Biden administration announces expansion of maternal home visit programs

(CNN) — A colicky baby and the lack of support led first-time mom Fatima Ray to call a number at the library offering parenting help.

It put her in touch with a home visiting program, in which trained professionals such as health-care workers, teachers and social workers help new moms with services such as breastfeeding and postpartum care as well as providing resources for young children such as developmental screenings and preparing them for school.

“I was prepared, but I wasn’t prepared for what being a new mom was like without any support besides my then-boyfriend. He’s my husband now. But at the time, it was just the two of us,” Ray said.

Home visiting programs like the one that helped Ray will be expanded as part of new investments aimed at improving maternal and early childhood health care, announced Tuesday by the Biden-Harris administration.

About $440 million will go toward the home visiting program for women and babies, and $118 million will go to the US Centers for Disease Control and Prevention to help “better identify and prevent pregnancy-related deaths.”

The services from the Maternal, Infant, and Early Childhood Home Visiting Program can be a lifeline for mothers like Ray, who says the home visitor “made a huge impact” in her family’s life.

Whether helping Ray decode her new baby’s cries, answering her questions about sleep or providing her with lactation consultants, the home visitor worked with them for several years, until the family relocated.

Ray’s home visitor also helped guide the new mom through decisions about her future, encouraging her to go back to school for her master’s degree.

“I would say that as a participant in the program, it changed my life, and now I’m able to help other moms reach their goals,” she said.

Ray is now a maternal health coordinator for the Primo Center for Women and Children, which helps provide health care, housing and early childhood development services for underserved communities in Chicago.

Ray works with pregnant mothers, preparing them for their new babies and talking to them about their careers and their mental health, including postpartum depression. The center offers new mothers clothing, diapers and even child care, she said.

“I help them realize who are your support systems and garner community with that. Sometimes, it doesn’t look like what you think it is supposed to look like, but you do have support in certain areas,” Ray said.

US Department of Health and Human Services Secretary Xavier Becerra said Tuesday that the model “aims to reduce disparities in the access and treatment that women receive for their time during pregnancy and right after. It’s a way to, again, address the deficiencies we see and to address health inequities that we also find.”

There are 167,000 participants in the program, and the new investments are expected to reach 30,000 more people, according to Carole Johnson, administrator of the Health Resources and Services Administration.

The new investment focuses on programs that offer long-term support. It doesn’t apply to short-term programs that help families during “the fourth trimester,” such as Family Connects Oregon, which offers up to three home visits by a public health nurse to all families with newborns.

“We are hopeful that our national leaders and Members of Congress will recognize the need that all families have for support in the ‘fourth trimester’ period and will ensure there are Federal funds available for this much-needed short-term service which can be very helpful in identifying families who could benefit from long-term home visiting and connecting them to those programs,” Kimberly Friedman, the chief program officer of Family Connects International, told CNN.

Oregon state Sen. Dr. Elizabeth Steiner, who is also an adjunct associate professor in Oregon Health & Sciences University’s Department of Family Medicine, told CNN’s Meg Tirrell that programs like Family Connects Oregon are important to prevent infant mortality and can also decrease new mothers’ health care problems, such as anxiety and postpartum depression.

“It’s one thing to have the baby’s doctor say something about it in the confines of a doctor’s office. It’s a totally different thing when the nurses in your home and says, ‘Hey, can I take a look at your sleeping arrangements and help you find something that works well for all of you and keeps your baby safe?’ That’s a very different conversation, so that can help reduce infant mortality,” Steiner said.

“We are way behind the curve in the United States, and it’s one of the reasons that the United States has some of the highest infant and maternal mortality in industrialized nations in the world. And that’s not a status to be proud of. So the more we can do to offer these kinds of services to families when babies come home, the more likely they are to have healthy moms and babies and change the trajectory for them in the future.”

The rate of women dying in pregnancy, childbirth or postpartum in the United States is much higher than in other high-income nations, although there have been recent improvements.

A report published this summer pointed to the US health-care system, policy differences and maternity care deserts – where residents have limited or no access to maternity health care – as factors driving the high maternal mortality rate. The maternal death rate for Black women is also higher than for other women due to barriers to accessing adequate health care.

On Tuesday, HHS also announced $118 million in funding for the CDC to go toward establishing a public health infrastructure that can review deaths that happen within a year after a pregnancy, determine whether they were preventable and propose solutions for the future.

“Every pregnancy-related death is a tragedy for the family and the community,” said Dr. Wanda Barfield, director of the CDC’s Division of Reproductive Health. This investment “will support more jurisdictions in their critical work to save mothers’ lives,” she said.

CORRECTION: This story has been updated to reflect that Family Connects Oregon is not part of the Maternal, Infant, and Early Childhood Home Visiting Program and corrected Kimberly Friedman’s affiliation.

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