Maternal health care mobile clinic offers antenatal and postpartum care –

In what is known as a hotspot for maternal mortality in the United States, Mallory Mpare seeks to make a difference for pregnant women of color in the district through a mobile health clinic that provides comprehensive care to parents and children. babies in rooms 7 and 8.

The Mama and Baby Bus offers free services, including prenatal, postpartum and general reproductive care.

Mpare, 34, is the DC chef de mission for March of Dimes’ Better Starts for All program. The national non-profit organization aims to bring maternal health resources and programs on the ground to maternity care deserts – areas where few, if any, hospitals offer access to obstetric care, to maternity care centers. birth or obstetrician-gynecologists or midwives.

The Mama and Baby Bus also offers STD screenings, contraception consultations, breast exams and Pap tests.

“Anything you could do in a fixed clinic, you should be able to do in our mHealth clinic,” said Mpare, who has lived in the district for more than 10 years.

The bus itself is run by midwives, a choice meant to encourage patients to develop one-on-one relationships with their providers, according to Mpare.

“We want to make sure we have a community focus,” she said of this and other decisions about program operations.

Monique Stevens in the “Mama and Baby Bus” (Photo by Kaela Roeder)

No hospital east of North Capitol Street provides midwifery care, which is “heartbreaking” for Monique Stevens, a 39-year-old nurse practitioner and midwife with nine years of maternal health experience.

“There is a good chance that [the patient] may not follow through because she can’t get to that other location to get this ultrasound or to perform this procedure, ”Stevens said during the patient referral. “It can cause sleepless nights. “

The bus runs every other Friday and turns between the Marshall Heights Community Development Organization in Ward 7, the Far Southeast Family Strengthening Collaborative in Ward 8, and the University’s Capital Region Health Medical Group. from Maryland to Laurel, Maryland. The mobile clinic is only accessible by appointment, with some leeway in the event of an emergency. (To make an appointment, dial 301-437-5788 on weekdays between 9 a.m. and 4 p.m.)

The “Mama and Baby Bus” debuted in February and provides services including prenatal, postpartum and general reproductive care. (Photo by Kaela Roeder)

Insurance is not required, allowing people ineligible for Medicaid, including non-U.S. Citizens, to receive care. Immigrants are one of the main recipients of services on the bus, Stevens said.

“A lot of women feel like when they move to a country they don’t have any care or help,” Stevens added. “And that’s what this bus is here for, is to try to help them.”

Stevens began her career in the military, where she worked in labor and delivery. She was stationed across the world, including Japan, Iraq, Germany, and California.

“I fell in love with women and women’s health,” Stevens said of the way forward to focus on access for families of color to quality care. “And that led me to become the intersectional practitioner that I am today. It warms my heart to be able to take care of women.

In its role with March of Dimes, Mpare works with local community partners, hospitals and organizations to expand the group’s programming and ensure families have access to quality care. The Mama and Baby Bus began operating in the district in February.

Originally from Chapel Hill, North Carolina, Mpare previously worked in women’s health policy and advocacy roles for about a decade. In the district and cities around the world, Mpare has seen firsthand how racism fuels the negative consequences of childbirth and maternal care, she added.

“Seeing how stark the differences are … for black women and other women of color and non-black women is really what made me want to do something actionable to improve these results,” Mpare said. “We know what indicates what a person’s health might be, is their race, their ethnicity. … It’s really racism that shapes the results of these people.

According to data from the nonprofit United Health Foundation, the maternal mortality rate in the district in 2019 was 35.6 per 100,000 live births, compared to a national rate of 29.6. The rates for black women are about twice as high: 71 deaths per 100,000 live births, compared to 63.8 nationally.

Across the country, more than 7 million women of reproductive age live in an area where there is no or limited access to maternity care, according to a 2020 March of Dimes report. In DC, the level of access varies depending on whether one looks at the city as a whole or at specific neighborhoods or neighborhoods.

“What we do know in DC is that it’s a very resource-rich area,” Mpare said. “There are many hospitals and universities that have access to world-class doctors. But this distribution of suppliers is not evenly distributed across the city.

Medical racism has affected black women in various ways since the beginning of modern healthcare in the United States. J. Marion Sims, known as the father of gynecology, spent years in the 1840s conducting experiments without consent on enslaved black women.

In the 1990s, state lawmakers introduced bills that, if passed, would have given women convicted of drug use during pregnancy or child abuse a choice between using the Norplant contraceptive – a contraceptive implant that has been found to have serious side effects – or serve a prison sentence. Women of color and those living in poverty were targeted by this bill in what one article saw as an effort to “reduce the underclass”.

Similar abuses still occur today. In December 2020, more than 30 inmates and former inmates at a U.S. immigration and customs control center in Georgia underwent unwanted or unnecessary gynecological procedures.

As these harsh realities persist, DC is making an effort. lawmakers to bring comprehensive maternal care to wards 7 and 8: Earlier this year, Christina Henderson, a member of the General Council for the first term, proposed the Maternal Health Resources and Access Act, a draft law to fill gaps in maternal care through transportation subsidies and reimbursement. program for doulas via Medicaid.

On the recommendation of the Health Committee, the DC Council allocated funds for the legislation in its version of the FY2022 budget, which got final approval last week but still needs the mayor’s and signature’s signature. consideration by Congress. Meanwhile, the budget support law includes language allowing the establishment of doulas as a profession regulated by the Medical Council.

By funding the legislation, the council budget provides $ 480,000 per year to cover travel expenses to and from appointments starting in October 2021. Reallocated funds from the US bailout will also be used for reimbursement. Medicaid for doula and midwifery services from fiscal year 2022 to 2024.

Legislation like Henderson’s is new, and there is no blueprint for what the services offered would look like in practice, according to Mpare. But programs like doula reimbursement appear to be a “promising practice” in expanding access to care, she said.

“It’s really exciting,” she said.

This article was co-published with Street Sense Media.

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