Last month, the National Association of County and City Health Officials (NACCHO) named Interconception Care, a Grand Rapids Health Department program, a Model Practice.
This title honors Interconception Care for its work in reducing infant mortality rates among high-risk Kent County women, particularly African-Americans. Mortality rates among African-American infants are three times higher than for white infants in Kent County.
The Model Practice designation gives the Interconception Care program the “recognition it deserves,” according to Peggy Vander Meulen, director of Strong Beginnings, the community initiative from which the Interconception Care program stems.
“Model Practice is the highest designation that NACCHO gives. It means that they think that this is a really effective model, and so it might be replicated by others.”
Interconception Care is a community coalition that began in 2006 with the goal of reducing infant mortality rates in Kent County. The program is aimed at improving the health of at-risk women who have recently had an adverse pregnancy outcome: low birth weight, premature birth, stillbirth or infant death.
Because women who have previously had an adverse pregnancy are three to four times more likely to have problems with their next pregnancy, the health of the mother between these pregnancies is critical.
Since 2007, 400 women have been enrolled in the Interconception Care program. Compared to the adverse pregnancies these women experienced previously, their later pregnancies show significant improvements.
After receiving care, women were pregnant an average of 5.5 weeks longer before giving birth, and their babies weighed an average of 2.3 lbs. more. Vander Meulen hopes that the program can receive additional funding to expand so they can do more to reach the “huge unmet need” of women who experience poor birth outcomes.
The issue of race is one major factor in the occurrence of adverse pregnancies. When Interconception Care started in 2006, Michigan had the third highest rate of African American infant mortality in the country.
“We are convinced that the underlying cause for the disparities in birth outcomes between people of color and whites is racism in all of its manifestations — individual, institutional, systemic and internalized,” says Vander Meulen.
“So because of that, a lot of our work [at Strong Beginnings] in addition to the Interconception Care program has been about promoting racial equity and dismantling racism. That’s woven into everything that we do.”
Women enrolled in Interconception Care are assigned a caseworker to help them create a custom plan to improve their health with the success of future pregnancies in mind. Vander Meulen cites this relational emphasis of Interconception Care as one of the factors that makes it a notable program.
“Over a period of 18 months, having a nurse or community health worker going to visit you in your home and forming this long-term, very supportive trust relationship is critical. And having that relationship enables the home visitor to connect the woman to needed resources that she may otherwise be reluctant to use,” said Vander Meulen.
Enrollees are educated about general wellness practices like diet, exercise, dental hygiene and the treatment of mental health issues. At-risk social situations are also addressed.
Three-quarters of the women enrolled are unmarried and their pregnancies unplanned; the same percentage are on Medicaid and have only a high school diploma or less.
“We realize that things like poverty, lack of education, domestic violence, racism — all of those things contribute to poor health and poor birth outcomes,” Vander Muelen said.
She describes Interconception Care’s approach as holistic because the case workers address the social as well as physical aspects of a woman’s health.
“[They address] things like helping her get a job, teaching her interviewing skills, helping her get housing or complete a GED. Whatever it is that the individual woman’s needs and goals are.”
Vander Meulen says that the most exciting thing for her in working with Interconception Care has been “seeing the amazing changes that the women and families that we work with make in their lives. It really is the families themselves that are making those decisions. We’re just there to help support them and help them give the tools and the skills that they need to make those changes and decisions.”
