Destiny Strong remembers being alone and pregnant about 30 minutes from the closest hospital with maternal care.
With several young children and a boyfriend in and out of jail, the Manchester mother often felt depressed and even suicidal with pregnancy-related issues such as high blood pressure and low iron, which led to poor diet and further health complications. She depended on family for transportation and advocated for her own health care, often discouraged when clinicians didn’t take her concerns seriously.
“I kept going back to the hospital and they sent me home,” said the mother of 5, ranging in age from 3 months to 4. “I had to keep going back almost every day.”
Strong’s situation changed late last year when she enrolled in Wellstar Health System’s new Healthy Start program for women and their families before, during and after childbirth in three West Georgia counties. She was eight months pregnant with her youngest at the time and believes she had an easier experience compared to previous pregnancies as a result of the program’s services.
Wellstar last year received a five-year $5.5 million grant from the U.S. Health Resources and Services Administration’s Healthy Start program to provide maternal care in Butts, Spalding and Troup counties. Wellstar believes it is the first health system in the region to receive the federal funding, implemented with local OB-GYN offices.
Patients who see Wellstar clinicians in Troup, Spalding or Butts can enroll in the Healthy Start program even if they live outside those counties.
Strong lives in nearby Meriwether County, but travels about 30 miles to Wellstar West Georgia Medical Center in Troup County for maternal care. The average travel time for Georgia women to their closest birthing center is 13.5 miles, according to a March of Dimes report last year on maternal care access.
About 42% of Georgia’s counties are considered maternity care deserts compared to the national average of about 35%, the report found. These counties may lack hospitals or birth centers offering obstetric care and access to obstetric providers. Other counties, such as Troop and Butts, have little access to maternity care, including hospitals and birthing centers with obstetric care and obstetric clinicians, and a higher proportion of women ages 18 to 64 without health insurance.
Georgia’s rate of preterm births, infant and maternal mortality are also higher than the national average, the March of Dimes reports.
Wellstar’s Healthy Start program attempts to bridge the gap in maternal care access in the most rural counties it serves by providing clinical and community services, including a case manager, nurse navigator, doula, and health educators, to improve maternal and infant health and prevent deaths. The program serves mothers, fathers, partners, other relatives such as grandparents, and children up to 18 months.
“I don’t feel like I’m in this alone. I have a caseworker and a doula if I need anything. I feel like my health improved. I’m finding the joy in more things I do.”
Credit: Destiny Strong
Credit: Destiny Strong
Her OB-GYN, L. Joy Baker, said Destiny had preeclampsia, a common but potentially deadly pregnancy complication involving high blood pressure, following her youngest son’s birth. Preeclampsia can lead to seizures, stroke and heart failure if not treated early and appropriately, Baker said.
“It’s the number one reason patients are readmitted after the birth,” said the West Georgia Medical Center doctor. “She might not have noticed the post-birth warning signs.” Her doula was able to teach Destiny that her headaches and elevated blood pressure meant she was experiencing serious complications. “Her doula was very hands-on and went to the ER with her and she was able to access appropriate care.”
Credit: Wellstar Health System
Credit: Wellstar Health System
Before the Heathy Start program, Wellstar patients saw an OB-GYN or other clinician during their pregnancy. But then they might not return for post-pregnancy care for about a month, Baker said. “That model did not serve our patients well. There were gaps in education, communication, and certainly gaps in urgent follow-up if the patient needed it.”
Now doulas offer patients continuous support and keep in touch with clinicians and the care team, which regularly checks on the patient between their medical appointments, she said.
A case manager also arranges appropriate care along with insurance coverage, which tends to be through Medicaid, and connects patients with community resources such as housing, food, employment, transportation, child care services, health education and parenting classes.
“I believe this will change maternal mortality statistics in these counties,” said Baker, one of 10 health care clinicians at West Georgia Medical Center in LaGrange participating in the Healthy Start Program. She estimates her practice enrolled about 100 patients in the program so far.
The larger Wellstar Healthy Start program has enrolled more than 600 participants so far toward its goal of at least 700 a year as part of the grant requirements, said program director Khristen Flennoy. The HRSA grant supports the daily operations of Flennoy and a staff of 14 coordinating patient care, prenatal education and community services, she said.
Credit: Cameron Mitchell
Credit: Cameron Mitchell
The Healthy Start program also tries to address disparities in health care. Nearly half of all births in Georgia are covered by Medicaid, particularly in non-metro areas, where families tend to have lower annual earnings, Baker said.
In addition, maternal mortality rates for Black non-Hispanic women were more than double that of other race categories, according to the latest figures from the Centers for Disease Control and Prevention.
“By reducing maternal mortality across the board, we hope to address the unique needs of Black mothers as well,” Baker said. “The Healthy Start program helps us find the secret sauce between high qualify, safe and respectful care and the patient and family experience really making a difference when it comes to improving maternal and infant outcomes.”
Adding Wellstar to Georgia’s community-based nonprofits and public health organizations receiving Healthy Start funding “is a testament to the persistent issues and problems” of poor health and death risks facing mothers and infants in the state and the need for varied groups to work together to reduce them, said Jemea Dorsey, CEO of the Center for Black Women’s Wellness in Atlanta. The center, which serves patients in the metro area, has received Healthy Start funding since 1998.
The center reported that its Atlanta Healthy Start Initiative helped 755 men, women and children last year. Among its accomplishments, the initiative helped 95% of pregnant participants receive early prenatal care and 82% a postpartum visit within 12 weeks of their delivery.
Women and children received preventive health visits, 86% and 96% respectively. Nearly all women in the program, 99%, were screened for interpersonal violence and depression, the initiative reported. The initiative’s 2024 benchmarks exceed national averages, it reported.
Flennoy said Wellstar hopes to expand its Healthy Start program from the West Georgia rural counties to elsewhere across the health system service area.
Roni Robbins has been a journalist for 37 years. This is her second stint as a freelance reporter for the AJC. She also freelances for Medscape, where she was an editor. Her writing has appeared in WebMD, HuffPost, Forbes, NY Daily News, BioPharma Dive, MNN, Adweek, Healthline and others. She’s also the author of the award-winning Hands of Gold: One Man’s Quest to Find the Silver Lining in Misfortune.
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