Maternal and Child Health

What is maternal health

Maternal health refers to women’s health and well‑being during pregnancy, childbirth, and postpartum.

What is child health

Child health includes the physical, mental, social, and emotional well‑being of children from birth through adolescence.

How many women in the U.S. are of childbearing age

About 66 million women ages 15–44.

How has the age of first childbirth changed

It has increased from 26.6 to 27.5 over recent decades.

How many U.S. women die yearly from pregnancy‑related causes

More than 700 women each year, up to one year postpartum.

What proportion of maternal deaths in Texas are preventable

Four out of five maternal deaths are preventable.

How have U.S. maternal mortality rates changed from 2018–2023

They nearly doubled.

Which racial group has the highest maternal mortality rate

Non‑Hispanic Black mothers.

Determinants of maternal health

Multiple gestation, maternal age >35, history of pregnancy complications, preexisting conditions, lifestyle factors, education, lack of insurance, lack of paid leave, provider shortages, ethnicity.

Consequences of poor maternal and child health

Difficulty breastfeeding, poor nutrition, reduced interaction, premature birth, low birth weight, emotional and behavioral delays.

Main barrier to mental health services for women

Cost.

Define infant mortality

Death of an infant before their first birthday.

Leading causes of infant mortality

Birth defects, preterm birth and low birth weight, SIDS, unintentional injuries, maternal pregnancy complications.

Key child and adolescent health indicators

Growth milestones, nutrition, health status, obesity, insurance coverage, access to care, mortality.

Sheppard‑Towner Act purpose

Created a social welfare program for mothers and babies.

Title V purpose

Provides a block grant framework for maternal and child health services.

CHIP purpose

Provides health insurance coverage for children.

Pregnant Workers Fairness Act purpose

Requires employers to provide reasonable accommodations for pregnancy‑related limitations.

PUMP Act purpose

Expands workplace protections for expressing breast milk.

Integrated health care model (HRSA)

Patient‑centered, equitable, team‑based, preventive, high‑quality care.

CMS Transforming Maternal Health (TMaH) model focus

Improves access, workforce capacity, quality, safety, and whole‑person care for Medicaid and CHIP enrollees.

OT assessments used in maternal health

COPM and the Barkin Index of Maternal Functioning (BIMF).

OT roles in maternal health

Supporting role transitions, breastfeeding and lactation, pelvic health, co‑occupations, early intervention, ADL/IADL performance.

Examples of parental occupations

Caring for baby, decision making, advocating, employment, leisure, personal well‑being.

Infant occupations

Regulation, growth, sleep, feeding, play, attention, interaction.

Define co‑occupation

A shared occupation between parent and infant involving mutual physicality, emotionality, and intentionality.

OT interventions in postpartum care

Infant assessment, parent education, barrier reduction, adaptations, and strategies to support occupational performance.

History of maternal and child health

Maternal and child health evolved through early public health programs, federal legislation, and expanding social welfare initiatives.

Infant mortality disparities

Non‑Hispanic Black infants have the highest mortality rates compared to all other racial and ethnic groups.

State infant mortality variation

Infant mortality rates vary widely across states, ranging roughly from 3.3 to over 9 deaths per 1,000 live births.

Healthy Texas Mothers & Babies purpose

Improves maternal and infant outcomes through education, professional training, community empowerment, policy development, and quality improvement.

HTMB individual awareness strategies

Hear Her campaign, infant safety campaigns, lactation support, peer dad programs, newborn information resources.

HTMB professional education strategies

Annual summits, grand rounds, online provider education, webinars, workshops, and technical trainings.

HTMB community empowerment strategies

Community coalitions, innovation networks, forums, and listening sessions.

HTMB community improvement strategies

High‑risk care coordination, mother‑friendly worksites, safe sleep promotion, smoke‑free environments.

HTMB quality improvement strategies

Maternal mortality review, TexasAIM, congenital syphilis prevention, violent pregnancy death prevention.

Examples of maternal health services

Prenatal care, ultrasounds, nutrition and lactation support, mental health screenings, postpartum care.

Policies promoting maternal and child health

Federal and state policies aim to improve maternal safety, workplace protections, and access to care.

TMaH prenatal phase

Jaya meets with a midwife, identifies health and social needs, and builds a care team including a doctor, doula, and social worker.

TMaH birth phase

Jaya delivers in a hospital with support from her midwife and doula, receives postpartum planning and social work support.

TMaH postpartum phase

Jaya receives 12 months of Medicaid coverage, home visits, telehealth diabetes monitoring, parenting classes, and stable housing support.

OT in postpartum care

OT supports maternal role transition, physical recovery, mental health, infant care, and co‑occupations.

Next steps for OT in MCH

Increase research, advocate for OT inclusion across perinatal and postpartum care, and improve reimbursement pathways.