Kara Hoppe Using Telehealth and Community Partnerships To Improve Postpartum Care for Black Mothers in Wisconsin

With funding from a New Investigator Program grant from the Wisconsin Partnership Program at the UW School of Medicine and Public Health, the project Advancing Postpartum Care For Black Women in Wisconsin By Engaging Community Partners With a Home Telehealth Service for Hypertension, expands upon a successful telehealth patient monitoring program by developing a collaboration with a trusted community partner.

Black mothers in Wisconsin experience maternal and child health disparities that result in adverse birth outcomes and high infant mortality, which are amongst the worst in the United States. Moreover, postpartum hypertension and psychiatric conditions are leading indications for pregnancy related hospital readmission for Black women.

Mothers struggling with hypertension in the postpartum period face challenges and barriers ranging from being on a magnesium drip after a C-section birth to mental health issues – all impacting their ability to connect with and care for their babies.

Dr. Hoppe, who has studied telehealth within her specialty, describes what ultimately lead to this research. She said, “There wasn’t a lot of work being done in the postpartum period, so I decided that I would try to focus there. I felt like we could improve the care we were providing.”

In collaboration with Tia Murray, BS, co-founder of Harambee Village and Susan Passmore, PhD, of the Center for Collaborative Health Equity, the project’s primary goal is to expand a home telehealth/remote patient monitoring for postpartum hypertension program, to include an all-inclusive approach to addressing the postpartum needs of Black mothers.

Murray is a certified doula who, for the last six years, has been entrenched within the realm of racial disparities in maternal child health. “I see this grant as a wonderful example of a university and community partnership, especially in respect to this urgent health equity issue.” she says.

With this grant, Dr. Hoppe and her partners are working to expand the home monitoring program currently in use, called Staying Healthy after Childbirth, which primarily focuses on moms with high blood pressure. The program’s intention is to detect blood pressure exacerbation earlier in hopes of reducing hospital readmissions.

While Staying Healthy after Childbirth is seeing great success, understanding and incorporating the lived experiences behind the statistics and reaching the Black community is crucial. With this community partnership, the Harambee Village Doulas are able to bring this all-inclusive approach to the program in order to address the needs of the new mothers in their community.

Harambee Village Doulas serve families within marginalized communities, particularly focusing on Black infant and maternal mortality. Once a mother has been identified early on as high risk, she has the option to then work with a doula throughout their pregnancy and smoothly transition to the postpartum period by continuing care through virtual follow-ups with the doula.

The role of community-based doulas and certified lactation counselors in this project is essential in providing social and emotional support for mothers while fostering a trusting relationship. The doulas work on addressing postpartum care, lactation, and social and mental health needs for women in the program.

“There’s a lack of trust in communities of color in respect to our system and with this partnership we could show the community that there’s trust in this project,” explains Murray. “So we thought that all of these ripple effects could occur and we could really wrap our arms around families in a much better way.”

The use of telemedicine has been foundational for this project. Remote patient monitoring is the specific type of telemedicine that is used in the Staying Healthy after Childbirth program. Biometrics are collected and sent off to a provider for examination and later provide the patient with feedback to improve care.

Dr. Hoppe explains how this project leverages true synchronous live video conferencing to provide the in-person experience with patients, while also continuing the remote monitoring aspect that is guided by a hypertension nurse team.

“It’s important especially now with COVID-19 because people are at home and they’re restricted to resources. This project can increase access to care that’s delivered by people that care about the patients and can connect with them. I just think there are so many benefits,” said Dr. Hoppe.