Grady Memorial Hospital Interpregnancy Care Program

Grady Memorial Hospital’s interpregnancy care program served black women in the Atlanta area who had recently delivered a very low birthweight infant. Participants received case management, care coordination, and medical care including reproductive care, oral health services, and chronic disease management, as well as treatment and referral for alcohol, tobacco, and substance abuse. A medical provider educated patients about the health benefits of spacing pregnancies, and helped them develop reproductive plans. Trained laypeople called Resource Mothers also visited patients’ homes to assist with psychosocial stressors, life skills, parenting, employment, and housing and relationship issues. Services were provided for 24 months or until a subsequent pregnancy^{1, 2}.

• Increased access to care

• Improved birth outcomes

• Reduced rapid repeat pregnancies

• Improved care for chronic conditions

Grady Memorial Hospital’s model of interpregnancy care is a suggested strategy to increase access to care and improve subsequent birth outcomes for women with previous adverse birth outcomes³. Available evidence suggests that such care may reduce rates of stillbirth and low birthweight births^{2, 4}, reduce the likelihood of closely spaced pregnancies, increase identification of chronic conditions, and improve acquisition of life skills². However, additional evidence is needed to confirm effects.

The Grady Memorial Hospital intervention originally cost $2,397 per participant². In Michigan’s Kent County Infant Health Initiative, partially modeled on Grady’s approach, potential treatment costs for infants with poor birth outcomes far outweighed program expenditures⁴.

Many programs are modeled after or similar to Grady Memorial Hospital’s interpregnancy care program. Examples of these programs include the Louisiana Birth Outcomes Initiative’s Healthy Start New Orleans Project⁵, the Kent County Infant Health Initiative in Michigan⁴, Christiana Care Healthy Beginnings in Delaware⁶, the Mississippi Interpregnancy Care Project, and the Internatal Care Program in Arizona⁷.

Preliminary results from an evaluation of the Healthy Start New Orleans Inter-Pregnancy Care project indicate that such programs must consider patients’ clinical and socio-economic needs when determining how to effectively deliver care⁸.