Enter Title

Priority Area 4: Healthy Mothers, Babies, and Youth

The well-being of mothers, infants, and children influences the health of the next generation and forecasts the future health challenges of Montana families, communities, and the health care system. Unintended pregnancy can results in adverse maternal and child health outcomes. In 2015, 32% of Montana births were unintended and of these, 7% were the result of an unwanted pregnancy. Women with unintended pregnancies are more likely to engage in risky behaviors during pregnancy, such as smoking and drinking. Drinking alcohol while pregnant can cause Fetal Alcohol Spectrum Disorders (FASD), which can lead to intellectual and developmental disabilities for the growing child. Among American Indian women and young adult women (aged 18 to 24 years), one in three pregnancies are reported as intended.

Approximately 12,000 live births occur each year in Montana. The majority of infant deaths in Montana are sleep-related incidents. In 2015, the American Academy of Pediatrics reported the national breastfeeding initiation rate was 65%, while the rates among Women, Infants, and Children (WIC) participants was 70%. Montana's WIC breastfeeding rate is higher than the national rate at 78%, but still lower than the Healthy People 2020 target rate of 82%. Low birth weight and preterm birth are associated with numerous poor birth outcomes, including respiratory distress syndrome, retinopathy, jaundice, infections, and other serious conditions. They are also associated with developing diabetes, heart disease, high blood pressure, developmental disabilities, and obesity later in life. Montana's American Indian populations have disproportionately higher rates of preterm birth at 13%, compared to 9% for all Montana births.

Goals

  1. Decrease unintended pregnancies by increasing the use of effective contraception methods.
  2. Increase home visiting services for all Montana families.
  3. Increase education and awareness of the importance of prenatal care, birth outcomes, postpartum care, and childhood health.
  4. Increase childhood and adolescent immunizations.
  5. Decrease maternal and child health disparities among American Indian populations.

Objectives for all Montanans by 2023

  • Decrease the infant mortality rate for all Montanans from 6 per 1,000 live births to 5 per 1,000 live births (Baseline: MT Office of Vital Statistics, 2016)
  • Decrease the number of sleep-related infant deaths from 1.4 per 1,000 to .84 per 1,000 (Baseline: MT DPHHS FICMR Data System, 2016)
  • Increase the percentage of babies in safe sleep environments from 80% to 84% (Baseline: PRAMS, 2017)
  • Decrease the percentage of births resulting from unintended pregnancy from 23% to 22% (Baseline: PRAMS, 2017)
  • Decrease the percent of live births that were low birth weight (less than 2,500 grams) for all Montanans from 7.9% to 5.9% (Baseline: MT Office of Vital Statistics, 2016)
  • Decrease the percent of live births that were preterm births (less than 37 weeks gestation) for all Montanans from 9% to 7% (Baseline: MT Office of Vital Statistics)
  • Increase the percentage of pregnant women who receive early and adequate prenatal care from 86% to 91% (Baseline: MT Office of Vital Statistics, 2016)
  • Increase breastfeeding initiation rates of WIC-participating Montana infants from 78% to 82% (Baseline: MT DPHHS WIC Data System, 2017)
  • Increase the percentage of children aged 24-35 months who receive the recommended doses of DTaP, polio, MMR, Hib, hepatitis B, varicella, and pneumococcal conjugate vaccine from 62% to 70% (Baseline: National Immunization Survey, 2018)
  • Increase the percentage of adolescents aged 13-17 years who have at least one dose each of Tetanus, Diphtheria, and Pertussis (Tdap), Meningococcal (MCV4), and Human Papillomavirus (HPV) from 90% (Tdap), 71% (MCV4), and 49% (HPV) to 93%, 80%, and 70% respectively (Baseline: National Immunization Survey, 2017)
  • Increase the percentage of people immunized against influenza in all children aged 6 months to 17 years from 49% to 60%, adults aged 19 to 64 years from 34% to 60%, and adults aged 65 and older from 65% to 70% (Baseline: National Immunization Survey, BRFSS, 2017-2018)
  • Increase the percentage of women who are screened for postpartum depression after delivery from 91% to 96% (Baseline: PRAMS, 2017)

Objectives to improve health equity by 2023

  • Decrease the infant mortality rate for American Indians from 13 per 1,000 live births to 11 per 1,000 live births (Baseline: MT Office of Vital Statistics, 2016)
  • Decrease the percent of live births that were preterm births (less than 37 weeks gestation) for American Indians from 13% to 11% (Baseline: MT Office of Vital Statistics, 2016)
  • Increase the percent of pregnant women who receive early and adequate prenatal care for American Indians from 41% to 43% (Baseline: MT Office of Vital Statistics, 2016)
  • Increase breastfeeding initiation rates of American Indian infants from 80% to 84% (Baseline: PRAMS, 2017)
  • Establish a baseline measure for children aged 19-35 months enrolled in Medicaid who receive the recommended doses of DTaP, polio, MMR, Hib, hepatitis B, varicella, and pneumococcal conjugate vaccine

Prevention and health promotion strategies

  • Promote the use of effective methods of birth control for women not desiring pregnancy, especially for youth, low-income women, and American Indian women.
  • Promote home visiting services through outreach to health clinics, local and tribal health departments, WIC, birthing hospitals, and local Child Protective Service (CPS) (“First Years Initiative” project).
  • Provide Breastfeeding Peer Counseling services at local agencies and Breastfeeding Learning Collaborative training at the Baby-Friendly Hospitals.
  • Promote and increase the number of local and tribal health departments that provide access to public health services (e.g., pregnancy-related services and education, child immunizations, and postpartum care).
  • Promote and increase the number of local and tribal health departments providing education and support of safe-sleep environments.
  • Increase awareness about adult vaccines, including influenza.
  • Participate in HPV/Adolescent Working Group activities, including MT TeenVax.

Clinical strategies

  • Increase the percentage of Title X Family Planning clients and Medicaid members using effective birth control methods.
  • Increase the number of health systems implementing pregnancy support interventions such as the Medicaid Promising Pregnancy Care program.
  • Build new functionality into the State immunization registry, imMTrax, so clinics can review coverage levels in real time.
  • Provide monthly missing immunization reports to participating providers.
  • Pilot stand-alone clinic assessment (AFIX) visits for select providers.
  • Health systems adopt integrated, team-based behavioral health services to screen for and treat perinatal SUD and mental illness during prenatal care.

Policy strategies

  • Implement evidence-based teen pregnancy prevention programming in Montana public schools.
  • Support integration and collaboration between Maternal and Child Health population-based programs with other DPHHS programs that support this group (e.g., asthma home visiting, tobacco cessation, chronic disease self-management, and communicable diseases prevention and treatment for Sexually Transmitted Infections, immunizations, and HIV/AIDS.
  • Annually examine existing requirements for licensed child care facilities and update as necessary to align, as feasible, with the Advisory Committee on Immunization Practices.

Health equity strategies

  • Develop culturally competent materials for American Indian communities.
  • Promote the use of social media to reach youth populations.
  • Secure funding for public health programs that serve low-income populations.

Text/HTML

Workgroup meeting materials

Date Agenda Minutes
September 14, 2020 09/14/2020 09/14/2020
May 22, 2020 05/22/2020 05/22/2020
February 6, 2020 02/06/2020 02/06/2020
September 24, 2019 09/24/2019 09/24/2019
June 7, 2019 06/07/2019 06/07/2019

Data

See additional data related to maternal and child health and create customized reports with MT-IBIS. For help with MT-IBIS, contact the Office of Epidemiology and Scientific Support (OESS). You can also access all recent data reports on multiple topics from OESS.