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 Maternal Wellness Update 

 

June 2021

Commitment Statement on Equity

We are committed to using written and oral language that is inclusive and straightforward. In communicating, we also seek to elevate the voices of the communities we serve by using terms and language that are rooted in communities’ strengths. 
 
Specific to the maternal & child health populations, we commit to acknowledge that the state of being pregnant, the act of giving birth or otherwise ending a pregnancy, and the act of parenting and caregiving are inclusive of all genders. Furthermore, we acknowledge that intersections of oppression matter, in that a person with multiple dimensions of oppression (racism, classism, gender identity, ableism, national origins, etc.) likely face additional, more complex barriers to receiving high-quality, timely care and services. To the extent that is possible, we use the term “pregnant and postpartum individuals, persons, or people” or “new and expectant parents'' in the communication products for which we have direct responsibility.  
 
If you would like to contribute to the developing statement, please share your thoughts through this 1-question survey. We acknowledge that in this newsletter we often share items developed by other organizations that may reflect more gendered language.
HOT TOPICS


International Fathers’ Mental Health Day was June 21, 2021

New research published in the Journal of Psychosomatic Obstetrics & Gynecology by the University of Colorado School of Public Health found paternal anxiety to be
around 11 percent, compared to prevalence previously reported by the World
Health Organization (WHO) at four percent. For individuals moving into
parenthood, anxiety can start as soon as the first trimester throughout the first year postpartum, suggesting a need for early identification and treatment. Read the press release or summary
 
Because commonly-experienced mental health issues are differently stigmatized among individuals who identify as men or fathers, it is important to show support to fathers this and every year! Start here to learn about International Fathers’ Mental Health Day (June 21, 2021) and consider giving dads the long-lasting gift of self-care, compiled by Colorado’s own Dr. John Holmberg and George Davis.
 
Below are additional resources, tools and opportunities to share with new and expectant dads!

Breastfeeding Community Assessment

The Center for African American Health is conducting a community assessment to better understand the breastfeeding landscape for families in Metro Denver, including the challenges facing African American families with breastfeeding and identifying key strategies to drive change and improve breastfeeding outcomes for the community. They have developed multiple surveys to gather data for this assessment from different populations. If you are a healthcare provider in the Metro Denver area please respond yourself and help share the surveys with others. Survey responses are due by July 11.
A note about terminology: For the purposes of this survey, the CAAH uses the term "breastfeeding" to describe the action of human milk feeding by any method. This term includes and may be used interchangeably with "chestfeeding" as an alternate term for lactating individuals that prefer not to use the term "breast" when referring to their own bodies.
 

Coming Soon - Public Awareness Campaign Gets a New Look!

Stay tuned for a Special Edition of the Maternal Wellness Update next week highlighting the refresh for the pregnancy-related depression and anxiety public awareness campaign! 
 

The Future of Colorado’s Preschool

In November 2020, voters passed a ballot measure that will pay for all children in their year before kindergarten to attend preschool at least 10 hours per week. The Colorado Children's Campaign and Early Milestones Colorado have been leading the charge to identify the most critical considerations for the full implementation of the initiative, slated to start in 2023. Seven briefs have been produced as part of the Future of Preschool in Colorado Engagement Process, including An Overview, Governance, Funding, Workforce, Participation, Program Quality & Standards and Community Voices.
 

Peer Support for Families Affected by Substance Use

The Colorado chapter of Circle of Parents® is seeking to identify six additional counties to pilot the Circle of Parents Expansion. The national evidence-informed peer network model currently has more than 40 groups across the state (supported by Illuminate Colorado). There is no cost to participate for eligible counties that are already implementing the Dependency and Neglect System Reform Program (DANSR). Learn more
 

Calling all Families and Caregivers!

The Colorado Partnership for Thriving Families (CPFT) is a collaborative between state and local departments of human services, public health, education and others aimed at creating positive family and community connections. Facilitated by Illuminate Colorado, the CPFT Caregiver Space is looking for interested community and family members to tell stories, fight family isolation and silence, and generate collective strategies to inform the CPFT in its work. Check out and share the English Flyer and Spanish Flyer. Incentives for community participation are available.
 

Requests for Presentations for Colorado Behavioral Health & Wellness Summit

The deadline to submit presentations to the 2021 Colorado Behavioral Health & Wellness Summit has been extended to July 9. This year’s conference will take place on October 25-28 with key themes being awareness and education, training and skills; policy and advocacy to address the intersection of substance use, mental health, and wellness, especially among marginalized communities. 

Job Announcements

 

Please help disseminate the following job announcements for the Colorado Department of Public Health and Environment to your personal and professional networks. We are committed to increasing the diversity of our staff and providing culturally responsive programs and services. We encourage applicants of diverse backgrounds and abilities to apply. 
Tri-County Health Department is hiring for a Maternal Child Health Coordinator within the Community Health Promotion Division. This position will focus on the Title V Maternal and Child Health priority of Social Emotional Wellness and will provide subject matter expertise for mental health and wellness across the life course with a focus on the adolescent and perinatal period. 

MCH Updates Maternal & Infant Health


While creating new data and educational products for the 2021-2025 MCH priorities, the CO MCH program developed icons to represent and demonstrate connection to each of the seven MCH priorities. The icons shown here were developed with input from MCH staff, the department’s community advisory board and local public health agency staff. 
 
These recently released 2-page Priority Overviews provide a brief description of each MCH priority: 

Trainings


Due to evolving guidelines and preferences related to COVID-19, please contact the organizing entities to confirm whether a training or event takes place virtually. 


Essentials of Pediatric Psychiatry in Primary Care Training Series
July 8 - August  26, 2021
Register
 
2021 Harmon Lecture Honoree - Dr. Lydia Prado
July 15, 2021
Webinar
 
BUILD Initiative Conference
July 19-22, 2021
Register
  
The Colorado Health Symposium
August 5-6, 2021
Information 
 
5th Annual Colorado Breastival  - Free!
August 7, 2021 
Sign up
 
Economic Mobility & Well-Being National Conference 
August  22-26, 2021
Registration
 
2021 Public Health in the Rockies
August 25-27, 2021
Early bird registration ends July 16

 
HEALTH CARE POLICY 
 

Adjournment of the 2021 Colorado Legislative Session

 The Colorado General Assembly officially adjourned on June 8, 2021, passing more than 502 pieces of legislation, including an unprecedented $34 billion state budget. Below are brief highlights of enacted legislation that most closely impact the maternal and infant populations. 
 

Maternal Health-Related Legislation

  • SB21-101: Sunset Direct-entry Midwives (Certified Professional Midwives): This bill continues the registration of direct-entry midwives until 2028 and implements recommendations contained in the 2020 sunset report by the Department of Regulatory Agencies, including provisions for trained midwives to practice at birth centers.
  • SB21-137: Behavioral Health Recovery Act: Provides $114 million for a variety of behavioral health activities to address substance use prevention, harm reduction, criminal justice response, treatment, and recovery, including the medication-assisted treatment expansion pilot program, harm reduction grant program, and the maternal and child health pilot program. This bill requires screening for perinatal mood and anxiety disorders be available to the caregiver of each child enrolled in the Medicaid program according to HRSA guidelines and expands the data linkage project for perinatal substance use to include additional data sources.  
  • SB21-193: Protection of Pregnant People in Perinatal Period: Establishes additional protections for pregnant and postpartum people, with a primary focus on those who are incarcerated; requires the Colorado civil rights commission to receive reports about harm or mistreatment of pregnant or postpartum people; and makes changes to the requirements for medical malpractice insurers.
  • SB21-194: Maternal Health Providers: Requires HCPF to seek federal approval to extend Medicaid and CHP+ eligibility to 12 months postpartum; requires health plans to reimburse labor and delivery providers, ensures provider best practices and collaboration in transferring pregnant individuals from home or a birthing center to a health facility, requires CDPHE to study the use of research evidence in perinatal policies, and to make recommendations to improve publicly-available maternal health data and to report those findings to the general assembly. 
Other legislation enacted in 2021 related to public health, mental and behavioral health care, health-related financing and insurance, and family strengthening:  
  • HB21-1021: Peer Support Professionals Behavioral Health
  • HB21-1097: Establishment of a new Colorado Behavioral Health Administration (BHA)
  • HB21-1232: Establishment of a Standardized Health Benefit Plan Colorado Public Option 
  • HB21-1299: Establishment of an Office Of Gun Violence Prevention with the Colorado Department of Public Health & Environment 
  • HB21-1304: Creation of a stand-alone state Department of Early Childhood by 2022
  • HB21-1311: Increasing state contributions for Earned Income Tax Credit and Child Tax Credit beginning in 2022. 
  • SB21-009: Medicaid Contraceptive Coverage for Undocumented People & 12-Month Supply
  • SB21-016: Ensuring Access to All Forms of Contraception without Costs to Patients
  • SB21-025: Expanded Income Eligibility for Medicaid Family Planning Services to align with CHIP eligibility limits for pregnant people. 
  • SB21-027: Emergency Supplies for Babies and Families (Diaper Distribution Centers)
  • SB21-148: Creation of Financial Empowerment Office to grow the financial resilience and well-being of Coloradans.
  • SB21-251: General Fund Loan for Family Medical Leave Program (one-time funding) to assist with expenses of set up before premium revenue from Proposition 118 is available.
 
USEFUL RESOURCES 
 

New IRS Child Tax Credit portal for non-filers!

This week, the IRS activated a new Child Tax Credit Non-filer Sign-up Tool to help families sign up to receive the expanded child tax credit. What do families need to do to receive the credit of up to $3,600 per child? 

NOTHING if they:
  • Filed taxes in 2019 or 2020. The credit will be deposited in their bank account or sent via a check in the mail on the 15th of every month for the rest of the year, starting July 15.
or
  • Gave the IRS their information in 2020 to receive a stimulus payment.
TAKE ACTION if they:
  • Did not file taxes in 2019 or 2020. If they did not file a tax return and haven't given the IRS their information to receive a stimulus payment, they need to sign up through the Non-filer Sign-up Tool available at www.childtaxcredit.gov. It's not too late!
Watch for additional social media materials to be added to this tool kit in the coming weeks to help promote the portal for non-filers to sign-up for tax credits. 
 

Bilingual Helpline & Resources for Expectant and New Parents!

The Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR) and Elephant Circle manage a bilingual Helpline (720-634-6247), with resources ranging from home birth, food or diapers, breastfeeding, and much more. Check out and share the flyers in English or Spanish, or fill out this Google form.
 

Celebrate National Breastfeeding Month and World Breastfeeding Week 2021!

These annual celebrations of breastfeeding encourage families, communities and the world to support breastfeeding to improve the health of mothers and babies. Based upon the World Alliance for Breastfeeding Action’s (WABA) 2021 World Breastfeeding Week, the Colorado WIC Program has developed a logo and population-specific postcards and materials to share with breastfeeding families. Feel free to edit and adapt any of the materials and share widely with those in your community.
 

Pregnant and Got Questions about COVID-19 Vaccines? 

MothertoBaby, a service of the Organization of Teratology Information Specialists, provides a live chat to pregnant and breastfeeding individuals on questions about safety, risks and exposures of a variety of natural and manufactured chemicals and substances, including COVID-19 vaccines. English and Spanish language information and resources also include texting, telephone and email and are consistent with the most up-to-date research and guidance by the Centers for Disease Control and Prevention (CDC), such as this Fact Sheet on COVID-10 Vaccines.
 

Women Caregivers of Young Children Speak Up about Work During the Pandemic

Since the pandemic began, millions of American parents have experienced job loss and reduced hours. The RAPID-EC project at the University of Oregon found more than one out of three women have left the workforce or reduced their work hours, with black and Latinx families disproportionately impacted by financial and emotional hardships. Read more about the RAPID-EC project and its recommendations.
 

YouTube Video on PMADS by Postpartum Wellness Center/Boulder

Dr. Patricia Widra, a reproductive psychiatrist, recently created a short informational video on perinatal mood and anxiety disorders for the Postpartum Wellness Center/Boulder. Please share with partners and providers!
 

Educational Videos & Supportive Content  - Caring for Opioid-Exposed Infants and Families in the Pediatric Setting

The American Academy of Pediatrics provides resources for pediatric providers on recovery-friendly and family-centered care, including this four-part series on Recovery-friendly Pediatric Care, Opioid Use and Pregnancy, Planning for Maternal and Infant Discharge and Care Coordination to Support Maternal-Infant Health.
 

2019 Supplemental PRAMS Data - Indicators on Opioid Use in Pregnancy

The Centers for Disease Control & Prevention recently released 2019 supplemental data with new indicators on opioid use during pregnancy and maternal disabilities for selected states that added the supplemental indicators on their 2019 surveys. In Colorado, 6.6% of postpartum individuals reported pre­scription opioid use during pregnancy in 2019. Among them, 20.9% reported misuse, 21.1% indicated wanting or needing to cut down or stop using, and 67.9% received counseling on how prescription opioid use during pregnancy could affect an infant. Read more.  
 

Disproportionate, Race-Based Impact of COVID-19 on Family Health

Against the backdrop of the rising mortality rate among pregnant and postpartum individuals in the US, new efforts continue to underscore the disproportionate impact of COVID-19 on certain populations. See the latest interactive “Data Insights” from the National Institute for Health Care Management (NIHCM) Foundation on the disproportionate impacts of COVID-19 on Maternal Health and Young Children of color.
 

Peer Support for Wellness - What’s in a Name?

The need for mental health providers and services has been exasperated by the pandemic. Certified peer support models are increasingly filling that gap, and its efficacy has been acknowledged by the Centers for Medicare and Medicaid Services (CMS), SAMHSA, HRSA, Mental Health America among others. Read more about the model and pilot study conducted by 2020Mom that makes the case for training new parents as peer support specialists. Additional resources about peer support, from roles and supervision to self-care, are also available through the National Training and Technical Assistance Center (NTTAC) for Child, Youth, and Family Mental Health.
 

Evidence, Research and State Paid Leave Programs

A fact sheet from the Washington Center for Equitable Growth looks at research on—and lessons learned from—state-provided paid family and medical leave programs in the US. The fact sheet outlines some of the research and evidence on paid family and medical leave as it relates to families’ economic security, human capital development, employer experiences, and national economic growth.
 

Missed a Recent Webinar or Training? Recordings & Materials are Now Available for the Following:

-Advancing Maternal Health Equity & Reducing Maternal Deaths (National Academies of Sciences, Engineering and Medicine)
-
Centering Pregnancy for Improved Prenatal-3 Outcomes (Centering Healthcare Institute, Password: Centering2021! )
-
Colorado ACOG Conundrums (Colorado Chapter - American College of Obstetricians and Gynecologists)
ARTICLES OF INTEREST 
 

Caring for Families Impacted by Opioid Use - A Qualitative Analysis of Integrated Program Designs

A recently published qualitative analysis identified models of integrated care that offer medical care and social services for children and families impacted by opioid use in the postpartum year. The authors outlined how each program was developed, designed and sustained as well as explored positive and negative factors in successful implementation of a dyadic, two-generational approach to care.
 

Leveraging Provider Perceptions to Inform Treatment of OUD in Pregnancy

In this study, authors revealed opportunities to promote and facilitate access to medication treatment for opioid use disorder during pregnancy by supporting families early on in their journey. However, gaps in treatment and challenges in provider, health systems and patient factors persist and include inconsistencies in treatment provision, access and uptake.
 

The Importance of Provider Discussion about COVID-19 Vaccination with Women of Childbearing Age

Given the high rates of vaccine hesitancy in this vulnerable population, it is especially important for maternal care providers to discuss vaccination with mothers and women of childbearing age and provide accurate information. Check out this editorial from Dr. Ruta Nonacs of the MGH Center for Women’s Mental Health, as well as resources for patients and providers from ACOG and other information about the COVID-19 vaccines that are suitable for pregnant and breastfeeding patients.
 

Lessons from the Pandemic on Social Connectivity of New Parents

New parents frequently experience a burden of their new roles, inadequacy of virtual contact, and sadness and worries about lost social opportunities. While partner support can provide a source of strength toward positive family bonding, a recent study provides evidence and asserts, through new social norms established by COVID-19, that it still “takes a village” to raise children, even in high-income societies.
 

Excessive Information-Seeking Leads to Poorer Perinatal Mental Health

An international study in 64 countries conducted in 12 languages found that individuals who excessively sought information about COVID-19 were more likely to show elevated anxiety and depressive symptoms, and experienced higher levels of worries related to obtaining health care services. The authors reaffirmed the need to address these “modifiable pandemic-related behavioral or cognitive factors” as well as isolation and loneliness as public and medical health systems conduct interventions.
 

Mothers Left Behind in Post-COVID Economic Recovery

The author of this blog from the Hamilton Project describes ways in which the labor market trajectory of mothers prior to the pandemic has not only been disrupted, but meaningfully turned back. Through an examination of data about labor participation rates, child care scarcity and food insecurity, the author asserts that mothers — particularly those of children under five and unmarried individuals — are being left behind in the economic recovery from COVID-19
Copyright © 2021 Colorado Department of Public Health and Environment / Prevention Services Division, All rights reserved.
A monthly communication for maternal wellness and early childhood partners.

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4300 Cherry Creek Drive South
Denver, CO 80246

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