’ in West Virginia.

“We have 20 birthing hospitals with one free standing birthing center,” she said. “With obstetrical deserts in West Virginia, women are having to travel really far, sometimes up to two hours, to get to these hospitals that are doing these deliveries.”

Cherry listed the many initiatives underway to improve mortality outcomes for infants and mothers, including monitoring a hospital’s levels of care to make sure that they are at the appropriate level of care and treating the patients that they should. There’s a project to reduce the incidence of very low birth weight infants born outside of tertiary care centers and a quit-nicotine-cessation project because of the high risk of smoking and preterm births.

Cherry made special note of the relationship between rampant, statewide substance use disorders and pregnant women.

“Drug Free Moms and Babies is a program that addresses those issues, a program that deals with care coordination including prenatal care, postpartum care and routine OB care,” she said.“ In addition to that, let’s add the care coordination for all the other services that moms may need. They need outreach, for communities to do a needs assessment to see what they actually do need in their communities. They need follow up referrals; home visitation; WIC support, housing; childcare; transportation, all of those things.”

Dr. David Didden, Medical Director of DHHR’s Office of Maternal, Child and Family Health also addressed and took questions from the interim committee.

Following up on a statement from Cherry, Del. Mike Pushkin, D-Kanawha, noted a 2020 report from WVU Medicine that Black infants died at almost twice the rate of white infants in West Virginia.

Didden said the problem is well known and being addressed.

“We’re working with organizations that historically have reached out into the African American community in West Virginia. Based on experiences in the pandemic and working with the Dunbar School Foundation in Fairmont, we are hoping to get more information, qualitative data from the minority communities, and to be able to find out just what services are needed,” Didden said. “One of the promising practices we’re looking at is establishing through our home visiting program, a Doula Network. Doulas are birth attendants; birth assistants, knowledgeable in prenatal care, knowledgeable in labor and delivery. At least, we can step up and create a demonstration project in some of our hardest hit communities. We’re aware of the disparities, working with our academic partners, who are also studying this and moving forward.”

Sen. Hannah Geffert, D-Berkeley, asked Didden about the challenge in recruiting doctors following the state’s abortion ban.

“One of the one of the problems we’re having in our area is we can’t get OBGYN’s to move into our state because they have fear of what this body might do to doctors who are performing abortions. For example, lose their medical license for doing that,” Geffert said. “I’m not quite sure why people assume that, that’s exactly what’s going to happen, but they can’t even get hired headhunters to get OBGYN’s to come to our community.”

Didden said West Virginia has suffered a medical provider shortage for years, especially with OBGYN’s.

“If we’re able to activate our nurse midwives, and successfully recruit more obstetricians to the state, I think that partnering with local organizations that like the Perinatal Partnership, we can send the message that we are in support of reproductive health for women, and that this is a promising place to come and practice medicine,” Didden said. “It’s a tough sell. We’re going to continue to try to establish best practices and standards of care, and I hope we’ll be able to convince some more providers that this is a good place to practice medicine. The distance to a birthing hospital is a major issue. So we’re going to continue to work with with the perinatal partnership to try to solve some of these problems and come up with some structural changes that I’m hopeful we’ll activate more local resources, get nurses and other members of the care team practicing at the top of their license, so that rather than having to transport someone, two hours to get an evaluation done, we may be able to provide those resources more closer to home.”