Delaware program connects rural mothers to doulas, prenatal care

What are journalists missing from the state of Delaware? What would you most like WHYY News to cover? Let us know.

Maternal health providers in Sussex County are launching a new initiative aimed at connecting pregnant women in rural Delaware with care earlier in their pregnancies, particularly women of color and immigrant families who often face barriers accessing services.

Last month, La Red Health Center partnered with the Delaware State Housing Authority and several community organizations to launch the Maternal Outreach and Mobile Services: Advancing Health for Rural Delaware Families initiative, known as MOMS.

The program uses community health workers, doulas and La Red’s mobile health unit to bring maternal health services directly into underserved communities throughout southern Delaware.

“Far too many women in Southern Delaware have difficulty accessing women’s health care services,” said Rachel Hersh, CEO of La Red Health Center. “Some of the reasons are as simple as a lack of transportation. Ensuring that all women have the opportunity to receive care, but also care that is well-coordinated will only help improve outcomes for Delaware women. Ultimately, that will lead to healthier communities, which benefits us all.”

For Lisa Butterworth, a certified nurse midwife and clinical director of women’s health at La Red, the initiative is part of a larger effort to address longstanding disparities affecting women of color.

“We know that women of color face a much higher maternal morbidity and mortality rate, and it’s not genetic,” Butterworth said. “It is because of systemic failures.”

“When we address the issues that are affecting Black and minority women, we know that improving the Black and minority women’s health is going to improve all of our health,” she added.

Addressing barriers to care

Butterworth said Latina women in Sussex County often face multiple barriers when seeking prenatal, postpartum and reproductive health care.

“We noticed with the Latina population, they have a lot of barriers to health,” she said. “In Sussex County, we don’t have enough obstetrical providers in general, and then to have obstetrical providers who can provide culturally competent care and provide language services when needed is even harder for this population,” Butterworth said.

Many women also remain uninsured during pregnancy, causing them to delay care.

“They often don’t come into prenatal care until late in the pregnancy,” Butterworth said, adding that cost is also a barrier. “They just can’t afford the visits, the ultrasounds, blood work, all the things that come along with prenatal care,” she said.

Transportation can also be difficult, especially for families living in rural communities.

“Getting to one of the offices that exist for maternal health care can be difficult,” Butterworth said. “A lot of families share a car, a vehicle, and doctors’ offices are open during the day when their husbands are at work.”

The challenges often extend beyond health care itself.

“If you have a mother who’s trying to provide for her kids and she can’t put food on the table and they’re hungry, going to a doctor’s appointment isn’t going to be her priority,” Butterworth said. “Her priority is going to be finding a way to make money to feed her family.”

To help address those barriers, La Red’s MOMS initiative brings services directly into communities through its mobile health unit and a team that includes a bilingual community health worker and a bilingual Latina doula.

“We saw that Sussex County really needed to expand and get out of the building to reach some of these people,” Butterworth said. “That’s kind of why we applied for this grant and we’re so happy to get it to bring the care to the more rural areas of Sussex.”