When the healthcare system doesn’t work for women, community workers in Kansas City try to fill the gap. KCUR

Marcella Metcalf stands outside Nurture KC’s offices in Westport as she prepares to welcome 25 families with newborn babies.

She and her fellow Kansas City Community Health Workers, University Health and Training KC, a non-profit organization focused on improving the health of mothers and children. Metcalf is a Lead Community Health Worker at Nurture KC.

As the mother parks her car and approaches the back door of the office with her newborn daughter in her arms, Metcalf closes the distance to greet her and meet the baby. This time it contains mango, strawberry and baby carrot.

Metcalf said she was always drawn to working with her mother. After studying social work in Ecuador, Metcalf worked as a medical interpreter and bilingual family support in Tulsa, Oklahoma. Almost six years before him, Metcalf moved to join his Nurture KC.

She soon realized that pregnant or new mothers and their babies face many barriers.

“A very big problem I see is transportation to visits,” she said. “We also see a shortage of health care. Right now people, especially women from other countries, are having a very hard time getting medical care.”

Both Missouri and Kansas suffer from poor birth outcomes compared to most parts of the country.

Between 2018 and 2020, Missouri had the 12th highest maternal mortality rate in the nation and Kansas had the 17th highest. According to the Kaiser Family FoundationKansas had the 12th highest infant mortality rate in 2020, and Missouri had the 19th highest, according to the CDC.

The Wyandot County maternal mortality rate is 83.5 per 10,000 live births, with a state average of 61.9.

in the March of Dimes Latest Report Card For preterm birth rates, Missouri was D-, the 16th worst in the nation. Jackson County, Missouri received an F. Both are below the national grade of D+.

A Nurture KC community health worker loads a cart with maternal produce from University Health

For a limited time, Nurture KC partners have partnered with University Health to provide fresh produce to families with newborns. Some children take diapers.

Marvia Jones is Director of the Kansas City-Missouri Department of Health. Jones is particularly concerned that Kansas City is improving mortality and morbidity among white women, but not among women of color, especially black women.

Jones points to higher hospitalization rates, more complications during the birth process, and poorer mental health.

“We know that poor maternal health is not only a factor in what happens when these women show up at the hospital, but also has to be related to the broader social fabric. “There is something about the environment and living conditions of these people that leads to more social determinants of health concerns.”

Black mothers often feel neglected or neglected by health care professionals during pregnancy, Jones said. I’m here.

It’s where groups like Nurture KC try to meet the communities they’re in. Nurture KC focuses on the 14 metropolitan zip codes with the highest infant mortality rates.

Missouri zip codes are 6109, 64111, 62124, 64126, 64127, 64128, 64130, 64132 and Kansas 66101, 66102, 66104, 66105, 66106, 66111.

Metcalf recently met an expectant mother in one of those zip codes. She will continue to work with the baby until she is 1.5 years old as part of a federally-approved program. healthy start programNurture KC is one of 101 such programs nationwide and one of two programs located in Missouri, the other working at the booth.

Metcalfe and her mother reviewed safe sleep instructions.

Sudden infant death syndrome (SIDS) is the unexplained death of an infant under the age of one year. This syndrome is also called crib death because it occurs while the infant is asleep and is the leading cause of death in infants from the first month of life to her one year old. Year.

Sleep-related deaths are particularly disappointing, Metcalf said, because most of them can be prevented with education and outreach, such as having mothers leave their cribs empty or babies lying on their backs. .

Now it’s her mission to make more mothers aware of the recommended habits.

“If you can’t come, I’ll go to your house and do a home visit,” Metcalf said. “The most important thing is to pass on information and education.”

Marcella Metcalf car seat

Marcela Metcalf (left) and an expectant mother demonstrate the proper use of a stroller seat.

After the safe sleep instruction, the mother leaves with a crib and car seat for her baby. Pregnant and new mothers can also earn points for attending appointments and redeem them for other useful baby-related items.

Metcalf is one of seven community health workers, each working with 25 to 40 families. Nurture KC executive director Tracy Russell said the community health worker model is critical to their success.

“Healthcare workers in these areas have a personal, one-on-one relationship,” Russell said. “They become very credible advocates for the mothers and those children they serve.”

Mothers’ work can range from education to helping them access health care and housing.

Nurture KC’s community health workers also train to become doulas, professionals who provide guidance and support before, during and after childbirth.

Hakima Payne is Wuzazi Village, a non-profit organization working to improve infant and maternal health in black and brown communities. On staff are her eight culturally matched doulas, who reflect, and sometimes grew up in, the communities they serve. She recommends that clients choose a home birth or birth center if eligible.

“The current health care system has failed us as Black women and until the system chooses to reform itself, Black women are better off going out of the system to care for themselves. That’s our argument,” said Payne.

In the last 10 years, 15% of clients in Uzazi village gave birth outside of hospital. 9% gave birth in a birthing center with a doula and 6% at home with a midwife and doula. Payne said this shows that efforts to educate mothers about their options are working.

Marcela Metcalf of Nurture KC looks at items moms can earn through a points system, such as diapers, backpacks and bathtubs.

Marcela Metcalf of Nurture KC looks at items moms can earn through a points system, such as diapers, backpacks and bathtubs.

The data also show improved outcomes for mothers who used doula services in Uzazi Village. However, for many people, doula services are too expensive. Some states offer reimbursement for these services through Medicaid, but Missouri is not included.

Payne believes all states will pass legislation that will give them easy access to cost-effective ways to improve the health of mothers and their babies. She said that focusing on culturally competent doulas that reflect the communities they serve reduces racial disparities.

“I think cultural fit is a key piece that we’re missing,” Payne said. “Our doulas are trained to be really knowledgeable about the healthcare system and the gaps in it. because it is intended to

Payne is optimistic about legislation to support doula services, but worries about the big picture.Missouri Legislature Tries to Block Anti-racism training for health care providerswhich may make it harder to improve birth outcomes for black and brown babies and their parents.

“(Anti-racism training) is exactly what I want to be at the top of my list to improve things for people who have black children,” Payne said. , they don’t really know what to do about it. ”

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