Saving Our Babies Initiative Showing Promising Impact on Improving Birth Outcomes for Black Women
May 2, 2023
MADISON, Wis. – The Dane County Health Council (DCHC) and the Foundation for Black Women’s Wellness (FFBWW) are celebrating the one year anniversary of the ConnectRx Wisconsin program, a central component of the Saving Our Babies Initiative and its strategies to improve Black birth outcomes in Dane County.
The Saving Our Babies Initiative coalesced in 2018 as a result of the Dane County Health Council and partners joining forces in response to a 2017 community health needs assessment confirming that maternal and child health is one of Dane County and Wisconsin’s most pressing and persistent health concerns. Recent reports indicate that Dane County continues to have one of the worst Black infant mortality rates in the United States, accompanied by significant racial disparities in household income and a growing life expectancy gap between Black and white women. As documented in the Saving Our Babies Report, at the root of these disparities is the stress caused by economic insecurity, racism and bias in the daily experiences of Black women and their families, and disconnected and difficult to navigate community services.
Launched in April 2022 by the DCHC, FFBWW and partners, ConnectRx Wisconsin is a care coordination system designed to address these challenges at their root. The aim of the program is to reduce low birth weights for babies born to Black mothers by meeting the clinical and non-clinical needs of expectant mothers and their families. ConnectRx Wisconsin specifically supports Black pregnant women and birthing persons through a wrap-around service delivery model that connects both clinical and trusted non-clinical community providers who work together to support patients’ health, social, economic, mental health, and other resource needs. A clinic and community-based workforce of Community Health Workers (CHWs) and Doulas
provides additional assistance to highest risk patients, ensuring they are supported throughout their pregnancy and postpartum.
All Black pregnant women and birthing persons served by local hospitals and clinics are screened for social determinants of health. If a patient screens positive in one of the following social determinants of health—financial resource strain, food insecurity, housing stability, stress, or transportation—and they consent, a referral is made to ConnectRx Wisconsin. In addition, through the electronic health record, a curated list of resources pulled from United Way of Dane County’s 211 is provided to the patient.
Since its launch, more than 400 Black women have been screened and referred to ConnectRx Wisconsin, connected to a vast network of community-based partner agencies and programs providing family-stabilizing resources and services. With an estimate of roughly 600 births by Black mothers or birthing persons each year in Dane County, these referral numbers clearly show the need and uptake. Early results also indicate that Black women patients participating in ConnectRx Wisconsin are experiencing fewer C-sections, more full term births, and higher infant birth weights as a result of doula assisted births and deeper partnerships between clinical providers, patients and the community workforce that make up the wrap-around service model.
“We are encouraged by the early indicators of improvement we are seeing in the birthing experiences among Black women participating in ConnectRx,” said Kyle Nondorf, President of SSM Health St. Mary’s Hospital in Madison and one of the DCHC partner organizations. “Though we have much more to learn from our formal evaluation efforts, we are seeing evidence that our efforts are translating into a new standard of care for Black women and birthing people.”
Nondorf and others contribute these early signs of success to the unprecedented collaboration that the Saving Our Babies Initiative has enabled across its many partners to align priorities, share leadership, and to co-design community-informed solutions. The initiative continues to grow community capacity to address Black birth disparities by building and bridging critical clinical and community infrastructure for a unique and integrated care coordination approach.
In the community, ConnectRx Wisconsin participants are supported by FFBWW, which manages the initiative’s doula provider network and provides additional out-of-clinic CHW support. The Black Maternal Child Health Alliance (BMCHA) sits on the Health Council, informing the effort and providing broad leadership and advocacy locally and statewide. An additional network of trusted community based organizations and service providers are embedded in ConnectRx Wisconsin’s wrap-around support, accepting referrals to assist patients with housing, mental health, transportation, employment, and other critical family-stabilizing needs.
“What we’ve known all along and are demonstrating in these efforts is that viable, systemic solutions for Black women and communities must be co-built and co-led by Black women and communities,” said Lisa Peyton-Caire, CEO and President of the Foundation for Black Women’s Wellness. “We’re showing that innovation and real change in disrupting stagnant health and birth disparities emerge when systems listen to, partner with, and invest in community capacity. It works.”
Peyton-Caire and Annette Miller, president of EQT By Design, a co-partner on the project, say that ConnectRx Wisconsin is leveraging partner strengths and paving the way for Dane County to
become a ‘center of excellence’ for Black Maternal and Child Health. Black women and families are being centered in the work. Health systems are embedding deeper training and education for its leadership and staff to improve care delivery to Black women and birthing persons. Community-based organizations are connecting patients to local resources in tandem with CHW’s and Doulas. The collaboration between health systems and community partners is bridging previously disconnected systems, forming a safety net for those most impacted by inequitable health outcomes in the Dane County community.
“To see our collective efforts materialize this way in concert with Black women and community is confirmation that partnership is the answer,” said Renee Moe, President and CEO of the United Way of Dane County which has been a member of the Dane County Health Council for more than 20 years. “We are demonstrating the power of collaboration and collective impact in helping solve one of our community’s greatest and most pervasive challenges.”
As their work continues, the DCHC and partners understand the urgency of sustaining efforts for the long haul. Post pandemic data show that COVID-19 was likely a key driver of the more than 60% increase in deaths from pregnancy from 2019 to 2021. Black women and birthing people continue to face the biggest threats and now experience the highest mortality rates in recent memory; 69.9 deaths per 100,000 live births.
“The pandemic has and likely will continue to disproportionately impact Black birthing people and their families,” said Dr. Tiffany Green, co-chair of the Black Maternal and Child Health Alliance of Dane County and associate professor of Population Health Sciences and Obstetrics & Gynecology at the University of Wisconsin School of Medicine and Public Health.
Green, a health economist and nationally recognized expert on reproductive health equity, says continuing to center Black women, birthing people and babies is critical to mitigating the effects of COVID-19 on pregnancy- and birth-related outcomes. “This is not the time to drop our guard. Healthcare systems and providers must continue to protect the most vulnerable by holding themselves accountable to the communities they serve,” she said.
Ariel Robbins, Project Director for the Dane County Health Council, says initiative partners are encouraged by the positive early impacts that the Saving Our Babies Initiative and ConnectRx Wisconsin are yielding, but that there is much more to do to strengthen the work and to ensure its sustainability for the long haul. “We’re committed to doing our part to eliminate racial birth disparities in our community, but it will take a collective effort from all sectors and corners of our community to make it happen. The problem wasn’t created in a day, and it will not be solved tomorrow. But with the support and investment of everyone and every sector – from business, philanthropy, to economic development, housing, and policy – we have a fighting chance to save our babies.”
The Dane County Health Council is a coalition of healthcare providers, government and nonprofits with a mission to eliminate gaps and barriers to optimal health and reduce disparities in health outcomes in Dane County. Council members include Access Community Health Centers, Black Maternal and Child Health Alliance, Group Health Cooperative of South Central Wisconsin, Madison Metropolitan School District, Public Health Madison & Dane County, SSM Health St. Mary’s Hospital, United Way of Dane County, UnityPoint Health – Meriter and UW Health.