For the second year in a row, a community staple is getting financial support to expand its outreach and improve the health outcomes of women and babies. Mamatoto Village, a perinatal family support organization located in Ward 7, provides non-clinical assistance for DC expectant mothers. Recently the nonprofit received additional funding that will help it hire more helpers, boost salaries of select staff members and get educational materials.
Mamatoto Village has received a grant from March of Dimes for its Comprehensive Maternity Support Program (CMS), which involves wraparound support for mothers in pregnancy and postpartum. It pairs expectant mothers with perinatal health workers who provide prenatal and postpartum support to mothers and their families. Participants receive health education, care coordination and social support during pregnancy and throughout the infant’s first three months.
In operation since 2013, the program serves an almost exclusively African-American population in Wards 5, 7 and 8. The CMS program is designed to combat preterm deliveries, low birth weight and infant and maternal mortality and morbidity.
Aza Nedhari, CEO of Mamatoto Village, explains how the funding will be put to use. “This grant will allow us to continue to work with mothers in the program, doing prenatal and postpartum visits and establishing a birth control plan. The program is also going to address smoking cessation.”
She adds that funding can also help with goals beyond pregnancy. “Additional funding will help with things outside of the program like pathways to leadership where the clients work with team leaders. We can now offer an additional stipend on top of what they are getting paid. The education coordinator targets professional development. The rest of the grant will go to salary support and materials for the program.”
Pregnancy and Smoking
Pregnant women have been cautioned against tobacco use since the 1960s, but the addiction to nicotine can be a hard habit to break even during pregnancy. According to the Centers for Disease Control, 2.6 percent of expectant mothers in DC smoked at some time during pregnancy. The DC Department of Health Perinatal Health and Mortality Report for 2018 gives more specific data. It showed that 4.6 percent of non-Hispanic black mothers smoked during pregnancy, more than double their non-Hispanic white and Hispanic counterparts. Maternal tobacco use during pregnancy can lead to a number of health problems for the infant, including preterm birth, birth defects and low birth weight. Additionally, 20 percent of the preterm live births and 23 percent of low-birth-weight infants born to non-Hispanic black mothers in the District were of mothers who had smoked prior to pregnancy.
The Case for Space
When it comes to multiple children, timing matters. March of Dimes recommends that mothers try to plan for babies to be born at least 18 months or more apart. The intervals give the mother’s body time to recover. Wait time between pregnancies also reduces the risk of health problems that can occur later such as developmental delays and asthma.
Family planning is a service provided in the Comprehensive Maternal Support Program and was a selling point for March of Dimes to give the grant to Mamatoto Village. Anne Eder, maternal child health impact leader at March of Dimes, says Mamatoto’s vision and work was all the evidence they needed to decide to support the program. “We were excited by the fact that during the course of the program they offer support in two particular programs that we at March of Dimes have identified as important. One is smoking cessation and two to encourage the women to space their pregnancies at least 18 months apart so that they will have a greater likelihood of giving birth full term. Those were things that particularly attracted us to the program.”
The probability of preterm birth (being born before the 37-week benchmark) is elevated when the intervals between pregnancies are shorter. A study published in the International Journal of Obstetrics and Gynaecology in 2014 found that black women are at the highest risk for preterm births due to insufficient birth spacing. When babies are delivered prior to 37 weeks, they miss critical time in the womb when organs such as the brain and kidneys complete development.
The family planning service that Mamatoto offers can help women decide which birth control method best suits them in the postpartum phase and thus reduce the risk of getting pregnant again too soon.
Home Visitation Breaks Down Barriers
Optimal prenatal care is often envisioned as regular visits to a physician’s office to check on biomedical needs. But what about the social support that happens beyond the walls of the examination room, where will that come from?
Oftentimes expectant mothers, especially first timers, have questions, need assistance or want support as they go along their maternal journey. Home visitations by a perinatal professional can address those concerns on a private, one-to-one basis. Mamatoto Village recognizes the need to remain in touch with expectant moms outside office hours.
“Home visitation humbles the practitioner. It shifts the power dynamic,” says Nedhari. “When you’re in someone’s home and their personal space, you can see that person in a very different way. It centers the care around that individual person and not to the necessity of the practitioner. A lot of times with Medicaid- and Medicare-eligible populations there can be barriers to visits, particularly around transportation. There may be limited resources, and that person may be trying to get to you, but that ‘getting to’ is a barrier within itself. This gives us the option to say, ‘Do you want me to come to you or do you want to come to us?’”
Eder adds that home visits help educate the family so that they can provide a better safety net for the mom-to-be. “We focus on the mother, but we don’t want to overlook the home. There may be some other issues going on in the mother’s life. We offer support to the mom as well as the family to increase the likelihood of the baby being born full term and the mother gets the support that she needs. If the community worker identifies that there is a need in the home that should be addressed, they have the resources to refer the mother and family to the appropriate services.”
Healthy pregnancies lead to healthy mothers and babies, and that is the ultimate goal for Mamatoto Village and March of Dimes. With the right supports in place Mamatoto can continue the mission of caring for expectant mothers.
Candace Y.A. Montague is the health reporter for Capital Community News. Follow her on Twitter @urbanbushwoman9.