Recommendations at a glance
The AMCHP (Association of Maternal and Child Health Programs) Compendium identifies recommendations for improving birth outcomes in seven broad areas, and aligns them with the Frieden’s Health Impact Pyramid. This approach was taken in order to present a comprehensive, multi- level framework that states can use in their efforts to improve birth outcomes.4
In looking at the recommendations identified by the Coalition, there was clear symmetry in how they aligned with the AMCHP Compendium. The Coalition wanted to utilize a framework that would ensure a comprehensive approach that would impact different levels of community and multiple populations. To that end, the Coalition grouped its priority recommendations based on the different tiers and recommendations in the AMCHP Compendium. This also became a strategy for implementation as the Coalition will recommend the implementation of a multi-tiered approach tier to deliver a comprehensive initiative to improve birth outcomes in the state of Connecticut. Following is a complete listing of recommendations and strategies organized by tiers. Those that were selected for priority action are depicted in boxes and elaborated on in the main part of the Plan. The other ones are briefly elaborated on in the Appendices section of the Plan.
1A: Raise awareness among legislators, leaders, and administrators about social determinant of perinatal health and the Life Course perspective
1B: Invest in preventing and mediating early life trauma and violence
1C: Identify opportunities to reduce stressors affecting families during the interconception period
1D: Increase provider knowledge of community resources addressing social needs (housing, food, childcare, legal aid, and transportation)
1E: Identify and implement strategies aimed at reducing/eliminating institutionalized racism
1F: Create supportive housing initiatives for pregnant women and their families
1G: Integrate financial literacy into family planning and counseling services, as well as in other relevant programs serving MCH populations
2A: Establish and evaluate pilot projects involving holistic MCH medical home models
2B: Integrate mental health, oral health, and wellbeing into hospital-based perinatal education models, group prenatal care, as well as home visiting programs
2C: Create trauma-informed environments for pregnant women, Infants, and their families
2D: Establish a statewide community health worker system similar to the one in Massachusetts: this can include models involving lay home visitors, community doulas, preconception peer educators, peer breastfeeding counselors, oral health, etc.
2E: Engage in a broad effort to reduce maternal fear and stigma about the spectrum of emotional and psychological complications of pregnancy and childbirth by increasing provider-patient communications, including perinatal mental health in childbirth education programs, raising public awareness, and developing a coordinated system of treatment and care
2F: Expand person-centered care model (PCCM) to include women’s health, including oral and
mental health, with a Life Course approach
2G: Expand state Husky to undocumented women and families
3A: Support the provision of preconception health care throughout the childbearing years.
3B: Integrate Life Course education into provider training.
4A: Support the provision of behavioral health services and oral health care throughout the life course and during the perinatal period
4B: Integrate into provider training mental health, social stressors, and trauma education relevant to infants and families
4C: Increase access to midwifery care for all women considered low-risk (medically)
4D: Increase access to childbirth and postpartum doula services (Medicaid reimbursement; adding doula care to existing home visiting services)
5A: Scale up (or continue investing) in fatherhood initiatives to increase social support within the family and home environment
5B: Integrate education and preconception and interconception health including mental and oral health, into hospital-based prenatal education models, group prenatal care, as well as home visiting programs
5C: Integrate mental health and well-being into the State Department of Education school health curriculum
5D: Integrate Life Course education into the State Department of Education school health curriculum
5E: Engage in a broad effort to raise awareness of the important relationship between emotional and psychological wellbeing and physical wellbeing
5F: Raise consumer awareness about the midwifery model of care and available midwifery options.