Rural Maternity and Obstetrics Management Strategies (RMOMS): West Virginia Perinatal Partnership
The Georgia Health Policy Center recently spoke to Shauna Lively, who serves as a nurse with the West Virginia Perinatal Partnership and the outreach education director and project director for the West Virginia RMOMS, which serves an eight-county region.
To date, what has been the biggest accomplishment or win in your program?
This is our planning year, so we have been working over the past nine months to get the data piece together. Data is really important — if you do not have the data, you cannot prove that you did anything. We are bringing together some teams that have never really worked together before, including the West Virginia Health Information Network, which is our health information exchange, and the Federally Qualified Health Centers, and the research group at Charleston Area Medical Center that will pull all the data together and help develop our plan.
What is a tip that you would share with an organization launching a similar RMOMS program?
A big tip is to open your junk email! We did not know that we had this notice of award sitting in our executive director’s junk box for weeks. In all seriousness, though, go ahead and plunge in. I was a little hesitant to bother people — to pick up the phone and call people and say, ‘We got the grant we need your help.’ I did not start that as early as I probably should have, so I would say just hit the ground running.
Also, I think the biggest thing with RMOMS, and the success of our perinatal collaborative, is relationships. I celebrate and award people when I can, like if somebody has decreased C-sections in their hospital or initiated a certain program or completed an initiative on OB emergencies. We give them framed awards. I think it is important to celebrate people and build relationships by going into their hospitals, going into their clinics and seeing what they are going through on a day-by-day basis.
How do you see participation in the Federal Office of Rural Health Policy’s Office grant program impacting your broader health improvement efforts?
If you would put your hand right in the middle of West Virginia, you would find that there are no providers right there. And we included two of the counties that are a little bit north that do have delivering hospitals. If I could show you a drive-time map, you would see that some of these women have to drive over two hours to get to their prenatal visit or to get to delivery — and in the winter over these rural two-lane roads, it is not a good thing. Accessibility should not deter health care delivery services.
The West Virginia Perinatal Partnership is a collaborative that was initiated in 2006. We found that we had silos in West Virginia — the three medical centers were working in silos. We wanted to learn from each other and grow.
At the Perinatal Partnership, we are not service providers, but have been working on outreach education — educating health care providers. The Partnership has a Drug Free Moms and Babies (DFMB) program that has enabled 17 DFMB treatment and counseling sites throughout West Virginia. We enhance maternity care through legislation, such as getting insurance to cover good breast pumps for all the nursing moms; provision of postpartum long-acting reversible contraceptives paid through the Medicaid insurers. We have a payer group that includes Medicaid payers and public insurance for teachers and other public employees. We present what we do and what we would like to see happen. I see this as enhancing services, like doula care, to help with West Virginia’s high rates of preterm birth, low infant birth weight, high rates of smoking while pregnant and substance use disorder that we struggle with.
What will your organization be doing more of or differently to emerge stronger from the pandemic?
We put some of our education online, which is now more robust and ubiquitous. I think the mileage on our cars will be permanently decreased because of the pandemic. My colleague from the Breastfeeding Alliance just received a grant to enhance breastfeeding and establish an institute in West Virginia. A lot of the education that we do for lactation support used to be five days in a hotel somewhere and it was very expensive. Now, she is doing it online and it is just as robust. The providers love it because they can do part of it asynchronously and it has turned out to be fabulous for disseminating information.
I am looking forward to the day that maybe we can do some more birth education in person. It is better to meet in person because of the positioning and trying to show labor support. Doula education is a hybrid —about 20 hours online and four hours hands on in Charleston, West Virginia. The big message is that we can do some of the things online, but some of the workshop sessions really need to be in person.