Community-led initiatives nurture maternal health in American Indian and African American communities

MINNEAPOLIS – A roundtable discussion Friday at the Minnesota Indian Women’s Resource Center spotlighted vital work to support healthy pregnancies and improve birth outcomes in American Indian and African American communities. Lieutenant Governor Peggy Flanagan, Human Services Commissioner Jodi Harpstead and Deputy Commissioner Nikki Farago listened to community leaders and families talk about their experiences and challenges.

With financial support from the state through the Integrated Care for High Risk Pregnancies program, community-led care collaboratives are promoting integrated care and enhanced services for pregnant people at risk for adverse birth outcomes. The collaboratives strengthen partnerships between pregnant and parenting people, community organizations, clinics, community health workers and doulas.

The goal is to decrease some of the nation’s worst racial disparities in birth outcomes through direct support of American Indian and African American communities in Minnesota. The integrated care approach reduces risks during pregnancy, improves care for American Indian and African American pregnant people and their partners, and results in better birth outcomes.

“The crisis we are facing in maternal health across both our state and country – particularly for Black and Indigenous parents and babies – is unacceptable,” Flanagan said. “That’s why our administration has prioritized investments that protect and promote the health and safety of babies, moms and new families. As a Native mom, I’m proud of this work to improve outcomes for high-risk pregnancies so that every new family gets their best possible start.”

Integrated Care for High Risk Pregnancies care collaboratives serve both parents, support workforce and leadership development in the community, and engage in broader education and advocacy for the health of pregnant people, positive parenting and early childhood brain development.

“This program is an important way for us to improve racial health equity in Minnesota,” Harpstead said. “We worked with communities to create this model, and the communities are leading the work. It’s inspiring to hear firsthand about the difference this approach is making.”

Despite the state’s overall low rate of adverse birth outcomes, Minnesota has some of the nation’s highest disparities for these outcomes for African Americans and American Indians, compared to white residents. Adverse outcomes include prematurity, low birth weight and infant mortality. Infants with low birth weight are at substantially higher risk of death in their first year. Addressing the psychosocial needs of pregnant people and providing early access to high-quality prenatal care reduces the risk for low birth weight.

Integrated Care for High Risk Pregnancies began as a pilot program with funding from the 2015 Legislature. Lawmakers approved additional funding to expand the program in 2021. It’s available in regions with the highest concentrations of African American and American Indian births in Medical Assistance, Minnesota’s Medicaid program. Medical Assistance covers 40% of births in the state, including about 90% of American Indian births and 80% of African American births.

Another recent change significantly improves support for new parents after giving birth. As of July 1, Medical Assistance covers postpartum care for 12 months, up from only 60 days before the change.

“Giving birth is one of the most significant medical events in a person’s life,” Farago said. “This investment in community-led care collaboratives and the expansion of Medicaid postpartum coverage are important steps to support Minnesota families, address structural racism and get us closer to a state where all children have the opportunity to reach their full potential.”