A new health care program developed by University of Illinois Chicago researchers and Melanated Group Midwifery Care, or MGMC, that aims to combat disparities that affect maternal and infant outcomes for Black pregnant people has received $9.9 million in funding.
The five-year award was granted by the Patient-Centered Outcomes Research Institute, or PCORI, an independent, nonprofit organization authorized by Congress in 2010 to fund research that will provide patients, their caregivers, and clinicians with evidence-based information needed to make better-informed health care decisions.
Black women are four times as likely to die from complications related to pregnancy or birth, compared with white women, and an estimated two-thirds of those deaths could be prevented. Because of structural racism, Black women face barriers to high-quality maternity care and support, resulting in less trust and engagement with the health care system, according to the project’s proposal.
“No single intervention has been shown to move the bar on maternal morbidity and mortality, especially for Black pregnant people. We need to change the whole paradigm, beginning with centering the needs and expertise of Black mothers,” said Kylea Liese, UIC assistant professor of human development nursing science and co-principal investigator.
The program is part of a study that will compare the usual maternity care received by most people to a new care model that combines strategies to improve Black people’s experiences and outcomes during pregnancy and postpartum.
“We know the racial concordant care model is successful in all ethnicities, yet there is a lack of melanated midwives. We hope this study will highlight the importance of color and advocating for diversity,” said Karie Stewart, UIC adjunct faculty member and the study’s lead co-investigator. Stewart, who also is the director of midwifery services at the University of Chicago, runs Melanated Midwives, a not-for-profit organization that supports and promotes the diversification of the midwifery workforce, and the project’s community partner.
By combining four evidence-based strategies, the project aims to show how racially concordant care providers, and longer term, coordinated care can improve pregnancy outcomes for Black patients.
The strategies are:
- Black patients receiving prenatal care from a Black midwife;
- Prenatal care is provided in a group setting with a cohort of 8 to 10 other Black patients with similar due dates;
- Maintaining connections with the health system and community resources through a proactive care coordinator who is a Black, licensed nurse;
- And, after having their babies, patients will be supported in their homes by a trained postpartum doula, who is Black, for up to a year postpartum.
Stewart said research on health disparities and maternal outcomes does not typically include observing care in its entirety from prenatal through postnatal, making this study unique.
“Research shows complications happen in those first days and can carry through up to one year of postpartum. We want to test the idea of care coordinators and postpartum doulas who facilitate with prenatal and postnatal care, so patients’ concerns can be addressed without having to wait until their next doctor’s appointment,” she said.
Stewart said they plan to enroll 432 women in their first trimester of pregnancy. Half of the participants will be randomly assigned to the Melanated Group Midwifery Care model and the other half will have their usual one-on-one care with a midwife or obstetrician.
Participating patients will complete surveys about their health and health care, and the research team will review their medical records for data about health outcomes for women in both groups. Some participants and all MGMC providers will be interviewed about their experience with the maternity care model at their clinic. Women in both groups who experience complications will be interviewed to better understand how these different models impacted the healthcare experiences and pathways.
Stacie Geller, UIC professor of obstetrics and gynecology, is a principal investigator.