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The White Paper highlights:
• The alarming racial disparities in maternal and infant morbidity and mortality that exist in the U.S. and Nebraska,
including the significant contributing factors and economic burden.
• Potential solutions including the provision of doula care (with a focus on culturally congruent doulas for Black,
Indigenous, and People of Color (BIPOC) communities), implicit bias training for providers, improved access to
prenatal care, and addressing social determinants of health through policy changes.
• Establishing Medicaid reimbursement for doula services in Nebraska is proposed as a key intervention involving
a doula-led workgroup to develop implementation guidelines, training, credentialing, and quality assurance
• The need for collaborative, multifaceted, and community-driven efforts involving doulas and affected
communities is crucial to implement meaningful, holistic changes and ultimately improve maternal and infant
health outcomes while ending racial disparities.

We encourage you to review the White Paper to understand Nebraska's maternal health landscape better and, most importantly, identify opportunities for policy, systems, and environmental changes that could significantly improve outcomes for ALL Nebraska mothers, babies, and their families.

The Nebraska Department of Health and Services released the Maternal Mortality Review Committee Report for 2017-2021 this month. From 2017-2021, 50 Nebraska women died while pregnant or within one year after the end of pregnancy. Non-Hispanic Black women in Nebraska experienced the highest pregnancy-associated mortality ratio (PAMR), with 110.2 deaths per 100,000 live births, representing 7.5% of total live births but 20% of pregnancy-associated deaths. Twenty-eight percent of maternal deaths were due to a pregnancy complication, 93% of which were found to be preventable.

This month, the Nebraska Department of Health and Services released the Child Death Review Annual Report for 2021. In 2021, at least 122 children died before turning one, an infant mortality rate (IMR) of 5.2 deaths per 1,000 live births. Significant disparities exist in IMR for African American infants compared to White infants, 11.6 vs 5 per 1,000 live births. The top three causes of infant deaths in 2021 were Perinatal Conditions, Congenital Anomalies, and Sudden Unexplained Infant Death (SUID).

On November 16th, the March of Dimes released the 2023 Prematurity Report Card for the United States and Nebraska. The U.S. received a D+ and Nebraska fell to a D- (D). The preterm birth rate in Nebraska climbed to 11.3% (10.8), the highest it has been in the last 10 years. Significant disparities continue to exist for Black and Indigenous Groups.

JOIN US. Friday, Sept. 29th | 7:45 a.m. – 4:34 p.m.

The 2023 NPQIC Fall Summit "Upstream Solutions to Maternal Health Equity" will provide a foundational understanding of the current Black maternal health crisis and the landscape of Black maternal health in Nebraska. Sessions will equip healthcare teams with the most up-to-date practices around severe maternal morbidities, trauma-informed care, and chronic conditions and substance use in pregnancy. Providing evidence-based and equitable care to marginalized populations is critical for improving pregnancy health outcomes in NE.

In March 2023, NPQIC hosted a live Webinar, “Opioid Prescriptions in Pregnancy." This webinar is now available for free CME, DEA MATE, and Opioid Prescriber Credit.

On May 26th, 2023, the Nebraska Perinatal Quality Improvement Collaborative (NPQIC) hosted a meet-and-greet event for the Rooted Doula Care and Support Program, a pilot program that will connect 30 Black pregnant people with the support of full-spectrum doulas at no cost. Other program partners include I Be Black Girl, Nebraska Medicine, the Nebraska Black Doula Collective, and United Healthcare.

The CDC recently released the results of their national survey of Maternity Practices in Infant Nutrition and Care (mPINC) which assesses maternity care practices and provides feedback to encourage hospitals to make improvements that better support breastfeeding.

On May 4th, 2023, the Policy Center for Maternal Mental Health, in collaboration with George Washington University, released the first-ever grading of state efforts in addressing maternal mental health. These State Report Cards provide the first-ever comprehensive view into the state of maternal mental health in America. The U.S. is failing – with 42 receiving Ds and Fs. Nebraska received an F.

Trial: Functional Scoring a Better Guide to Neonatal Opioid Withdrawal Tx— NIH trial affirms benefit of increasingly popular approach to get babies home sooner.

Save the Date: 2023 Annual Summit

NPQIC's Annual Summit will be held on September 29th, 2023 at the Thompson Alumni House in Omaha, NE.

The Pregnancy Risk Assessment Monitoring System (PRAMS) is a research project sponsored by the Centers for Disease Control and Prevention and the Nebraska Department of Health and Human Services. The study aims to discover why some babies are born healthy and others are not.

A detailed view of prenatal care and infant mortality in Nebraska, plus measurable steps to improve outcomes for all moms and babies by 2030.

NPQIC Attends CDC Perinatal Quality Collaborative Kick Off Meeting
NPQIC Attends CDC Perinatal Quality Collaborative Kick Off Meeting

Nebraska was 1 of 27 states represented at the CDC Perinatal Quality Collaborative Kick Off Meeting in Atlanta, GA on December 1-2, 2022.