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provider accused her of just wanting more pain medication . “ And then I went back a couple of days after because it was to the point where I couldn ’ t walk , I couldn ’ t really hold my daughter , I was struggling to move pretty much . And then they found out that it was very infected , so she apologized to me and said that she was sorry for accusing me of just wanting more pain medicine basically .”
These are only a few experiences listed in the newly released report , A Qualitative Assessment of Prenatal Care and Prenatal Care Access in Jefferson County , 1 sponsored by Ready for K Alliance , 2 the Louisville Metro Department of Public Health & Wellness ( LMPHW ) 3 and Metro United Way , 4 with support from the James Graham Brown Foundation – Louisville , 5 to provide a better understanding of barriers expecting and new parents face in our community – specifically Black , immigrant and refugee parents and those who have experienced substance use disorder .
The 2017 Louisville Health Equity report 6 highlighted the fact that Black women and women with lower levels of income have inequitable rates of preterm birth , low birth weight and maternal and infant mortality . For example , in Jefferson County , babies born in West Louisville neighborhoods die at twice the rate of babies born in other parts of the city , and more than triple the rate for white newborns .
These devastating impacts can be avoided , and voices from parents with lived experiences can help lead the way . Here are a few recommendations based on the findings in the report :
• Work with and respond to parents to make sure they feel heard . Parents valued building trusting relationships and rapport with providers . Parents wanted to know the people who provided pregnancy care , including at the time of delivery . They wanted to be sure that these providers valued parents ’ birth plans and interests .
• Increase access to caseworkers , doulas and other advocates for parents during prenatal care .
• Increase the presence of Black women and nurse midwives in obstetrics ( OB ) settings .
• Promote options for births outside of the hospital , vaginal birth after Caesarean ( VBAC ), unmedicated births , water births and models of care such as midwifery .
• Increase support following delivery – i . e ., breastfeeding , mental health / postpartum depression and postpartum-related assistance and care .
Maternal health and healthy birth outcomes are crucial to the future well-being of Louisville families . Parents told us that they want more relational , respectful and culturally competent services from their health care providers . Our organizations pledge to do more to elevate the voices of parents like those who participated in this study . We envision new opportunities to learn from their lived experiences , their recognition of community assets and their recommendations for more inclusive systems of care . We believe that learning from and working with families is the best way to co-create a healthier future for Louisville parents and children .
References
1
https :// louisvilleky . gov / health-wellness / document / qualitative-assessment-prenatal-care
2 http :// www . readyforkalliance . com /
3 https :// louisvilleky . gov / government / health-wellness
4 https :// metrounitedway . org /
5 https :// jgbf . org
6 https :// louisvilleky . gov / government / center-health-equity / health-equity-report
Dr . Moyer , a family medicine physician , is the Director of the Louisville Metro Department of Public Health and Wellness through June 31 . In July she begins a new role as Chief Medical Officer for Humana ’ s Medicaid business in Kentucky – Humana Healthy Horizons .
Adria Johnson is the President and CEO of Metro United Way .
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