More About the W. Va. Perinatal Health Partnership

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The Perinatal Partnership is a model project to improve birth outcomes through a collaboration of health sciences centers, state agencies, professional associations, private medical providers, and civic groups. The project, funded by the Claude Worthington Benedum Foundation since 2006, is coordinated by WV Community Voices.

During 2006, the Partnership conducted studies to identify the problems associated with poor birth outcomes in West Virginia and identified ten primary areas needing attention. In 2007, the Partnership issued a series of reports and recommendations in the Blueprint to Improve West Virginia Perinatal Health, issued an action plan, and began implementing the work plan through a series of committees. Accomplishments since 2007 include the following:

1. Established a Statewide Perinatal System
  • Identified and published guidelines for obstetrical and neonatal practices and developed educational programs to promote their use by perinatal providers.
  • Worked to identify a uniform prenatal risk assessment tool and supported legislation that called for its use in West Virginia. The legislation passed in 2009. Maternal, Child, and Family Health has established a committee to routinely evaluate and identify a universal tool.
  • Identified recommendations to improve the system for perinatal transport, engaged the WV Emergency Medical System office, and began plans to establish a “One Call” system and Bed Board for hospitals.
  • Demonstrated consultation via telemedicine between community perinatal providers and specialists at a tertiary hospital. Partnered with CAMC Research Institute and the WV Telehealth Alliance to identify the needs of maternity hospitals for broadband width and equipment.
  • In collaboration with CAMC, received funding from USDA and to develop perinatal telecommunication “Connect to Care” network for rural hospitals and prenatal clinics. Eighteen hospitals and rural health sites partnered with Connect to Care.
  • Studied the adequacy of Neonatal Intensive Care Unit (NICU) beds and made a recommendation to the WV Health Care Authority to allow bed increases and to keep WV babies needing NICU care, close to home. NICU bed increases were gained by WVU and Cabell-Huntington hospitals.
  • Established the Hospital Self Assessment Initiative to engage birthing hospitals in meeting national guidelines for personnel, training, and equipment. Fifteen WV hospitals have completed the self assessment.
2. Identified and Address Obstetrical Provider Shortage Areas
  • Identified rural areas where access to maternity care is seriously limited and designed a model rural maternity service that makes economic and social sense for underserved areas. WV Primary Care Association is encouraging development of these services in community health centers.
  • Identified financial aid programs that are available to nurses interested in becoming certified nurse midwives (CNMs).
  • Worked with the WV Hospital Association to identify CNM credentialing best practices.
  • Worked with Marshall University School of Nursing to establish a joint MSN/CNM degree program through partnership with Shenandoah University in Virginia, which will begin this year.
  • Identified educational loan arrangements available to nurses for their CNM education occurring in State.
3. Addressed the Lack of Oral Health Care during Pregnancy
  • Identified data to set benchmarks and measure changes in use of oral health care by pregnant women covered by Medicaid and partnered with “Right from the Start” program to increase oral health care among pregnant women.
  • Partnered with WVU Department of Pediatrics and WV Birth Score program to issue a report on oral health among all pregnant women in the state.
4. Identified Costly Medical Procedures Associated With Poor Birth Outcomes
  • Studied the frequency of labor induction among first-time mothers, both in cases with and without preexisting medical complications.
    Collaborating with the WV Health Care Authority and the March of Dimes to conduct the Obstetrical Collaborative Quality Initiative to reduce elective deliveries prior to 39 weeks gestation. Elective deliveries decreased from 21.8% of births to 8.3% of births from January through August of 2009. Fifteen WV hospitals participated.
  • Identified the frequency of C-section among first-time mothers after elective labor induction. Developed recommendations for elective labor induction to occur only after 39 weeks gestation.
  • Studied the incidence of infants born addicted to drugs or alcohol and the associated cost of care in the NICU. The studies were released at the Perinatal Summit in 2008.
5. Developed an Approach to Identify and Treat Drug Use During Pregnancy
  • Researched WV Health Care Authority data to attempt to identify the extent of substance abuse by pregnant women in West Virginia and issued report.
  • Conducted medical and legal research to clarify the issues and drafted a policy position paper.
  • Obtained additional funds for committee work from WV Health Care Authority.
  • CAMC put into place a medical service for addicted pregnant women.
  • Drafted and issued Guidelines to Identify Drug/Alcohol Use during Pregnancy and Refer for Treatment and developed an educational program for medical and nursing providers.
  • Issued Tool Kit to identify addicted newborns.
  • Collaborated on the umbilical cord tissue study with 8 WV hospitals participating and identified 19% use of drugs/alcohol by pregnant women.
6. Encouraged the Development of Perinatal Worksite Wellness Programs
  • Five worksites put into place the March of Dimes Healthy Baby program for employees
  • Twenty-one worksites have been recognized by the WV Breastfeeding Alliance for worksite improvements to support employees who breastfeed.
7. Promote and Support Breastfeeding
  • Supported the Legislature in its deliberations to establish that breastfeeding is not an act of public indecency. The legislation passed in 2007.
  • Obtained $20,000 in FY 07 and 08 through efforts of the Legislative Oversight Committee on Health and Human Resources to provide hospital obstetrical nurses and others training in lactation consultation. Over 70 health care professionals were educated and certified in lactation consulting in 2007 and an additional 70 will receive the training in May 2009.
  • Promoted the establishment of the WV Breastfeeding Alliance to promote partnerships that help medical/nursing professionals stay current on lactation education.
8. Support Expanded Testing of Newborns
  • Supported expansion of testing in newborns to cover all 29 potential metabolic conditions. Legislation passed in 2007 and testing was scheduled to begin in January of 2009.
9. Promote creation of the WV Maternity Mortality Review Team
  • Called for legislation to establish the routine examination of maternal mortality in West Virginia. The legislation passed in 2008 and is being implemented in 2010.
10. Studied the incidence of pregnancy among WV teens and developed policy recommendations to improve the situation.
  • Commissioned the study of unplanned pregnancy in WV and submitted reports to the State Legislature in response to HCR 53 to promote the education of youth regarding how to have a healthy pregnancy.
  • Provided testimony to the State legislature regarding HCR # 104 and 105 to promote the coverage of dependants for contraception and for pregnancy.
  • Worked with HAPI and Partners In Community Outreach to implement an educational program to space pregnancies by 24 months.
  • Obtained a 2010-11 grant from the National Campaign to Prevent Teen and Unplanned Pregnancy. Will be working with Community and Technical Colleges to reduce dropout rates connected with unplanned pregnancy.
11. Studied the incidence of births to single WV women, which has increased by 35% since 1980.
12. Commissioned the review of the WV Medicaid Family Planning Waiver and developed a policy recommendation regarding the waiver.
13. Currently collaborating with the State Tobacco Control project and Right from the Start to support programs that curb the use of tobacco during pregnancy by pregnant women and others in the home.
14. Established the WV Perinatal Outreach Education Project in 2009 to bring up to date educational opportunities to perinatal providers and to share knowledge and expertise across the State.