“This is new, eye opening work for this profession. This is changing the way clinics think about taking care of their patients"

Assisting someone through a healthy pregnancy requires attention to a wide range of factors. Health care providers have become adept at watching and responding to risks from issues such as hemorrhage, diabetes, and hypertension. Yet a state report published in 2016 found 60 percent of pregnancy-related deaths were preventable.

The leading underlying cause of pregnancy-related deaths were mental and behavioral health conditions (30 percent): death by suicide and substance overdose/poisoning, according to the work of the state Maternal Mortality Review Panel. The panel develops a report and recommendations to help reduce preventable maternal deaths and improve health care for women.

Health professionals from across the state are using the Healthier Washington Collaboration Portal to respond to this issue and introducing a new way of thinking about care to address death by suicide and accidental opioid overdose during or shortly after pregnancy.

In early 2022, the Washington Maternal Mental Health Access (MaMHA) project began training and supporting members of primary care clinics in our state to reduce pregnancy-related deaths.

“This is new, eye opening work for this profession. This is changing the way clinics think about taking care of their patients to address death by suicide and accidental opioid overdose,” said Ian Bennett, MD, PhD, of the Departments of Family Medicine and Psychiatry and Behavioral Sciences at the University of Washington.

Bennett has been leading this work with financial support and collaboration from the state Department of Health’s Perinatal Unit of the Office of Family and Community Health Improvement.

Helping clinicians make meaningful changes

The MaMHA project has formed a learning collaborative, developed a webinar series, and set up a virtual educational lecture series and patient case discussions to improve provider preparedness to treat patients and improve patient outcomes.

Within a few months, hundreds of health care professionals have been able to participate in the learning collaborative sessions. Hundreds more are visiting WA Portal regularly to access a rich cache of resources gathered by Bennett’s team.

In addition to offering guidance on training, client screening, and establishing efficient processes, this work promotes collaboration and coordination as keys to success. Clinicians are shown how to work across traditional silos, from obstetrics to mental health to substance use providers, and then transition clients smoothly into primary care and pediatric care.

“We have engaged in a meaningful way with these clinics that are making changes in their practices and they are making great progress in their obstetrics work,” Bennett said.

Not unlike the new lives they help bring into the world, growth and change at the clinical level takes many months, but the MaMHA project is catching on and showing healthy growth.

“We’ve been very successful at developing an outreach plan. We have successfully reached out to more than 100 clinics, particularly inclusive of practitioners with clients at high risk of suicide and overdose,” Bennett said. “That has been really important and we can use that in our next steps in continuing to build on that outreach for future work.”