National Health Outreach and Engagement Conference 2024

Mebane, P, Nesmith-Dimery, R, and Biddle, E.
In South Carolina, between 2016 and 2021, there were 112 pregnancy-associated deaths. Black
and Hispanic women made up over 70% of postpartum maternal deaths. The leading causes of
maternal mortality in South Carolina are linked to Hemorrhaging, Cardiovascular Conditions,
Infections, Cardiomyopathy, and Mental Health Conditions. Nearly 3 out of 4 deaths were
deemed to be preventable by the SC Maternal Morbidity and Mortality Committee (MMMR).
Factors contributing to maternal mortality in South Carolina were discrimination at 52%,
obesity at 24%, substance use disorders at 20%, and mental health conditions at 16%. The SC
MMMR recommends implementing programs and projects that increase the coordination of
care and referrals, provide linkages to clinical interventions, address discrimination and unequal
treatment, improve healthcare access, providing access to preconception, perinatal, and
postpartum healthcare support will reduce maternal deaths in South Carolina. The collaborative
nature of rural communities across the Pee Dee Region of SC provides an environment where
these recommendations can be easily incorporated by utilizing the Alliance for Innovation on
Maternal Health Community Care Initiative (AIM CCI). This initiative has been implemented
in 11 states across the US with high maternal mortality rates.

The AIM CCI Initiative leverages the knowledge and reach of community organizations to
uncover, address, and over come systemic inequalities that lead to poor maternal outcomes and
close gaps between clinical care and community support for prenatal and postpartum
women/birthing persons. Developing a workgroup composed of organizations and individuals
that advocate for, serve, or have lived experience can significantly improve communication
between internal and external partners, increase coordination of services, education, and support
for perinatal women/birthing persons, and develop shared measures to depict maternal health
outcomes in the community accurately.

The AIM CCI initiative encapsulates equity to address maternal mortality by applying the
extension’s model of implementing evidence-based strategies and tools to address maternal
mortality. There are four sets of strategies or “bundles” that address various maternal health
issues, including establishing a foundational community postpartum support system and
managing maternal morbidities, including high blood pressure & diabetes, intimate partner
violence, and maternal mental health. A workgroup of over 50 maternal health advocates has
collaboratively utilized these bundle elements to create a shared vision with mutually
reinforcing activities that increase awareness of the maternal health crisis and community
resources that improve these outcomes. The AIM CCI workgroup shares data from various
organizations and captures data that depicts maternal health outcomes in communities that are
considered a maternal care desert or low access area. These communities are historically
underreported.

Utilizing elements of the extension model has improved communication among clinical and
community partners, established a shared agenda and common language, which improved data
collection surrounding maternal health outcomes, and increased awareness of maternal health
outcomes and support resources.