Rural Maternal Health – Models and Innovations

Evidence-Based Examples

Domestic Violence Enhanced Home Visitation Program (DOVE)

Updated/reviewed March 2024

• Need: To reduce violence against pregnant women and women with infants in rural Missouri.
• Intervention: A tool for existing home visiting programs, DOVE was a brochure-based and safety planning intervention for women experiencing interpersonal violence.
• Results: Women receiving the DOVE intervention saw a larger average decrease in number of violent incidents than women in the control group.

UAMS IDHI High-Risk Pregnancy Program

Updated/reviewed January 2024

• Need: Arkansas had high rates of low birthweight babies, and pregnant individuals in rural areas had difficulty accessing specialty obstetric care.
• Intervention: The University of Arkansas for Medical Sciences (UAMS) created the Institute for Digital Health & Innovation (IDHI) High-Risk Pregnancy Program to increase access to care for pregnant individuals in an effort to improve outcomes for high-risk pregnancies.
• Results: The program has increased access to care and improved neonatal outcomes for rural Arkansas individuals through a variety of programs and has been recognized by various organizations as a model program.

Effective Examples

Perinatal Health Partnership Southeast Georgia

Updated/reviewed February 2023

• Need: In 12 rural southeast Georgia counties, high-risk pregnant individuals potentially face adverse birth outcomes, including maternal or infant mortality, low birthweight, very low birthweight, or other medical or developmental problems.
• Intervention: An in-home nursing case management program for high-risk pregnant individuals in order to maximize pregnancy outcomes for mothers and their newborns.
• Results: Mothers carry their babies longer and the babies are larger when born, leading to improved health outcomes.

Promising Examples

Healthy Connections, Inc. Healthy Families Arkansas

Updated/reviewed December 2022

• Need: High poverty rates and lack of access to healthcare make caring for unborn and newborn children difficult for young mothers in Arkansas's Polk and Garland Counties.
• Intervention: An Arkansas-based program provides a national healthcare service to expectant and young mothers. Prenatal check-ups, education, transportation, well-baby checks and child immunizations are all provided by the Healthy Connections, Inc.
• Results: The program's results demonstrate an increase in first trimester prenatal care rates and child immunization rates, as well as a dramatic decrease in confirmed cases of child abuse.

Contingency Management Smoking Cessation in Appalachia

Updated/reviewed June 2022

• Need: To reduce smoking rates of pregnant women and adolescents in Appalachian regions of eastern Kentucky and Ohio.
• Intervention: A web-based smoking cessation program that offered monetary incentives to reducing smoking.
• Results: Participants significantly reduced smoking rates or quit altogether.

Other Project Examples

Moms Do Care EMPOWER (MDC-E)

Added February 2024

• Need: To support pregnant or new parents in rural Massachusetts affected by substance use or on medication for opioid use.
• Intervention: This program offers a medical and behavioral health home, providing trauma-informed support before, during, and after childbirth.
• Results: Six months after enrollment, there was a 20% increase in the number of participants who felt socially connected and a 5% increase in abstinence from all substances.

ROAMS (Rural OB Access & Maternal Service)

Added February 2024

• Need: To improve maternal health in northeastern New Mexico.
• Intervention: The Rural OB Access & Maternal Service program provides obstetric and maternal fetal medicine telehealth, home telehealth kits, and free access to lactation consultants and family navigators.
• Results: ROAMS has worked with 1,500 unique individuals since July 2021.

Mother's Milk Bank of South Carolina

Updated/reviewed January 2024

• Need: Neonatal Intensive Care Units (NICUs) across the state of South Carolina were purchasing breast milk from out-of-state milk banks for preterm infants.
• Intervention: The Mother's Milk Bank of South Carolina (MMBSC) opened 26 sites in South Carolina for breast milk to be donated, safely pasteurized, and delivered to NICUs across the state.
• Results: Over 19,178,739 ounces of milk have been donated to MMBSC depot sites and over 13,830,600 ounces of milk have been delivered to South Carolina NICUs.

One Health Recovery Doulas

Added October 2023

• Need: To support pregnant and parenting women with a history of substance use, mental health, or co-occurring disorders in rural areas of Montana.
• Intervention: One Health, a consortium of Federally Qualified Health Centers (FQHCs), developed a team of "recovery doulas" – individuals who are dual-certified as doulas and peer-support specialists. The One Health recovery doula program offers group and individual services to women and their partners from pregnancy through the first years of parenthood.
• Results: A team of nine recovery doulas (or doulas-in-training) employed by One Health offer services in ten rural Montana counties. Recovery doulas have provided essential support to women with substance use disorder, survivors of sexual abuse, unhoused individuals, and individuals facing other complex challenges.

Project Swaddle

Added August 2023

• Need: To reduce poor maternal and infant health outcomes and improve access to prenatal and postpartum care for at-risk pregnant women and recent mothers in Crawfordsville, Indiana.
• Intervention: A home visitation program that uses community paramedics to deliver wrap-around care to women experiencing high-risk pregnancies and/or social and environmental challenges.
• Results: Since 2018, more than 200 women have been served by the program.

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