Essex County Improving Pregnancy Outcomes Project

1. Essex County Improving Pregnancy Outcomes Project Zeneyda Alfaro, Project Director zalfaro@spannj.org 973-642-8100 x 107 Funded by the NJ Department of Health (NJ DOH)

2. SPAN & Essex IPO Project • SPAN’s Mission and Vision • SPAN’s Activities • Essex County Improving Pregnancy Outcomes Project (Essex IPO) • Essex IPO’s Goals • Target population • Delivery of Services • Healthy Families Community of Care Council • Goal • Objectives • Structure • Calendar meetings

3. Statewide Parent Advocacy Network (SPAN) Who are we? • 25 year old, independent, 501(c)3 organization committed to empowering families as advocates and partners in improving education and health outcomes for infants, toddlers, children & youth. • Houses the PTI, F2F, Family Voices State Affiliate, chapter of FFCMH, Statewide Parent to Parent Program, Military Family 360 Project, Family WRAP & Superstorm Sandy Resiliency Project, Partners for Prevention, among others

4. SPAN’s Vision, Mission, & Values • Our vision is that all New Jersey families will have the resources and support they need to ensure that their children become fully participating and contributing members of our communities and society. • Our mission is to empower and support families and inform and involve professionals interested in the healthy development and education of children and youth. • Our values are equity, effectiveness, & engagement

5. Wholistic & Targeted Approach • Our focus is on the whole child and family, including education, health and mental health, human services, child care, and child welfare/prevention. • Our foremost commitment is to children and families with the greatest need due to disability or special health/mental health needs; poverty; discrimination based on race, sex, language, immigrant or homeless status; involvement in the foster care, child welfare, or juvenile justice systems; geographic location; or other special circumstances.

6. What do we do? • We provide: • Information • Parent & Professional Development • Technical assistance • Parent-to-Parent/Family-to-Family Support • Leadership Development/Capacity Building • Advocacy • In the past year we have expanded our work to not only support parents who already have children, but also to help improve pregnancy outcomes and prevent birth defects and developmental disabilities.

7. Essex County Improving Pregnancy Outcomes “IPO” • Funded by the NJ Department of Health • Focus: • Target underserved women in Essex County • Connect women to services and supports to improve preconception, prenatal, and interconception care with the goal of reducing pre-term birth, low birth weight, and infant mortality rates

8. Outreach • Target communities with the greatest need : • Communities of color • Immigrant and limited English proficient communities • Low-income communities • Women with chronic and acute physical and mental health conditions • Uninsured women • Women with multiple social or economic stressors.

9. Community Health Workers/ Family Resource Specialists • Link women to medical providers for preconception, interconception and prenatal care • Refer and provide one on one assistance to help women and their families utilize services • Recruit, train, support and provide stipends to 10 women from identified communities to provide peer-to-peer support groups, and inform our work on an ongoing basis.

10. Target population and service area • The target population is underserved women of childbearing age, in Essex County, with a special focus on the high-risk communities of East Orange, Irvington, Newark, and Orange. • Each of the selected communities is in the top ten of the state’s Priority High-Risk Municipality based on NJ Population Perinatal Risk Index of of 146 municipalities assessed.

11. Why these cities? http://www.state.nj.us/health/fhs/professional/documents/pra_report.pdf

12. What is PRAMS? • Pregnancy Risk Assessment Monitoring System is a surveillance system of the Centers for Disease Control and Prevention (CDC) and state health departments. • PRAMS collects state-specific, population-based data on maternal health before, during, and shortly after pregnancy

13. Pregnancy RiskAssessment • PRA is a risk assessment conducted during pregnancy to identify women who are at high risk for fetal or infant death or infant morbidity. The goal of this risk assessment is to prevent or treat conditions related to poor pregnancy outcome, and to connect or link to appropriate services and resources through referral. (2) • The IPO CHW’s will use the PRA with non pregnant women of child bearing age as well, in order to identify risk factors and refer to appropriate services.

14. The importance of Preconception Care • Preconception health: Being as healthy as possible before becoming pregnant or planning for a pregnancy can improve the likelihood of having a healthy baby.  This is a period where risk factors can be identified and treated before planning to get pregnant.

15. Interconception care • Interconception is the time between the end of one pregnancy and the beginning of the next one. • It is also a time to find those women who are at risk for poor birth outcome. This includes women who had a low birth weight baby, who had a miscarriage or a stillbirth, or who had a baby born with birth defects. • The goal of interconception care is to take steps to improve the outcome for the next pregnancy; or being as healthy as possible by preparing the body for the next unborn child.

16. Prenatal Care • Prenatal care is the health care a pregnant woman receives. It includes checkups and prenatal testing. It lets health care providers detect health problems early. Early treatment can address many health issues and prevent others. Through prenatal care risk factors are identified and steps are taken to a healthy pregnancy.

17. Unintended Pregnancies • About half (51%) of the 6.6 million pregnancies in the United States each year are unintended • Unintended pregnancy rates are highest among poor and low-income women, women aged 18–24, cohabiting women and minority women • Births resulting from unintended or closely spaced pregnancies are associated with adverse maternal and child health outcomes, such as delayed prenatal care, premature birth and negative physical and mental health effects for children • In NJ, 54% of all pregnancies in 2008, (106,000) were unintended

18. Teen pregnancy & birth • Births to teenagers are at higher risk of low birth weight and preterm birth, and death in infancy, compared with babies born to women in their twenties and older •  Childbearing during adolescence negatively affects the parents, their children, and society • In 2012, just over 305,000 babies were born to teen girls between the ages of 15 and 19 • The teen pregnancy rate in New Jersey was 62 per 1,000 women aged 15-19 in 2008

19. Summary • We will: • Take action even before a woman of reproductive age gets pregnant • Connect women and their families to appropriate services in the community • Work in partnership with direct service providers (hospitals, doctors, community organizations, schools) • We need your help!

20. Questions?