A federal program to combat the alarming rates of rural women dying from pregnancy complications has marked a first: It\u2019s supporting an organization that serves predominantly Black counties in the Deep South.<\/p>\n

The news came Sept. 27, three months after KFF Health News\u2019 reporting raised questions<\/a> about why a federal Health Resources and Services Administration program targeting rural maternal mortality hadn\u2019t sent a grant to serve mothers in majority-Black rural communities.<\/p>\n

Non-Hispanic Black women \u2014 regardless of income or education level \u2014 die of pregnancy-related causes at nearly three times the rate<\/a> of non-Hispanic white women.<\/p>\n

The Institute for the Advancement of Minority Health in Madison, Mississippi, was one of two winners in the latest round of an initiative administered by HRSA. Mary Hitchcock Memorial Hospital in Lebanon, New Hampshire, was the other winner, according to an agency announcement<\/a>.<\/p>\n

\u201cVery happy to see Mississippi,\u201d said Peiyin Hung, deputy director of the University of South Carolina\u2019s Rural and Minority Health Research Center. Mississippi has the highest rate of maternal deaths and injuries among Black people in the U.S., she said.<\/p>\n

Hung, who is a member of the health equity advisory group for the maternal grant program, said the Mississippi nonprofit is an unusual awardee because it is not part of a larger health system.<\/p>\n

In June, KFF Health News found that HRSA\u2019s Rural Maternity and Obstetrics Management Strategies Program, or RMOMS, had failed to fund any sites in the Southeast, where the U.S. Census Bureau shows the largest concentration of predominantly Black rural communities. The program began four years ago and had budgeted nearly $32 million to provide access and care for thousands of mothers and babies nationwide \u2014 including Hispanic women along the Rio Grande and Indigenous mothers in Minnesota.<\/p>\n

The rural Southeast was omitted despite a White House declaration<\/a> to make Black maternal health a priority, and despite statistics showing America\u2019s maternal mortality rate rising sharply<\/a> in recent years.<\/p>\n

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Rep. Robin Kelly (D-Ill.) introduced the \u201c CARE for Moms Act<\/a>\u201d in mid-September and \u2014 in response to KFF Health News\u2019 reporting \u2015 called for accountability and reporting requirements for maternal health grants under the Department of Health and Human Services.<\/p>\n
\u201cWhere is the money going?\u201d she said during a September press conference. \u201cIs it going where it\u2019s needed or is it going to bigger organizations who have the people who can write the grants?\u201d She added that \u201cmaybe smaller areas or more rural areas\u201d need it more.<\/p>\n
HRSA spokesperson Martin Kramer declined to provide more information about the rural maternity grant awards and did not respond when asked about Kelly\u2019s bill. The legislation also would establish regional \u201ccenters of excellence,\u201d Kelly said, to address implicit bias and cultural competency in health care providers. She said the bill would also \u201cbuild up the doula workforce\u201d and establish a state-based perinatal quality collaborative to improve care nationwide.<\/p>\n
In an interview with KFF Health News, Kelly, co-chair of the House Maternity Care Caucus<\/a> and a congressional leader in expanding Medicaid for postpartum care, suggested the lack of grants to the predominantly Black rural South could be because of \u201cimplicit bias,\u201d and she said her bill would help \u201cget to the heart of the matter and get [the money] to the people that really need it.\u201d<\/p>\n
The roughly $2 million in new rural grants are part of nearly $90 million<\/a> in maternal health funding announced in late September by HRSA, an agency within HHS.<\/p>\n
The Mississippi-based Institute for the Advancement of Minority Health was created in 2019 to reduce health disparities through partnerships, according to federal filings<\/a>. Chief executive Sandra Melvin confirmed in an email that this is the first time the institute has applied for the grant, but also noted that it has been working to reduce maternal and infant health disparities since 2019.<\/p>\n
Work performed with the grant \u201cwill be successful,\u201d she said, because the organization plans to take a community-based approach that includes partnering with health centers, hospitals, and a university.<\/p>\n
In past years, the grant application process skewed toward large health systems because they \u201chave much higher capacity to form a statewide network,\u201d Hung said. That\u2019s, in part, because grant winners were required to create a network of specific health care clinics, hospitals, and the state Medicaid office. In recent years, the agency has \u201cbecome much more flexible,\u201d Hung said.<\/p>\n
The success of the Mississippi application is a \u201cpromising signal\u201d for states that don\u2019t have large rural health systems focusing on maternal care, said Hung, who hopes a South Carolina applicant receives a grant in the future.<\/p>\n
In New Hampshire \u2014 where awardee Mary Hitchcock Memorial Hospital is part of the larger Dartmouth Health system in New England \u2015 three rural hospital labor and delivery units have closed in recent years. The closures forced pregnant women to drive up to an hour and a half to appointments or delivery services, said Greg Norman, senior director of community health at Dartmouth Hitchcock Medical Center.<\/p>\n
Its HRSA application included the North Country Maternity Network, a collaboration of hospitals and clinics created in late 2021, Norman said. The New Hampshire group did not win the federal maternity grant the first time it applied. But this time the network was more established , he said.<\/p>\n
The money from the New Hampshire grant \u2014 up to $1 million a year for four years \u2014 will help create standardized medical and social screening for pregnant people. It will also pay for a shared high-risk coordinator and increased use of doulas and community health workers who could do home visits, he said.<\/p>\n
The whole project, Norman said, is \u201ca step in the direction of more equitable care.\u201d<\/p>\n
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