♪ ♪ ♪ ♪ THE UNITED STATES IS IN THE MIDST OF A MATERNAL HEALTHCARE CRISIS.

MATERNAL MORBIDITY AND MORTALITY ARE ON THE RISE IN THE UNITED STATES DESPITE CONTINUED ADVANCED IN THE FIELD OF MEDICINE.

EXPECT ACT MOTHERS FACE INCREASING RATES OF PREGNANCY AND CHILD BIRTH RELATED COMPLICATIONS.

IN THE UNITED STATES, WOMEN ARE TWO TIMES MORE LIKELY TO DIE FROM THESE COMPLICATIONS WHEN COMPARED TO WOMEN IN OTHER DEVELOPED COUNTRIES.

PREGNANCY AND CHILD BIRTH COMPLICATIONS IN THE UNITED STATES HAVE INCREASED AMONG ALL WOMEN BY ABOUT 9% BETWEEN 2018 AND 2020.

IN THE DEVELOPED WORLD, THE UNITED STATES IS THE MOST DANGEROUS PLACE TO GIVE BIRTH, ESPECIALLY FOR WOMEN OF COLOR.

WHEN COMPARED TO WHITE WOMEN AND PREDOMINANTLY WHITE COMMUNITIES, WOMEN IN PREDOMINANTLY BLACK COMMUNITIES HAVE 63% HIGHER RATES OF SEVERE MATERNAL MORBIDITY.

THIS MEANS THAT RACE, INDEPENDENT OF EVERYTHING ELSE, IS IN AND OF ITSELF, A RISK FACTOR FOR SEVERE MATERNAL MORE MORBIDITY.

MATERNAL HEALTH IMPACTS BOTH THE MOTHER AND THE BABY.

MANY CAUSES OF INFANT MORTALITY ARE THE RESULT OF MATERNAL PREGNANCY COMPLICATIONS: PROVIDERS MUST UNDERSTAND THAT THERE IS A DARK HISTORY BETWEEN THE MEDICAL PROFESSION AND PEOPLE OF COLOR.

AS A RESULT, INTENTIONAL OUTREACH MUST BE ENCOURAGED.

>> HELLO AND WELCOME TO A VERY SPECIAL EPISODE OF CYCLE OF HEALTH, I'M DR. RICH O'NEILL.

TONIGHT'S TOPIC: MATERNAL CARE.

DISPARITIES IN ACCESS TO QUALITY MATERNAL CARE PERSIST GLOBALLY.

FACTORS SUCH AS SOCIOECONOMIC STATUS, GEOGRAPHIC LOCATION, RACE, ETHNICITY, AND CULTURAL PRACTICES CAN INFLUENCE ACCESS TO HEALTHCARE SERVICES, LEADING TO DISPARITIES IN MATERNAL HEALTH OUTCOMES.

TONIGHT WE'RE MEETING WITH FOUR EXPERTS FROM THE COMMUNITY TO DISCUSS THEY ARE: DR. BRIAN THOMPSON ASSISTANT PROFESSOR OF OBSTETRICS AND GYNECOLOGY FROM UPSTATE DR. NICHOLAS BARANCO MATERNAL FETAL MEDICINE SPECIALIST FROM UPSTATE MS. KRISTINE KNUTSON MANAGER OF COMMUNITY PROGRAMS IN THE CRISIS SERVICES DIVISION AT CONTACT COMMUNITY SERVICES DR. KENDRA DELOACH MCCUTCHEON, ASSOCIATE PROFESSOR FOR THE SCHOOL OF SOCIAL WORK AT SYRACUSE UNIVERSITY THANK YOU ALL FOR BEING HERE.

LET'S START OFF WITH CAN YOU DEFINE MORE MORBIDITY AND MORTALITY, THOSE MEDICAL TERMS, FOR THE LAY PERSON?

>> SO MORBIDITY AND MORTALITY CAN REFER TO A NUMBER OF DIFFERENT STATISTICS USED IN RESEARCH ABOUT OUTCOMES IN PREGNANCY AND INFANCY.

MATERNAL MORTALITY REFERS TO DEATH DURING PREGNANCY, CHILD BIRTH OR ONE YEAR AFTER DELIVERY.

INFANT MORTALITY REFERS TO DEATH WITHIN THE FIRST YEAR OF LIFE AND MORBIDITY REFERS TO ADVERSE OR BAD OUTCOME THAT ENCOMPASSES A BROAD RANGE OF SEVERE OUTCOMES SUCH AS INTENSIVE CARE UNIT ADMISSION, UNPLANNED SURGERIES, BLOOD TRANSFUSION AND OTHER OUTCOMES PEOPLE WOULD NOT WANT TO HAVE.

THOSE HAVE BEEN DEFINED VERY LOOSELY IN DIFFERENT RESEARCH.

SO EITHER CAN BE WHAT YOU HEAR WITH STATISTICS OR WHAT PEOPLE REFER TO.

>> NOW WHAT CAUSES THOSE?

Dr. THOMPSON, WHAT IS THE CAUSE OF THESE BAD OUTCOMES?

>> SURE.

ABSOLUTELY.

EVERYTHING THAT COMES TO MAKE US WHO WE ARE.

SO WHAT IS IN OUR BODY, WHAT WE EAT, OUR LIFESTYLE, OUR MIND, WHERE WE LIVE, THE LOCATION OF WHERE WE LIVE, RURAL VERSUS URBAN, RICH VERSUS POOR, BUT ALSO WHAT OCCURS DURING PREGNANCY.

SO WE CAN HAVE DIFFERENT COMPLICATIONS DURING PREGNANCY.

DIABETES OR HIGH BLOOD PRESSURE.

BUT ALSO DIFFERENT THINGS THAT CAN OCCUR OF WHETHER YOU HAVE A DOCTOR, WHETHER THERE IS A LABOR AND DELIVERY UNIT THAT IS CLOSE THIS WHERE YOU LIVE.

MAYBE WHETHER YOU HAVE A CAR.

OR WHETHER YOU HAVE A SUPPORT SYSTEM.

AND HOW YOU ARE DOING AS A HUMAN BEING.

>> SO ALL OF THOSE THINGS CAN CONTRIBUTE.

A NUMBER OF THOSE THINGS SOUND LIKE THEY'RE SYSTEMIC ISSUES.

NOT JUST WHAT THE PERSON DOES FOR THEMSELVES OR WHAT IS HAPPENING BETWEEN THEM AND THEIR PARTNER OR THEIR FAMILY.

TALK TO US ABOUT SYSTEMIC ISSUES.

>> YEAH, THOSE SYSTEMIC ISSUES ARE REALLY TROUBLING ESPECIALLY FOR AFRICAN-AMERICAN WOMEN, FOR WOMEN OF COLOR, BECAUSE WHEN YOU THINK ABOUT WITHIN THE U.S., AFRICAN-AMERICAN WOMEN ARE THREE TIMES MORE LIKELY TO DIE-- >> THREE TIMES MORE LIKELY.

>> THREE TIMES MORE LIKELY TO DIE DURING CHILD BIRTH, WHILE PREGNANT AND EVEN ONE MOTHER POST-PARTUM.

>> WOW.

>> SO WHEN YOU FACTOR IN ALL OF THAT, THAT GAP STILL PERSISTS AND THEY ARE MORE LIKELY TO DIE THAN WHITE WOMEN.

AND THAT GAP PERSISTS EVEN WHEN YOU FACTOR IN EDUCATION AND INCOME.

SO YOU ARE LOOKING AT HIGHLY EDUCATED WOMEN WHO HAVE A SOCIOECONOMIC STATUS THAT ALLOWS FOR THEM TO HAVE-- TO MEET THEIR NEEDS AND WANTS AND STILL THAT GAP STILL PERSISTS.

SO WHEN WE LOOK AT THESE ISSUES, WE ALSO HAVE TO FACTOR IN NOT JUST ONLY RACISM, BUT SEXISM BECAUSE WE KNOW THAT THERE IS AN INTERSECTIONALITY OF THOSE TWO SYSTEMATIC ISSUES THAT ARE NEGATIVELY AFFECTING PREGNANT WOMEN AND WOMEN WHO ACTUALLY DELIVER BABIES AS WELL.

>> WHAT IS HAPPENING IN THE MEDICAL SYSTEM THAT AFRICAN-AMERICAN WOMEN-- EVEN AFRICAN-AMERICAN WOMEN WITH MEANS-- ARE HAVING BAD OUTCOMES?

WHAT IS HAPPENING THERE?

>> WELL, THERE IS SOME SPECULATION THAT THERE IS A POOR RELATIONSHIP BETWEEN AFRICAN-AMERICAN WOMEN AND HEALTHCARE PROVIDERS.

JUST ROOTED IN STRUCTURAL RACISM, INSTITUTIONAL RACISM.

AND WHEN WE LOOK AT SOME OF THE RESEARCH, IT SUGGESTS THAT THERE ARE SOME IMPLICIT BIAS THAT IS OCCURRING WITHIN THE WAYS THAT AFRICAN-AMERICAN WOMEN SPECIFICALLY AND WOMEN OF COLOR, ARE RECEIVING CARE FROM THEIR HEALTHCARE PROVIDERS.

>> SORRY TO INTERRUPT.

BUT CAN YOU DEFINE IMPLICIT BIAS?

WHAT DOES THAT MEAN?

AN AFRICAN-AMERICAN WOMAN GOES TO HER PROVIDER WHILE SHE IS PREGNANT OR ABOUT MAYBE DELIVERING.

WHAT IS THAT-- HOW DOES THAT MANIFEST ITSELF CONCRETELY?

>> SURE, IMPLICIT BIAS ARE THE IDEAS OR STEREOTYPES OR TROPES THAT SOMEONE MAY HAVE REGARDING A PARTICULAR GROUP OF INDIVIDUALS OR PEOPLE BELONGING TO A PARTICULAR GROUP THAT MAY THEN INFLUENCE THE WAY THAT PROVIDER PROVIDES CARE FOR THAT INDIVIDUAL OR THOSE GROUP OF PEOPLE.

>> SO NOT NECESSARILY CONSCIOUS.

MAYBE UNCONSCIOUS BIAS.

>> CONSCIOUS, UNCONSCIOUS, INTENTIONAL OR UNINTENTIONALLY.

>> FROM A PROVIDER'S PERSPECTIVE, IMPLICIT BIAS MEANS TO MAKE A DIAGNOSIS OR CONSIDER A PROBLEM, THAT HAS TO BE SOMETHING I'M CONSIDERING THINKING, HAVE IN MY MIND AS A POSSIBILITY.

AND IF THOSE POSSIBILITIES ARE DIFFERENT WHEN I SEE A DIFFERENT PATIENT IN FRONT OF ME, THEN THAT'S AN IMPLICIT BIAS THAT'S GOING TO CHANGE MY CARE WITHOUT MY REALIZING THAT CARE IS CHANGING.

IT'S NOT A CONSCIOUS DISCRIMINATION.

IT'S A DIFFERENCE IN CARE BASED ON MY UNDERSTANDING AND WHAT I BRING INTO THE ROOM.

>> SO THEN THESE WOMEN OF COLOR, WHO ARE RECEIVING CARE THAT MAY BE A LITTLE BIT DIFFERENT, AND WE ARE HEARING THESE STORIES IN THE MEDIA MORE OFTEN THAN NOT, OF THEIR PAIN BEING DISMISSED OR PAST MEDICAL TREATMENT BEING SLIGHTLY DIFFERENT.

AND WHEN THEY'RE ADVOCATING OR SPEAKING UP ABOUT THESE ISSUES, THEY MAY NOT ALWAYS BE HEARD OR WHAT THE PEOPLE ARE HEARING, HEALTHCARE PROVIDERS ARE HEARING, MAY ALSO NOT BE ACTED UPON.

>> AND I ASSUME THAT THIS IS SIMILAR FOR ACCESS TO INSURANCE AND HEALTHCARE IN RURAL REGIONS.

I KNOW YOU DO SOME RESEARCH ON SIMPLY WHERE PEOPLE LIVE IS A RISK FACTOR.

>> ABSOLUTELY.

SO CENTRAL NEW YORK IS A GEOGRAPHICALLY SPACED AREA.

SYRACUSE SERVES AS A REFERRAL CENTER FOR COMMUNITIES ALL THE WAY FROM THE CANADIAN BORDER DOWN TO THE PENNSYLVANIA BORDER.

AND WE SERVE AS A REFERRAL HOSPITAL FOR ALL OF THE COMMUNITY LOCAL HOSPITALS IN THE SURROUNDING AREA.

SO WHEN WOMEN IN THOSE AREAS OFTEN HAVE DIFFICULTY GETTING TO A HOSPITAL, GETTING TO A DOCTOR'S OFFICE, THAT CAN BE RELATED TO ACCESS TO TRANSPORTATION... >> NO CAR, NO BUS.

>> RIGHT.

AND MY OWN RESEARCH LOOKS AT TRAVEL TIME BASED ON ZIP CODE OF RESIDENTS TO THE HOSPITAL OF DELIVERY AND TO A REFERRAL CENTER.

AND WE ARE FINDING THAT EVEN WHEN CONTROLLING FOR OTHER RISK FACTORS, JUST THAT TRAVEL TIME IS A RISK FACTOR OF ADVERSE OUTCOMES.

SO TRAVEL REALLY DOES MATTER.

>> SO THE LONGER TIME IT TAKES TO YOU GET TO THE HOSPITAL, THE WORSE YOUR PREGNANCY AND DELIVERY ARE LIKELY TO GO.

>> ON AVERAGE.

IT'S A RELATIVELY SMALL EFFECT COMPARED TO SOME OTHER CHALLENGES, BUT IT'S DEFINITELY PART OF WHAT GOES INTO HEALTHCARE OUTCOMES IN A RURAL AREA LIKE WE SERVE.

>> AND ONE OF THE MOST-- ONE OF THE THINGS THAT'S UNIQUE ABOUT OUR POPULATION HERE IN CENTRAL NEW YORK THAT WE FORGET ABOUT THAT BECOMES INVISIBLE IS OUR INDIGENOUS PEOPLES.

OUR NATIVE AMERICAN POPULATION HERE IN CENTRAL NEW YORK.

SO, I'LL GIVE YOU SOMETHING THAT IS INTERESTING TO PONDER.

IF YOU LOOK ON A NATIONAL LEVEL, WE WERE TALKING ABOUT INSURANCE BEFORE.

IF YOU LOOK AT A NATIONAL LEVEL, THE AMOUNT OF MONEY SPENT PER PERSON ON MEDICARE, IT'S ABOUT $15,000 A YEAR.

IF YOU LOOK AT MEDICAID, IT'S ABOUT 9,000 A YEAR.

IF YOU LOOK AT FOR NATIVE AMERICANS WHO RECEIVE THEIR SERVICE THROUGH THE INDIAN HEALTH SERVICE, IT'S ABOUT $4,000 A YEAR.

SO WHEN YOU THINK ABOUT THAT, IT'S JUST AN AMAZING NUMBER.

>> DISCREPANCY: WHAT ARE SOME OF THE COMMON COMPLICATIONS WOMEN ENCOUNTER DURING PREGNANCY AND DELIVERY?

WHAT ARE SOME OF THE THINGS THEY HAVE TO BE ON THE LOOKOUT FOR?

>> SO I THINK PROBABLY THE MOST COMMON MAJOR COMPLICATION IN PREGNANCY IS PRETERM BIRTH.

PRETERM BIRTH MEANS BIRTH MORE THAN THREE WEEKS BEFORE A DUE DATE.

RANGES FROM RELATIVELY MINOR PROBLEM RESULTING IN PERHAPS AN ADDITIONAL STAY, A FEW ADDITIONAL DOCTORS VISITS ALL THE WAY TO A REALLY CRITICAL PROBLEM RESULTING IN MONTHS OF STAY IN THE HOSPITAL, POTENTIALLY LIFE LONG COMPLICATIONS FOR THOSE INFANTS AND IS ONE OF THE LEADING CAUSES OF INFANT MORTALITY IN OUR COUNTRY.

COMPLICATIONS CAN ALSO BE MATERNAL, SO SEVERE HIGH BLOOD PRESSURE, SEIZURES, STROKE, AND EVEN MATERNAL DEATH.

>> AND I KNOW FROM OUR CHATTING BEFORE THE SHOW, THAT IF YOU DON'T GET MEDICAL CARE EARLY ON IN YOUR PREGNANCY, YOUR RISK OF A BAD OUTCOME JUMPS.

>> ABSOLUTELY.

SO IF YOU GET NO PRENATAL CARE, YOUR RATES OF HAVING A DIFFICULT OUTCOME DURING PREGNANCY ARE MUCH HIGHER THAN IF YOU RECEIVE CARE IN YOUR FIRST TRIMESTER.

YOUR RATES OF MORTALITY ARE MUCH HIGHER IF YOU GET NO PRENATAL CARE VERSUS YOU GET CARE IN YOUR FIRST TRIMESTER BUT WHAT ULTIMATELY WE ARE TRYING TO DO WITH A PREGNANCY, AND A MOM IS TO HAVE A HEALTHY MOM, HEALTHY BABY.

THAT'S OUR GOAL.

THAT'S WHAT WE WANT.

AND IF YOU LOOK AT THE OUTCOMES OF BABIES, IN UPSTATE NEW YORK, THE OUTCOMES-- THE SUCCESSFUL OUTCOMES ARE LESS THAN THEY ARE IN OUR DOWNSTATE REGIONS, UPSTATE REGIONS HAVE HIGHER RISK THAN NEW YORK CITY ITSELF.

ONE OF THE MOST IMPORTANT THINGS WE LOOK AT IS OUTCOMES WHAT WE CALL INFANT MORTALITY, AND THAT'S HIGHER IN UPSTATE THAN IT IS IN DOWNSTATE.

BUT ONE OF THE THINGS THAT CAN INCREASE THAT RISK OF OUTCOME ARE MENTAL HEALTH CONDITIONS.

MENTAL HEALTH CONDITIONS IN MOMS AND HOW IT WORKS IN TERMS OF HOUR BABIES.

LET'S LOOK AT A LITTLE VIDEO.

NESTLED IN THE HEART OF OUR COMMUNITY, A LOCAL SHELTER HAS BECOME A BEACON OF HOPE FOR WOMEN WHO ARE EXPECTING OR HAVE YOUNG CHILDREN.

BUT IT'S NOT JUST A PLACE TO FIND SHELTER AND SUPPORT.

JOSEPH'S HOUSE FOR WOMEN IS DEDICATED TO ADDRESSING A CRUCIAL ASPECT OFTEN OVERLOOKED: MENTAL HEALTH.

JOSEPH'S HOUSE IS FOR WOMEN WHO ARE EXPECTING OR WHO HAVE YOUNG CHILDREN.

WE HAVE WOMEN WHO ARE HOUSING INSECURE.

WE OFFER MENTAL HEALTH MENTAL HEALTH COUNSELING, LIFE SKILLS, WE PROVIDE HELP WITH NAVIGATING THE COMPLEX SYSTEM OF DEPARTMENT OF SOCIAL SERVICES, SNAP, WIC, NAVIGATING THE BUS.

WE DO ART THERAPY.

WE HAVE A SEWING LAB AND WORK ON DIFFERENT PRACTICAL SKILLS.

SOMETIMES IT'S AS SIMPLE AS LAUNDRY, JUST ALL THE SKILLS YOU WOULD NEED TO RUN YOUR OWN HOUSEHOLD IN THE FUTURE.

>> FOR LIFE SKILLS WE HAVE CLASSES TWICE A DAY AND I TEACH A LOT OF STUFF THAT HAS TO DO WITH PARENTING AND SKILLS.

SO I GET TO THE ROOT OF MAYBE WHY THEY GOT HERE AND WHAT THEY NEED HELP WITH AS FAR AS BEING A SINGLE MOM, BUT ALSO IN THE COMMUNITY AND WHAT THEY NEED TO DO TO LEAVE HERE TO BE SUCCESSFUL.

>> I WOULD SAY PROBABLY THE BIGGEST CHALLENGE THAT OUR RESIDENTS FACE IS JUST WHAT THEY HAVE BEEN THROUGH.

THE AMOUNT OF TRAUMA.

ONE OF OUR FACILITIES ADDRESSED UNLISTED WHICH ALLOWS US TO TAKE MOMS WHO HAVE BEEN IN DOMESTIC VIOLENCE OR HIDING FROM INTERPARTNER VIOLENCE.

THAT'S A SITUATION WE CROSS REGULARLY.

AND THAT COMES WITH BAGGAGE, WHETHER IT'S EMOTIONAL OR HABITS LEARNED, STUFF THEY REALLY NEED TO PROCESS.

BUT AS JOSEPH'S HOUSE WE BELIEVE ADDRESSING THE UNDERLYING ISSUES WILL HELP THEM FIND STABILITY FOR THE LONG-TERM FUTURE.

YOU CAN GET A JOB AND APARTMENT BUT CAN YOU KEEP THE JOB AND THE APARTMENT.

WITHOUT ADDRESSING THE UNDERLYING THINGS, YOU CAN'T GET HERE WITHOUT EXPERIENCING THINGS.

>> OUR CLASSES, TRAUMA INFORMED CARE.

I DIG INTO THE ROOT AND GENERATIONAL CURSES.

SO I TRY TO GET THEM FOCUSED ON TRYING TO STOP MAYBE WHERE THEY CAME FROM IN AND THE PARENTING THEY RECEIVED AND TO CHANGE THOSE THAT NARRATIVE GOING FORWARD.

I I AM ALSO A SINGLE MOM SO IT HITS CLOSE TO HOME FOR ME AND I'VE COME A LONG WAY AS FAR AS BEING FROM TRAUMA.

SO I USE A LOT OF MY EXPERIENCE, BUT ALSO MY TRAINING TO DO WHAT I DO.

HELPING THEM ADDRESS THE CHALLENGES THAT THEY FACED AND FIND HEALING FROM THAT FOR LONG-TERM STABILITY IS WHAT OUR MAIN GOAL IS AND IF THEY HAVE THE RESOURCES THEY NEED TO KEEP IT SO WE HELP NAVIGATE WHILE THEY'RE STILL LIVING HERE, GET IS D.S.S.

THROUGH DAYCARE, WHILE THEY'RE STILL LIVING HERE, CONNECTING THEM WITH ELIGIBLE RESOURCES THAT ARE OUT THERE.

SO WE ARE NOT EMERGENCY WITH A RUSH TO PLACE IN AN APARTMENT BECAUSE WE WANT TO HELP THEM BE ABLE TO MAKE THAT JUMP WITH, YOU KNOW, SOME MONEY IN THE BANK, WITH A LONG-TERM JOB, WITH A CAREER.

IN SYRACUSE, THERE IS NOT MANY SHELTERS THAT CAN ACCEPT WOMEN AND CHILDREN.

WE ARE NOT THE ONLY ONE, BUT THERE ARE ONLY A FEW AND WHEN YOU ARE NOT IN A STABLE PLACE LIKE A LOT OF OUR MOMS FIND OUT THAT THEY ARE PREGNANT AND THEY'RE LOSING THE PLACE TO STAY BECAUSE IT'S LIKE I CAN'T PUT ONE MORE PERSON IN THIS HOUSE OR THEIR PHENOMENON SUPPORT WAS IN THEIR SIGNIFICANT OTHER WHO IS NO THE INTERESTED IN RAISING THE BABY.

SO THE NEED IS EVER GROWING FOR A SAFE PLACE FOR WOMEN AND CHILDREN TO LAY THEIR HEAD AT NIGHT.

>> SO I KNOW THAT CONTACT COMMUNITY SERVICES IS DIRECTLY CONNECTED TO WHAT WE JUST SAW.

TELL US ABOUT CONTACT.

>> YEAH, I THINK THAT VIDEO FROM JOSEPH'S HOUSE IS A GREAT ILLUSTRATION OF SOME OF THE BIG CHALLENGES THAT FAMILIES WITH YOUNG KIDS, THAT WOMEN FACE.

SO THERE IS THE MENTAL HEALTH CHALLENGE.

THAT WAS REALLY SPOKEN OF VERY CLEARLY THERE.

BUT A LOT OF PRACTICAL NEEDS THAT PEOPLE HAVE THAT ARE JUST NOT MET IN OUR COMMUNITY VERY EASILY.

SO HOUSING INSTABILITY, NOT HAVING FOOD IN THE HOUSE, NOT HAVING TRANSPORTATION, THOSE ALL IMPACT ONE'S MENTAL HEALTH AND WE KNOW THAT DEPRESSION AND ANXIETY DURING PREGNANCY AND AFTER PREGNANCY CAN IMPACT THE MOTHER'S HEALTH AND THE BABY'S HEALTH, TOO.

>> AND I KNOW THAT SUICIDE, SADLY, IS ONE OF THE MATERNAL MORTALITY EVENTS.

>> IT CAN BE.

IT CAN BE.

SO SPECIFICALLY WOMEN THAT MIGHT HAVE UNDIAGNOSED, UNTREATED POST-PARTUM DEPRESSION, WHICH IS MORE THAN JUST BEING SAD.

IT'S MORE THAN JUST THE BABY BLUES, THEY MAY BE AT RISK FOR SUICIDE.

WHICH, YOU KNOW, IT'S THEIR LOSS BUT THEN A LOSS TO THEIR FAMILY.

IT'S A CHILD WITHOUT A PARENT.

SO THAT CAN BE PREVENTED.

THERE ARE REALLY EFFECTIVE TREATMENTS FOR THAT.

BUT FIRST WE HAVE TO ENSURE THAT WE ARE SCREENING AND CATCHING.

>> AND IT'S INTERESTING THAT I'M HEARING ABOUT SERVICES FROM CONTACT.

CAN YOU GO A LITTLE FURTHER ABOUT WHAT ARE THE SERVICES CONTACT PROVIDES AND WHO IS THE CLIENT POPULATION THEY SERVE?

>> WE SERVE EVERYBODY.

WE ARE THE LOCAL 211 FOR ONONDAGA.

>> 211 IS CALL ON YOUR PHONE.

>> YOU CAN.

YOU CAN CALL ON THE PHONE.

OUR WEBSITE IS 211CNY.COM SO YOU CAN GO ONLINE AND SEARCH YOURSELF FOR REVERSES.

ANYBODY LOOKING FOR BASIC NEEDS.

TRANSPORTATION, HOUSING HELP, FOOD HELP.

BUT ALSO SPECIFIC NEEDS FOR YOUNG DEVELOPING FAMILIES SO THAT MIGHT BE DIAPERS, FORMULA, CAR SEATS.

THESE ARE BIG CHALLENGES FOR PEOPLE THAT DON'T HAVE A LOT OF INCOME.

AND IT CAN CAUSE A LOT OF STRESS AND WORRY FOR THEM.

SO IF THEY CALL US, WE ARE AVAILABLE 24/7.

THEY CAN REACH OUT AND WE CAN HELP THEM KNOW WHO TO CONNECT WITH TO GET THOSE THINGS.

>> I THINK IT'S IMPORTANT TO SAY THAT THE INTERFACE BETWEEN THE MEDICAL SYSTEM AND SERVICES LIKE CONTACT IS REALLY IMPORTANT.

WE OFTEN SEE THAT WHEN WE ARE-- WHEN OUR PATIENTS ARE REACHING THE END OF THE MEDICAL POST-PARTUM PERIOD, SIX WEEKS AFTER DELIVERY, THEY'RE LOSING CONTACT WITH US.

THEY'RE LOSING CARE WITH US.

AND THERE ARE STILL SO MANY NEEDS THAT WE ARE NOT SET UP OR CAPABLE OF PROVIDING AND IT'S VERY DIFFICULT TO FIND SERVICES TO FIND MENTAL HEALTH SERVICES AND COMMUNITY RESOURCES FOR PEOPLE SO IT'S REALLY IMPORTANT TO HAVE THESE KINDS OF ORGANIZATIONS FOR PATIENCES TO TIE INTO.

>> I JUST PUT IN ANOTHER QUICK PLUG THAT WE HAVE A MATERNAL MENTAL HEALTH FOLLOW-UP PROGRAM.

SO PROVIDERS OR THE PERSON THEMSELVES CAN REFER, AND WE ACCEPT REFERRALS FOR BOTH THE BIRTHING PARENT OR THEIR PARTNER AS WELL.

SO JUST ADDITIONAL MENTAL HEALTH AND CONNECTION TO SERVICES IS AVAILABLE THROUGH THAT.

>> HOW DO PEOPLE CONNECT WITH THAT?

HOW DO PEOPLE GET THE SERVICES?

DO THEY GO TO 211 AND WHAT WAS THE REST OF THAT AGAIN.

>> 211CNY.COM IS THE WEBSITE.

SO THEY CAN GO TO THE WEBSITE, THEY CAN CALL 211, AND WE'LL HAVE REFERRAL INFORMATION THAT YOU CAN SHARE FOR THE MATERNAL MENTAL HEALTH FOLLOW-UP PROGRAM.

>> IS THAT 24/7?

>> IT IS.

>> 247?

AHA.

WE HAVE A COUPLE MORE MINUTES BEFORE WE STOP.

ANY LAST THINGS PEOPLE WANT TO ADD IN?

>> I THINK WHAT IS IMPORTANT TO UNDERSTAND IS THAT IN CENTRAL NEW YORK, WE HAVE A MATERNITY CARE CRISIS.

>> MA TENTER CARE CRISIS.

>> WE HAVE A MATERNITY CARE CRISIS.

MATERNITY CARE DESERT.

>> YOU MEAN WHEN YOU SAY DESERT, YOU MEAN THERE ARE NOT ENOUGH PROVIDERS FOR ALL THE PEOPLE HAVING BABIES?

>> THAT'S CORRECT.

IT'S SO IMPORTANT AND SO IMPACTFUL TO BRING THIS TO LIGHT, TO START TO HAVE THIS CONVERSATION, TO HAVE THIS CONVERSATION WITH OUR REPRESENTATIVES.

YOU KNOW, WE NEED TO HAVE OUR LOCAL REPRESENTATIVES INVOLVED.

WE THEY'D TO HAVE OUR STATE REPRESENTATIVES INVOLVED.

OUR HEALTH DEPARTMENT INVOLVED, AND OUR HOSPITALS AS WELL AS OUR OB AND PEED PEDIATRIC PROVIDERS.

>> AND THEY COME THROUGH IN A COUPLE OF CONCRETE WAYS.

OVER THE LAST COUPLE DECADES, WE HAVE LOST MA AT THE TIMER SERVICES AT THE OUTLYING HOSPITALS AND THOSE HOSPITALS ARE VULNERABLE TO LOSING ITSELF SERVICES AT OTHER HOSPITALS OVER THE NEXT FIVE TO 10 YEARS.

AND OUR SAFETY NET SYSTEM, FOR UNINSURED PATIENTS OR PATIENTS WITH PUBLIC INSURANCE, THE NUMBER OF DOCTORS WORKING IN THOSE SYSTEMS PARTICULARLY IS CRITICALLY SHORT.

AND WE ALSO HAVE A VERY SMALL NUMBER OF MATERNAL FETAL MEDICINE SPECIALISTS COMPARED TO OTHER CITIES OF OUR SIZE AND REALLY TO ALLOW US TO HAVE THE TIME AND RESOURCES TO CARE FOR WOMEN WHO ARE PARTICULAR WILL I HIGH RISK.

>> IT SOUNDS LIKE THESE ARE SOME SYSTEMIC ISSUES THAT WE NEED OUR POLITICIANS TO WEIGH IN ON TO GET US SOME MORE RESOURCES.

>> AND OUR HOSPITAL ADMINISTRATORS.

>> OUR HOSPITAL ADMINISTRATORS.

>> SO I THINK WE ALL NEED TO RECOGNIZE THAT WE HAVE A VOICE AND THAT WE NEED TO BE ABLE TO NOT ONLY VOICE THAT CONCERN TO OUR LOCAL LEGISLATORS BUT WE ALSO NEED TO WORK IN CONNECTION WITH OUR HEALTHCARE PROVIDERS SO THAT WE CAN PARTNER TO MAKE THAT VOICE HEARD, BECAUSE THERE ARE DIFFERENT ORGANIZATIONS THAT ARE TRYING TO BRING LIGHT TO THIS, BUT OF COURSE THEY NEED OUR LOCAL SUPPORT AND SO THAT COMMUNITY ORGANIZING COMPONENT AND ADVOCACY IS VITAL AT THIS TIME SO THAT WE CAN ADDRESS THIS IN A HOLISTIC COMPREHENSIVE MANNER.

>> I THINK FOR INDIVIDUAL PATIENTS, IT'S IMPORTANT TO MENTION THAT THESE SYSTEMIC PROBLEMS ARE NOT SOMETHING THAT AN INDIVIDUAL CAN REALLY FIX, TAKING THEIR OWN HEALTH INTO ACCOUNT FOR A PREGNANCY.

THE BEST THING THAT WOMEN CAN DO FOR OPTIMIZING HEALTH OF PREGNANCY IS TO PLAN PREGNANCY, TO TALK WITH THEIR HEALTHCARE PROVIDERS AND ANY SPECIALISTS THEY SEE FOR MEDICAL CONDITIONS ABOUT PREGNANCY SO THAT THEY CAN OPTIMIZE THEIR HEALTH AND COME INTO THE PREGNANCY AS HEALTHY AS POSSIBLE.

THAT IS CERTAINLY NOT GOING TO PREVENT ALL COMPLICATIONS BLUT BUT IT WILL GIVE PEOPLE THE BEST CHANCE OF A HEALTHY PREGNANCY AND HELP THEM BE PREPARED FOR DEALING WITH THOSE COMPLICATIONS IF THEY DO HAPPEN.

>> WELL, THANK YOU.

THAT'S ALL THE TIME WE HAVE, I WANT TO THANK ALL OF YOU.

... DR. BRIAN THOMPSON ASSISTANT PROFESSOR OF OBSTETRICS AND GYNECOLOGY FROM UPSTATE MEDICAL UNIVERSITY.

DR. NICHOLAS BARANCO MATERNAL FETAL MEDICINE SPECIALIST FROM UPSTATE KRISTINE KNUTSON MANAGER OF COMMUNITY PROGRAMS IN THE CRISIS SERVICES DIVISION AT CONTACT COMMUNITY SERVICES DR. KENDRA DELOACH MCCUTCHEON, ASSOCIATE PROFESSOR FOR THE SCHOOL OF SOCIAL WORK AT SYRACUSE UNIVERSITY FOR MORE INFORMATION AND RESOURCES ON MATERNAL CARE, PLEASE VISIT THE WEBSITES ON YOUR SCREEN.

IF YOU'D LIKE TO SEE MORE OF OUR PROGRAM, OR WATCH OUR WEB SERIES CHECKUP FROM OUR NECK UP, VISIT OUR WEBSITE, WCNY.ORG/CYCLEOFHEALTH.

TO HEAR OUR NEW COMPANION COMMUNITY FM RADIO SHOW, CHECK UP FROM THE NECK UP, VISIT WCNY.ORG/COMMUNITYFM.

FOR THE CYCLE OF HEALTH, I'M PSYCHOLOGIST DR. RICH O'NEILL.

THANKS FOR CHECKING IN.