Maternal and Child Health

Maternal and Child Health Resources and Case Studies

Below are resources and short case studies describing state specific initiatives that are focused on improving birth outcomes. There are also resources that states can use to show that prevention has a positive economic impact.

Submit your story about programs or projects your state or territory has undertaken that relate to ASTHO’s Maternal and Child Health Project.

Issue Briefs

The Neonatal Abstinence Syndrome Framework: Structuring Collective State-Level Efforts to Prevent NAS (2017)
An updated framework to aid in structuring stakeholder discussions at the state level to better understand how collective efforts can prevent in-utero opioid exposure and impact the incidence of NAS.

Utilizing Community Health Workers to Improve Access to Care for Maternal and Child Populations: Four State Approaches 
This brief describes how four states are using community health workers to promote individual and community health by providing family-centered support that is tailored to an individual’s or family’s unique needs.

Early Elective Delivery Issue Brief
This issue brief describes why early elective deliveries (EEDs) are a public health concern and describes national and state efforts to reduce rates of EEDs.

Smoking Cessation Strategies for Women Before, During, and After Pregnancy: Recommendations for State and Territorial Health Agencies
This issue brief introduces seven recommendations to improve smoking cessation among women before, during and after pregnancy with examples from current public health tobacco control practice. 

Maternal and Infant Disparities Issue Brief
This brief explores the importance of maternal and infant health disparities as well as highlights different programs states have implemented to address these issues.

Bright Futures Issue Brief
This issue brief illustrates how Illinois, New York, Virginia, and Washington have incorporated Bright Futures guidelines.

How State Health Departments can Use the Spectrum of Prevention to Address Neonatal Abstinence Syndrome
This report outlines Neonatal Abstinence Syndrome (NAS), the affected population, risks and exposures, and the primary, secondary, and tertiary prevention strategies to addressing NAS. 

MCH and Health Information Exchange Issue Brief
This brief provides an overview of federal and state health information exchange (HIE) challenges and opportunities for MCH and highlights several states' strategies for accelerating electronic health records (EHR) adoption and electronic HIE.


Early Elective Delivery State Levers for Change
This online toolkit provides resources and examples for state leaders to address early elective delivery, including: Policy/Leadership, Increasing Capacity/Systems of Care, Partnerships and Collaborations/Community Engagement, Messaging, and Data.

Coordinating WIC and Other Public Health Services Fact Sheets
ASTHO and NACCHO collaborated to promote the integrated delivery of the Special Supplemental Program for Women, Infants and Children (WIC) and other services at the state and local levels. The information in these fact sheets summarize successes, challenges, and lessons learned from interviews with WIC program survey participants.

Disability and Health Resources
These resources and case studies provide an overview of this important topic and a snapshot of what state health agencies can do to address the needs of people with disabilities.

Fact Sheets

State Efforts to Protect Confidentiality for Insured Individuals Accessing Contraception and Other Sensitive Healthcare Services
This fact sheet provides information on protecting confidentiality for insured individuals and explanation of benefits for adolescents.

Obtaining and Managing Private Funding for Long Acting Reversible Contraception Programs
This fact sheet provides information on best practices for identifying, acquiring and managing private funding for LARC initiatives.

Conducting Public Awareness Campaigns on Long Acting Reversible Contraception for Younger Audiences
This fact sheet provides information on best practices for increasing awareness of LARC among teens.

Addressing Healthcare Providers’ Needs for Postpartum LARC Training
This fact sheet provides recommendations on how state and territorial health departments can facilitate immediate postpartum LARC training for healthcare providers.

State Children's Health Insurance Program (S-CHIP) Coverage During Pregnancy
This fact sheet provides information on pregnancy coverage under S-CHIP within 19 states and Washington, D.C.

Partnerships to Reach At-Risk Populations: Pregnant Women
This fact sheet describes populations and partnerships with which state and territorial health agencies work to reach at-risk populations with a focus on supporting pregnant women to receive needed vaccinations.   

Assisted Reproductive Technology Fact Sheet
This fact sheet explains assisted reproductive technology and the common birth outcomes associated with the use of this technology.

Long-Acting Reversible Contraception (LARC) Fact Sheet
This fact sheet provides an overview of LARC, the barriers that women and physicians face when choosing LARC, and public health solutions to reduce these barriers.  

17 Alpha-hydroxyprogesterone caproate (17P) Fact Sheet
This fact sheet highlights how state health agencies can take the lead in promoting efficient, cost-appropriate, and safe dissemination of 17P.  

Medicaid Cost Savings Methodology
This methodology can be used for states to estimate the Medicaid cost savings if they are to reduce the rate of prematurity by 8 percent. The template includes how Texas used this methodology.

Summary of Texas' Medicaid Legislation on Elective Deliveries
This document provides a brief description of TX House Bill 1983, an effort to reduce the elective or non-medically-indicated induced deliveries and C-sections prior to 39 weeks of gestation.

Preconception Care Fact Sheet
This resource highlights preconception program and policy examples that states can adopt.

Perinatal Regionalization Fact Sheet
This fact sheet describes perinatal regionalization and provides programmatic and policy examples for states.

Perinatal Quality Collaboratives Fact Sheet
This resource describes perinatal quality collaboratives, their distribution throughout the country, and shares examples of PQCs in California, New York, Ohio, and North Carolina.

State Stories

Alaska Empowers Youth to Develop Healthy Relationships through the Fourth R Curriculum

Alaska Infant Safe Sleep Initiative Develops Toolkit for Birthing Hospitals

Alaska Perinatal Regionalization State Story

Arizona Addresses Newborn Screening Transit Delays

Arizona Celebrates 20 Years of Cultural Competency in Home Visiting Programs

Arkansas Focuses on College Students to Lower Teen Pregnancy and Birth Rates

Arkansas Promotes Breastfeeding Through Public and Private Partnerships

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Arkansas Trains African-American Sororities as Public Health Educators to Reduce Infant Mortality

Arkansas Trains and Educates Healthcare Providers to Increase Access to Long-Acting Reversible Contraception

The California Pregnancy-Associated Mortality Review

California Uses CDC Tool to Assess Maternity Facilities’ Levels of Care and Evaluate Regional Cooperation Agreement Use

Colorado Creates Public-Private Partnership to Ensure Access to Most Effective Contraception

Colorado Committee Convenes Stakeholders to Address Prenatal Substance Exposure

Colorado Significantly Decreases Unintended Pregnancies by Expanding Contraceptive Access

Connecticut Conducts Assisted Reproductive Technology Surveillance and Education to Reduce Harms from Multiple Births

Connecticut Works at All Levels to Reduce Prematurity Disparities

Delaware Addresses Racial Disparities in Infant Mortality Rates

Delaware Addresses Safe Sleep to Bring Down Infant Mortality Rates

Improving Breastfeeding in Delaware: Creating Breastfeeding-Friendly Communities

Georgia Addresses Infant Mortality Using Innovative Geographic Cluster Analysis

Georgia Partnerships to Improve Infant Mortality Rates

Georgia Uses Telehealth to Improve Maternal and Child Health Outcomes

Idaho WIC Program Aims to Increase Number of Pregnant Women Enrolled in Smoking Cessation Program - A Community Pilot Project 

Illinois Utilizes LOCATe Tool to Assess Perinatal Regionalization

Illinois Women’s Prison Promotes Breastfeeding and Maternal and Infant Health

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Kentucky Uses Quality Improvement to Improve Newborn Screening Timeliness

Louisiana Expands Medicaid 1115 Waiver to Include Interconception Care

Maine CDC Snuggle ME Guidelines Developed to Standardize Care for Families of Drug-Affects Babies

Maryland's Safe Sleep Program Bans Crib Bumpers and Fights Health Disparities

Maryland Targets Women Across the Lifespan to Improve Health and Birth Outcomes

Massachusetts Collaborative Improves Pregnancy and Birth Outcomes Through "Hard-Stop" Approach

Massachusetts Strengthens its Community Health Worker Workforce Through Broad-Based Policies and Collaboration

Massachusetts Uses Linked Data to Drive Education on Assisted Reproductive Technology and Reduce Adverse Birth Outcomes

Michigan Holds Summit to Raise Awareness of Infertility’s Public Health Impacts and Inform Future Work

Michigan Sheds Light on Causes of Maternal Death

Michigan's Telemedicine Program Provides Epilepsy Services in Rural Michigan

Montana Improves Birth Outcomes Through Home Visiting Services and Education

Nevada Benefits from Infant-at-Work Program

New Jersey Families as Partners in Medicaid and Managed Care Organizations

New Jersey Prioritizes Newborn Screening Program in the Face of Hurricane Sandy

New Mexico Leverages Reproductive Justice Advocates to Provide Patient-Centered Culturally Competent Care

New York Redesigns Maternal and Child Health Programs

North Carolina Leverages a Long History of Maternal Mortality Review

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North Carolina Links Community Resources with Providers to Establish Pregnancy Medical Home

North Carolina Reduces the Risk of Recurring Preterm Birth through 17P Project

North Dakota Health Department Embraces Healthy Maternity Policies in Workplace

North Dakota Transitions Healthcare Providers to Using Bright Futures Screening Tools   

Ohio Takes Comprehensive Approach to Reducing Prescription Drug Abuse and Neonatal Abstinence Syndrome (NAS)

Ohio Safe Sleep Initiative

Oklahoma Engages Families as Partners to Strengthen SoonerCare Program

Using Maternal and Child Health Quality Improvement Efforts to Advance State Health Agency Accreditation (Oklahoma)

Oklahoma Collaborative Reduces Elective Deliveries Prior to 39 Weeks with Voluntary "Hard Stop" Effort

Oklahoma's SoonerQuit Prenatal Helps Obstetric Care Providers Address Patients' Tobacco Use

Oregon Authorizes Pharmacists to Prescribe Hormonal Birth Control

Oregon Combines Title X and Medicaid Waiver Programs to Expand Family Planning Services

Public-Private Partnership in Puerto Rico Leads to Increased Access to 17P and a Lower Preterm Birth Rate

Rhode Island Collaborates to Increase Breastfeeding Rates

South Carolina Increases Access to LARCs Immediately Postpartum to Reduce Unintended Pregnancy

South Carolina's Perinatal Regionalized System of Care: Reducing Premature Births and Infant Mortality

South Carolina Website for Teen Health Benefits from Stakeholder Collaboration

Tennessee Forms Joint Collaborative to Reduce Early Elective Deliveries

Tennessee Launches Safe Sleep Campaign

Statewide Training and Certification Program Strengthens the Community Health Worker/Promotor(a) Workforce in Texas

Texas Addresses Maternal Mortality and Morbidity

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Texas Champions Healthy Babies Initiative to Improve Birth Outcomes

Washington AIM Access Bright Futures Services and Sustainable Billing Practices in Public Health

Washington State Guidelines and Programs Reduce the Number of Alcohol and Drug-Exposed Babies

Washington Uses Quality Improvement Measures to Reduce Elective Deliveries

West Virginia Identifies Infant Mortality Risk Factors Through Universal Screening Program

West Virginia's Coordinated Network of Providers Promotes Well-Being of Women and Babies

West Virginia’s Project WATCH Tool Allows for Real-Time Neonatal Abstinence Syndrome Surveillance

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Wisconsin Combines Newborn Screening Data Systems, Saving Time and Money

Wisconsin Fights Against Disparities and Inequities in Infant Mortality

Wyoming Uses CDC Tool to Conduct First Formal Assessment of Its Maternity Facilities’ Levels of Care


State Home Visiting Approaches Improve Early Childhood Outcomes and Systems
This primer examines how evidence-based home visiting ("home visiting") fits into a state’s overall early childhood approach, and how states are strengthening their home visiting services to promote maternal and child health and well-being.