By Debra Rainey
Babies and Moms. Two special groups with two strong champions – the March of Dimes, a long-time IS member since the 1980s, and 2020 Mom, which joined in 2014. For both, the adage “an ounce of prevention is worth a pound of cure” is the “north star” of their work to build the best start and best life for children and their mothers.
March of Dimes
Prevention has always been key for the March of Dimes. Its original focus was to find a cure for infantile paralysis, better known as polio. The organization was founded by and originally named the National Foundation for Infantile Paralysis in 1938 by President Franklin D. Roosevelt, who was diagnosed with the condition in 1921 at the age of 39. Comedian Eddie Cantor suggested in a radio appeal that Americans send money to the White House to show their support for President Roosevelt’s battle. Saying that “nearly everyone can send a dime,” Cantor jokingly called the campaign “the March of Dimes” – a play on the name of a popular newsreel at that time, The March of Time. His plea resulted in the delivery of more than 80,000 letters with dimes and dollars to the White House mail room totaling $268,000 that first year, about $6 million in today’s currency.
The “March of Dimes” continued as an annual event, providing major funding for the development of polio vaccines by Dr. Jonas Salk and Dr. Albert Sabin, which ended the polio epidemics in the U.S. In 1958 the Foundation took on a new mission to improve the health of babies, officially adopting the name of its most famous event in 1979. “We’ve been about prevention from the moment we were founded by President Roosevelt to prevent polio,” according to Dr. Edward R. B. McCabe, senior vice president and chief medical officer for the March of Dimes. “Today, we’re focused on improving the health of babies by preventing birth defects, premature birth, and other causes of infant mortality.”
Premature birth is the number one killer of babies. One out of every 10 babies is born prematurely, and the costs associated with labor, delivery, and first-year care for that one premature baby surpasses the costs for the other nine full-term babies combined. The Institute of Medicine has estimated the average cost of prematurity at $26 billion a year. While premature births have dropped steadily, the rate remains at 9.6 percent. The March of Dimes is striving to see it drop to 5.5 percent by 2030. “We feel we owe it to our babies to have this very aspirational goal, and we get there by prevention,” according to Dr. McCabe. “We’re developing a roadmap to get premature birth rates down, particularly in medically underserved and minority communities.”
The March of Dimes Prematurity Campaign is designed to address the crisis of premature birth and help families have healthy, full-term babies through community services, advocacy, research, and education. Major strategies include:
Premature Research Centers: The March of Dimes is investing $75 million in five Prematurity Research Centers around the country to help generate out-of-the-box thinking to find the unknown causes of pre-term birth and new approaches to prevention and treatment for babies.
Healthy Babies Are Worth the Wait®: This community-based program has a particular focus on underserved communities and communities of color. It uses public service announcements and education through hospitals and clinics to raise awareness and educate women about ways to improve their chances of delivering a full-term baby.
Premature Birth Report Card: The March of Dimes issues a Report Card each November that tracks the progress of the nation and individual states toward the goal to reduce premature birth. For the first time in 2015, the Report Card looked at the largest cities to compare their progress with that of their respective states, and provided a measure of racial and ethnic disparities.
The foundation provides a wide range of educational resources for patients and their families, including online information available on separate websites in English and Spanish, marchofdimes.org and nacersano.org. Some of the latest education centers around the Zika virus in pregnancy and its connection to a birth defect called microcephaly. March of Dimes also provides educational resources for physicians and other medical providers to help keep them abreast of advances in perinatal health care and provide counsel to patients and their families on how to ensure the birth of healthy, full-term babies.
Advocacy also is a major March of Dimes priority, including its work to support access to health care for more women and children; federal and state funding for research; prevention and education; and tax treatment of charitable contributions, postal rates, pension issues, and the activities of nonprofit organizations. Most recently, the foundation was instrumental in advocating for passage of the bipartisan “Protecting Our Infants Act,” one of the few bills signed into law by Congress during the 2015 lame duck session.
It began with a series of events led by a group of motivated women, including Joy Burkhard, who would become founder and CEO of 2020 Mom. In 2009, her California chapter of IS member The Junior League, The Junior League of Los Angeles advocated for a bill in the state legislature that would require hospitals to provide new mothers with information on the signs and symptoms of post-partum depression. While not enacted, it spawned a resolution in 2010 declaring the month of May “Maternal Mental Health Awareness Month” in California, which became recognized internationally in 2010.
While the birth of a child is supposed to be a happy time, approximately 80 percent of new mothers experience some degree of what many call the “baby blues,” which usually subsides within two weeks of birth. Up to 20 percent of new or expecting mothers, however, experience clinical depression or pregnancy and postpartum anxiety disorders, more serious conditions that often require medical treatment. And unfortunately, a small percentage of women experience a severe maternal mental health disorder called postpartum psychosis, which, though rare, could result in the woman doing harm to herself or her child if left untreated.
According to Joy, “My personal interest in maternal mental health is the result of four life experiences – my policy work with The Junior League, my 20 years of work on compliance and quality management at Cigna, a large health insurer, my struggles to find help for my little brother, whom I sadly lost to suicide, and the birth of my first son.”
In the 2010 resolution, the legislature called for the establishment of a volunteer task force, and Joy stepped up to the plate. Named the California Mental Health Collaborative, the task force served as a convening organization for stakeholders in California and throughout the U.S. The Collaborative and partner organization Postpartum Support International launched online maternal mental health training to help educate providers. Joy also launched the “2020 Mom Project,” which laid out simple steps that hospitals, health insurers, and health care providers could take to increase awareness and improve outcomes. The catchy “2020 Mom” moniker took hold and officially replaced the name of the collaborative in 2015.
Based in Valencia, California, 2020 Mom focuses on collaborative relationships with all stakeholders – including health insurers, hospitals, OB-GYNs, and other nonprofits in the space – to exchange ideas, to identify and remove barriers, and to expand opportunities to increase and improve maternal mental health awareness, diagnosis, and treatment in California and beyond – by 2020.These collaborative efforts include hosting annual “Emerging Considerations in Maternal Health” forums, also webcast to sites throughout the U.S., featuring new angles, possible solutions, education, best practices, policy issues, and topics that stakeholders may not have considered, but that are important to moms.
2020 Mom also works to bring together all nonprofits with an interest through the National Coalition for Maternal Mental Health, including engaging the March of Dimes, to collectively share information, raise awareness, and engage in advocacy. This advocacy included providing feedback on the recent recommendation by the government-appointed U.S. Preventive Services Task Force that called for the screening of all adults for depression, including women, during pregnancy and after birth.
2020 Mom supports and leads many of the advocacy efforts around maternal mental health on a state and federal level, including support for H.R. 3235, “Bringing Postpartum Depression Out of the Shadows Act of 2015.” The bill would authorize the Secretary of Health and Human Services to make grants to states for screening and treatment for maternal depression. Joy notes that the March of Dimes and the American Congress of Obstetricians and Gynecologists are significant players in the effort to secure passage of the bill. With the support of (IS member) The California Endowment and the California Health Care Foundation, 2020 Mom is leading the 12-month Task Force on the Status of Maternal Mental Health Care, comprised of more than 20 appointed members from state agencies and trade associations. The Task Force is expected to release a report in May 2016 recommending actions the state of California can take to address maternal mental health concerns.
“Research shows that children born to moms with untreated mental healthcare disorders can go on to have short- and long-term developmental problems, and higher healthcare costs over their lifetimes,” says Joy. “We have to do something to intervene early. We need to invest to prevent it in the first place, but when that’s not possible, we at least have to treat these moms right away. They need our help.”
To learn more about maternal mental health and how you can engage in this emerging issue, follow 2020 Mom on Twitter: @2020MomProject
Debra Rainey is the manager of grants development at Independent Sector.