MCH Block Grant FY21 Application & FY19 Report

Women/Maternal Health

NPM-01: Well-Woman Visit: Percent of women with a past-year preventive medical visit

FY19 Annual Report

Program Activities:

This Performance Measure appears to have been achieved (the Performance Objective was 55.0% and the Annual Indicator was 66.1%). However, due to the changes in the wording of the survey instrument we are uncertain of the comparability to previous data.

During FY19, the Maternal and Infant Health Program (MIHP) utilized the social media platforms Facebook, Pinterest, and Instagram, to share information on preventive health care visits. These messages were shared under the Power Your Life logo and branding. Nickee Palacios, the MIHP health educator also did an on air television spot on preconception/women’s health.

Educational outreach was done through numerous community events including, the annual Junior League “Care Fair,” University of Utah, West Jordan Chamber of Commerce Health Fair, an event for single mothers, a health fair targeting Spanish families sponsored by Centro Hispano, a preconception/women’s health class for women in the Hildale community, a Pacific Islander Family Wellness Fair, two health fairs at Utah Valley University, and the annual March for Babies event. At these events, MIHP and staff from Utah Birth Defects Prevention Network handed out informational pamphlets and brochures about preventive care as well as answering the specific questions of the diverse groups of people that attend these events.

MIHP was able to secure an intern from Utah Valley University (UVU) to help run and manage a peer education program on campus. This intern successfully recruited five peer educators and held two on-campus health fairs that educated on the importance of obtaining a family health history and preconception/women’s health. This intern also assisted with creating a community class targeting couples that are planning a pregnancy in the next year. The plan was to pilot this class at a local health department during FY19, however due to the public health recommendations for the COVID-19 pandemic, these classes were canceled.

Accomplishments / Successes:

A strong, mutually beneficial partnership between the MIHP and UVU has assisted us in reaching young college-aged women in Utah with messages about the importance of yearly preventive care, family planning, mental health awareness, and preconception health. UVU continually invites staff from MIHP and the Utah Birth Defects Network, to have a booth at a bi-annual student health fair. At each fair, we estimate educational materials about preventive health were given to about to 150-200 students.

The MIHP health educator presented the findings of the focus groups we conducted during FY19 at a national health education conference. This allowed staff to make connections with other health educators working on women’s health issues across the country.

A major success is the ongoing relationships the MIHP program has developed with community organizations. For example, ongoing relationships with UVU and the University of Utah provided us an opportunity to reach thousands of women with health messaging. A new partnership with Cherish Families allowed us to reach women in a former polygamous community with preconception health, birth control, general woman’s health, and birth defects prevention education. This population has been isolated and hard to reach in the past.

Summary of successes and accomplishments on “Moving the Needle” in relation to NPM-01:

• Ongoing, mutually beneficial relationships with a local university, Utah Valley University, has allowed the MIHP to reach thousands of college-aged women with education and information about the importance of routine preventive care.
• A new partnership formed with Cherish Families has enabled the MIHP to reach a historically difficult population to reach, the polygamous families that live in rural Utah. Through this partnership, MIHP staff were able to teach a class and have a booth at a local health fair in the polygamous town of Hildale. Topics educated on included preconception health, birth control, general woman's health, and birth defects prevention.
• MIHP health promotion coordinator was accepted to present on the well-woman focus group findings at the 2019 National Society of Public Health Educators (SOPHE) Conference.

Challenges / Gaps / Disparities:

The largest challenge faced during FY19 was retaining trained peer educators engaged in a preconception peer education program. The program competed with their other responsibilities, both academically and personal and it was challenging setting up ongoing planning meetings with them.

Agency Capacity / Collaboration:

Some of this work has been accomplished through the Health Utah Babies (HUB) partnership. HUB consists of participants representing the Utah Birth Defects Network, MIHP, WIC, MotherToBaby, Baby Your Baby, and Office of Vital Records and Statistics.

The Utah Birth Defects Network (UBDN) is a major partner for this performance measure. Staff from UBDN attend all health fairs with the MIHP staff. Program staff work together and often share resources and educational material. Both programs also use their respective social media accounts to share messages about preconception/women’s health.

Another important partner, MotherToBaby Utah (MTB UT), provides information to women about exposures in the preconception period, during pregnancy, and during breastfeeding. In FY19, MTB UT answered questions from 395 women and their providers about exposures as they were planning for future pregnancies. MTB UT provides information about immunizations, controlling chronic conditions, taking prenatal vitamins, and other exposures to help women plan for their pregnancies.

Summary Progress Report (2020) of ESMs related to NPM-01

ESM 1.1 - Formative Research: Number of focus groups conducted to understand why women are or are not receiving a yearly well-woman visit.*

*This ESM is currently inactive as the formative research has been completed during FY18.

During FY18 the MIHP contracted with the SUMA media group to conduct four focus groups with a diverse group of women of reproductive age. SUMA recruited the women from two urban (Salt Lake and Utah) and two rural (Tooele and Carbon) counties. Each focus group had 7-11 participants and were in various stage of life, some were single and others were married, some were mothers, and some self-disclosed that they were not yet sexually active. At the conclusion of the focus groups, SUMA submitted a written report with the finding and recommendations.

Recommendations the MIHP programs plans to further study included choosing one term, “preventive care,” “routine checkup,” or “well-woman exam” when educating and encouraging our target population to seek this type of care and creating a website and more educational materials that detail what should happen during a routine preventive care visit.

Finally, the contract with SUMA required they work with MIHP staff to create a survey on routine preventive care that would be conducted through social media.

ESM 1.2 - Peer preconception health: Number of institutions of higher learning partnered with to implement a peer preconception health program.**

**This ESM is currently inactive as the Peer preconception health has been completed during FY20.

Goal/Objective:

Increase the number of institutions of higher learning partnered with MIHP.

Significance of ESM 1.2:

The Title V Maternal and Child Health Services Block Grant to States Program guidance defines the significance of this goal as follows:

A well-woman or preconception visit provides a critical opportunity to receive recommended clinical preventive services, including screening, counseling, and immunizations, which can lead to appropriate identification, treatment, and prevention of disease to optimize the health of women before, between, and beyond potential pregnancies. For example, screening and management of chronic conditions, such as diabetes, counseling to achieve a healthy weight, and smoking cessation, can be advanced within a well woman visit to promote women's health prior to, and between pregnancies and improve subsequent maternal and perinatal outcomes. The annual well-woman visit has been endorsed by the American College of Obstetrics and Gynecologists (ACOG) and was identified among the women's preventive services required by the Affordable Care Act (ACA) to be covered by private insurance plans, without cost-sharing.

ESM 1.2 Progress Report:

During FY19, MIHP staff worked with UVU to offer an internship for a student to oversee, with assistance from MIHP staff, a preconception peer education program on campus. In August 2019, Taylor Gregory, an undergrad student majoring in health education, began this internship. She committed to a full school year, August 2019-April 2020.

Ms. Gregory had several goals for this internship:

1. Recruit fellow students to be UVU Peer Educators.
2. Create a peer education training for the UVU peer educators
3. Hold a preconception peer education program training
4. Hold at least two campus-wide events educating students on preconception health
5. Create and hold a community preconception class
6. Create social media messages for the Power Your Life Instagram account

August through September, Ms. Gregory successfully recruited five additional students to be trained as peer educators. All of these students were majoring in the health field, and in September 2019, were trained in preconception health and becoming a peer educator. Together the peer educators created a flyer on the importance of knowing your family health history. They distributed this flyer at a two health and wellness fairs put on by the Student Wellness Programs. Ms. Gregory had a booth on general preconception health. She created a “Jeopardy” type game where participants were asked a question about preconception health. When participants stopped and played the game, they were entered into a drawing for a bigger prize. She was able to reach 100+ students with this booth.

Working with MIHP staff, Ms. Gregory created a presentation targeting couples who were considering a pregnancy in the next year. The next steps were to offer the class through local health departments. However, this was not accomplished during FY19 due to COVID-19 limiting community gatherings. MIHP staff plan to use Ms. Gregory’s presentation and offer the classes during FY21.

A continuing challenge faced by the peer education program is keeping it sustainable. We have held or attempted to numerous training and ongoing planning with trained peer educators, however, competition for their time and energy pulled them away.

The new ESMs for NPM-01 are listed in the Annual Plan section.

MCH Block Grant FY21 Application & FY19 Report

Women/Maternal Health

NPM-13A: Oral Health: Percent of women who had a preventive dental visit during pregnancy

FY19 Annual Report

Program Activities:

The Performance Measure was not achieved. The Performance Objective was 53.8% and the Annual Indicator was 53.2%.

In October 2018, some changes were made in the Oral Health Program (OHP) structure. The OHP was a program directly under the MCH Bureau, but now it is a program in the Family and Youth Outreach Program, which is under the MCH Bureau. The State Dental Director (SDD) is not in this new program but is directly under the MCH Bureau Director. His time was also changed from 0.5 FTE to 0.25 FTE in this position. The OHS and the OHE continued to be full time.

In June 2019, at the Utah Dental Association annual leadership conference, the SDD presented information on Utah Medicaid updates. There were two Utah managed care dental care plans operating statewide for pregnant women which provides basic dental benefits, such as diagnostic, preventive, restorative (fillings), endodontists (root canals), oral surgery, and dentures (with prior approval). Most other adults have only emergency dental benefits. On July 1, 2019, fee reimbursements to dentists went up 21%.

The SDD provided general supervision in accordance with Utah laws, for the Oral Health Program’s two public health dental hygienists who operate in various public health settings. His time permitted him to visit a few events during the year. The SDD collaborated with Medicaid in efforts to increase the percentage of pregnant women who receive preventive dental visits.

The OHP continued to encourage, support, and partner in efforts with the Utah Oral Health Coalition, the Utah Dental Association, and the Utah Dental Hygienists Association to increase the number of pregnant women who had preventive dental visits during pregnancy. The OHP maintains strong relationships with all state dental and dental hygiene schools and connects staff from Home Visiting, WIC, Head Start, and other programs to the schools and other low-cost options. Efforts were made to help encourage any general dentists who have concerns about treating pregnant women, to see these women, and provide appropriate care during pregnancy. An example would be sharing the National Maternal Child Oral Health Resource on Pregnancy and Dental Care with these associations.

Efforts were made to increase the number of pregnant women, as well as children, that see the dentist. Concentrated efforts were made with five local Head Start/Early Head Start programs that had less than 50% of their pregnant women see a dentist.

The OHE provided in person staff training to Parents as Teachers Home Visiting sites on the 12 oral health messages. The OHE provided quarterly emails with updated educational resources for home visitors and families including, Brush Book Bed, National Maternal and Child Oral Health Resource Center, and Early Childhood Learning & Knowledge Center materials. The OHP also provided a low cost dental resource guide, by county, and worked to connect families to care. These emails and follow up calls included all of the home visiting sites. The OHS and OHE also trained family advocates at the Community Building Community (CBC) dental clinic in Midvale on the 12 oral health messages and motivational interviewing techniques. This health center had advocates going into patients' homes and providing home visits to vulnerable families.

In December 2019, the OHS, OHE, two OHP interns, and dental hygiene students from Fortis Dental Hygiene School (FDHS), provided education to 50+ refugee students. Several topics of oral health were discussed, including nutrition, pregnancy, and babies not going to bed with a bottle. The OHP collaborated with the Office of Health Disparities and Granite Peaks to provide access to care for these refugee students. At the end of the week, a free day of preventive care was provided for the refugees at FDHS. Over thirty-five children and adults received preventive care. 

In February 2019, the OHS, OHE, interns, and dental hygiene students provided maternal and infant oral health education, fluoride varnish, and referral resources to 150 refugees at the LDS Humanitarian Center. The OHS met with a case manager afterward to help coordinate care for those with dental needs.

In June 2019, the OHS and OHE, along with a volunteer dental hygienist, went to Ibapah, UT (Goshute Tribe) for a health fair. They provided screenings and fluoride varnish to over twenty-eight children and thirty-eight adults. Local dental resources in adjacent cities were provided. They also had educational materials, which included the 12 oral health messages, dry mouth, pregnancy, diabetes, and opioid awareness material from Violence Injury Protection Program.

The OHE presented to teen parents in Utah County about oral health during pregnancy and early intervention strategies for their infant and toddler children. Ten teen moms were reached through this effort and all teens and their children received dental supplies. The OHP presented at the Annual Utah Early Childhood Conference to early childhood caregivers and administrators. Topics covered included; “it's safe and important to go to the dentist during pregnancy,” regular snacks and meal times for children, and not putting babies to bed with a bottle.

The OHS and OHE work closely with State WIC staff providing information to WIC clients and staff statewide. The OHS and the OHE presented to statewide WIC directors and other WIC staff multiple times in the state, using the Smiles for Life! Preventive Strategies for Promoting Oral Health for Pregnant Women, Infants, and Children curriculum. This curriculum was created by the National Center of Early Childhood Health & Wellness. Both provided two minutes segments, three times a year, on a Utah Broadcast ‘Baby Your Baby’ on Pregnancy and Oral Health. In addition, the OHP attended the Junior League Care Fair and provided educational materials on oral health and pregnancy, infant care, and children's oral health. Over seventy-five materials were given out.

In August 2018, the OHS reached out to all community water fluoridation (CWF) engineers in the state by personal visits, emails, or phone calls. She shared evidence based research education promoting CWF by the American Academy of Pediatrics. The OHS also asked what barriers, concerns, and calls are they receiving from the public. Approximately 52% of the state of Utah receives the benefits of CWF. Future plans of CWF to be initiated in Moab, Utah.

Accomplishments / Successes:

October 2018, the OHS presented to family advocates from Cherish Families on oral health and motivational interviewing. Cherish Families provides help for former Fundamentalist Church of Jesus Christ of Latter-Day Saints members and others practicing polygamy https://cherishfamilies.org/about/). Basic oral health education was shared and messages of pregnancy and infant oral health care were stressed. Health Promotion Coordinator from the MIHP also came and spoke on preconception health to about fifteen local mothers. This population has not trusted public health workers in the past to come into their community, so this was a wonderful first step of bringing education and resources into this community.

The OHS researched three years (2015-2017) of visits to rural Utah emergency departments for non-traumatic dental visits. This data was presented at the Rural Hospital Administrators Summit in May 2019. Thirty-nine participants were in attendance, including all state rural hospital executive administrators. An MCH Epidemiologist from the Data Resource program helped with all the data information and graphs. Further retrospective research study of eleven full years, from 2007-2017, is ongoing and a report including all hospitals in Utah was released to the public December of 2019. Over 6200 visits of children ages 0-19 were documented.

In February 2019, the OHP held its first annual Oral Health Conference for Community Health Workers (CHW) at Roseman School of Dentistry. All CHWs in the state were invited to attend. The OHS coordinated this event with the Association of Utah’s Community Health Centers (AUCH), Roseman School of Dentistry, and the Community Health Workers Coalition of Utah. An introduction to Oral Health was given along with topics on systemic connections to oral health, pregnancy and oral health, and children’s oral health issues. Great discussions on overcoming barriers to care were discussed. Statewide dental resources were shared and Zoom/ Skype was used so all CHW in the state would join in.

The OHP partnered with Violence and Injury Protection Program to educate dentists and oral surgeons on Opioids for all populations, especially pregnant women and children. The OHP developed an opioid toolkit for dentists and oral surgeons in Utah. They also collaborated with the Utah Dental Association and the Association of Utah Community Health Programs. The OHS and OHE will be sharing information to dentists and oral surgeons statewide based on information published by the National Maternal and Child Oral Health Resource Center, “Prescribing Opioids for Women of Reproductive Age: Information for Dentists.” The Oral Health Program (OHP) will collaborate with Head Start, Early Intervention, the Utah Office of Home Visiting, and the Women, Infants, and Children Program (WIC) to target high-risk populations, share resources, and provide education and training to agency staff on the importance of dental care during pregnancy, with the goal to increase the percentage of pregnant women who have a preventive dental visit during pregnancy.

Summary of successes and accomplishments on “Moving the Needle” in relation to NPM-13A:

• The Oral Health Specialist and Oral Health Educator continue to present and coordinate four KUTV Baby Your Baby segments a year. Topics for these segments included Oral Health and Pregnancy, baby bottle use, “primary teeth are important,” and other oral health topics. These reached the public throughout the state of Utah.
• The Oral Health Program continued using the “12 Oral Health Messages” created for pregnant mothers and children in collaborative efforts with WIC, Head Start, Fostering Healthy Children, and Home Visiting programs.
• The Oral Health Program published and disseminated two Bi-Annual Oral Health Outreach Reports to stakeholders and other partners.
• The Oral Health Program continued to encourage and support efforts in the Utah Oral Health Coalition, the Utah Dental Association, and the Utah Dental Hygienists Association to increase the number of pregnant women who had preventive dental visits during pregnancy.

Challenges / Gaps / Disparities:

Limited funding resources and staff is a challenge as we try to reach all of the state to address social justice and health equities involving oral health. It is difficult to find programs to collaborate with that work with just pregnant women, so efforts continue with groups who have a significant number of pregnant women. It is also a challenge in some rural areas to find a dentist who accepts Medicaid to refer pregnant women for care. This is because all of the dentists in these areas who are Medicaid providers only see children. Language barriers are a problem for some pregnant women. Recent census data shows that about 120 languages are spoken in Utah, and about 14% do not speak English at home. Many of the women we work with have so many other challenges they are facing including lack of employment, a child with other medical issues, being a single parent, language barriers, transportation barriers, etc. This makes dental care low on their priority.

Emerging in Utah and nationwide is teledentistry. This is a proactive way to address access to care. The OHP and SDD are working together with the Utah Oral Health Coalition, Smart Smiles program (school based/long-term facility/public health setting), and others dedicated to expanding teledentistry. The OHS and OHE met with a major regional hospital that just opened a dental clinic at their location. The OHS is facilitating conversations between a manager of one Utah hospital and dental hygienist about implementing teledentistry options in their emergency room as a pilot. We are hoping to take this best practice model to other hospitals statewide. Future conversations with WIC and Head Start staff to implement pilot teledentistry days are being discussed.

Agency Capacity / Collaboration:

The OHP will also collaborate with the Utah Oral Health Coalition, the Utah Dental Association, Utah Dental Hygiene Association, Head Start, the Office of Health Disparities, WIC, Utah Office of Home Visiting, Smart Smiles, six dental hygiene schools, and two dental schools to reach the goal of increasing the percentage of pregnant women who receive a preventive dental visit.  

The OHS and OHE shared information with dentists and oral surgeons statewide at the Utah Dental Association regional meetings on a report published by the National Maternal and Child Oral Health Resource Center, “Prescribing Opioids for Women of Reproductive Age: Information for Dentists.” was published by the National Maternal and Child Oral Health Resource Center. This was done in collaboration with the Violence and Injury Protection Program on this Opioid project and funding.

The Oral Health Program (OHP) will collaborate with Head Start, Early Intervention, the Utah Office of Home Visiting, and WIC to target high-risk populations, share resources, and provide education and training to agency staff on the importance of dental care during pregnancy, with the goal to increase the percent of pregnant women who have a preventive dental visit during pregnancy. OHP also collaborated with MotherToBaby to be a resource for dentists and the public on questions regarding pregnancy and opioid prescriptions.

The OHP Oral Health Specialist served on the Early Childhood Caries National Committee under the direction of the Association of State and Territorial Dental Directors (ASTDD). She also served as the Dental Hygiene Liaison for the State of Utah for Head Start.

 

Summary Progress Report (2020) of ESMs related to NPM-13A

ESM 13.1 - Collaborate with Early Head Start (EHS): Percent of pregnant women who had a dental exam and/or treatment during pregnancy*

Goal/Objective:

Increase the percent of EHS pregnant women who have a dental exam and/or treatment during pregnancy.

Significance of ESM 13.1:

Measures the number of pregnant women in the EHS program who had a dental exam and/or treatment during pregnancy.

ESM 13.1 Progress Report:

The ESM 13.1 Performance Measure was achieved. The Performance Measure was 25.2% and the Annual Indicator was 25.9%. This ESM was designed to increase the number of pregnant women who visit the dentist during pregnancy in the Early Head Start program. Pregnant women in the Head Start Program are a group where many of them do not make it to the dentist, especially in some of the rural areas of Utah, where there are access to care challenges. The Oral Health Program will collaborate with EHS to help these women make it to the dentist.

*NPM-13A and related ESMs were discontinued following the 2020 MCH Needs Assessment.  
 

 

Other activities in the Women’s Health domain that contribute to improvement in the National Outcome Measures 

Utah works to adhere to the three-tier framework outlined in the MCH Block Grant guidance. While the focus of most activities is the ESM →NPM→ NOM framework, activities on improving NOMs outside of the NPMs transpires in parallel. The following programmatic activities also work to improve outcomes in this domain. 

National Outcome Measures (NOM)

NOM 1: Percent of pregnant women who receive prenatal care beginning in the first trimester

The Baby Your Baby program works to get women into early prenatal care by offering temporary Medicaid coverage to women while they wait for Medicaid approval. Additionally, the Baby Your Baby program runs a media campaign to encourage women to begin prenatal care in the first trimester.

During Fiscal Year 2019, MotherToBaby Utah (MTB UT) had 1795 contacts, who responded to demographic questions, with insurance coverage and 134 with no insurance. During Fiscal Year 2019 MTB UT provided education to 35 clients regarding folic acid use. During Fiscal Year 2019 12,316 MotherToBaby Utah English brochures and 2903 MotherToBaby Utah Spanish brochures, 9556 English/Spanish Rack Cards, 827 English Preconception brochures, and 2 Spanish Preconception brochures were distributed to families and providers to provide information about prenatal care and services.

NOM 2: Rate of severe maternal morbidity per 10,000 delivery hospitalizations

In Fiscal Year 2019, MotherToBaby Utah provided education to women and providers about  medications used to treat chronic conditions before and during pregnancy and while breastfeeding including cardiovascular, autoimmune, psychiatric, endocrine, respiratory, substance dependence, genetic, neurological, and other conditions. MotherToBaby Utah provided education to women, their providers, their partners, and other clients regarding the benefits and risks of medications compared to the untreated chronic conditions in an effort to help women remain healthy and avoid unnecessary acute episodes or hospitalizations due to questions about continuing medication treatments. Research showed that untreated maternal mood conditions result in additional costs to society of approximately $31,800 for each mother-infant pair. MotherToBaby Utah provided health information about mood medication in pregnancy and breastfeeding to 615 clients in FY 2019. Assuming that those 615 client contacts had the desired effect of helping pregnant and breastfeeding women and their providers decide to start, continue, or resume mood medications, then it could be inferred that MotherToBaby Utah saved over $19,000,000 for families, early intervention services, health insurance plans, special education services, taxpayers, and others.

Utah is a member state of the Alliance for Innovation on Maternal Health and partners with Wyoming to implement maternal safety bundles. Hospitals have been working in past years to implement the hemorrhage and hypertension safety bundles. In 2019, hospitals voted to begin work on implementation of the Obstetric Care for Women with Opioid Use Disorder safety bundle. Utah began a collaborative project with the University of Utah Maternal-Fetal Medicine Department to create an enhanced data set on severe maternal morbidity. This data set will include information gathered from severe maternal case review using the Council on Patient Safety's SMM review form. This enhanced data set will be used for analysis of SMM events in Utah.

NOM 3: Maternal mortality rate per 100,000 live births

In Fiscal Year 2019,  MotherToBaby Utah provided education to women and providers about medications used to treat chronic conditions (some women had multiple co-occurring chronic conditions) before and during pregnancy and while breastfeeding including cardiovascular, autoimmune, psychiatric, endocrine, respiratory, substance dependence, genetic, neurological, and other conditions. MotherToBaby Utah provided education to women, their providers, their partners, and other clients regarding the benefits and risks of medications compared to the untreated chronic conditions in an effort to help women remain healthy and avoid complications and death due to questions about continuing medication treatments.

Utah has an established maternal mortality review (MMR) committee and all maternal deaths are brought to the committee for review and prevention recommendations. Utah began using the MMRIA data system (Maternal Mortality Review Information Application) in 2015. Utah continued its collaboration with the CDC Foundation to contribute to enhanced surveillance and understanding of maternal overdose deaths. Utah was awarded a grant from the CDC via the Enhancing Reviews and Surveillance to Eliminate Maternal Mortality. With this funding, Utah and Wyoming are partnering to conduct a single maternal mortality review committee for both states. The grant also allowed Utah to hire a new epidemiologist dedicated to case identification and data analysis of maternal deaths. The program disseminated its findings that substance use and mental health are major contributors to maternal mortality in Utah. This brought attention to the need for more substance use disorder and mental health services in the perinatal period.

NOM 24: Percent of women who experience postpartum depressive symptoms following a recent live birth

During FY 2019 9,045 English Postpartum Depression brochures and 3,228 Spanish Postpartum Depression brochures were distributed to families and providers to help screen for depression and find local resources. During FY 2019 MotherToBaby Utah provided education to women and their providers about medications regarding the treatment of postpartum depression including the risk of untreated postpartum depression. Research showed that untreated maternal mood conditions result in additional costs to society of approximately $31,800 for each mother-infant pair. MotherToBaby Utah provided health information about mood medication in pregnancy and breastfeeding to 615 clients in FY 2019. Assuming that those 615 client contacts had the desired effect of helping pregnant and breastfeeding women and their providers decide to start, continue, or resume mood medications, then it could be inferred that MotherToBaby Utah saved over $19,000,000 for families, early intervention services, health insurance plans, special education services, taxpayers, and others.

A majority of Local Health Departments (9 to 13) provide resources and support for women in their community who have postpartum depression. They educate and screen prenatal clients for postpartum depression through WIC, breast feeding education, during clinical visits. etc. Many also provide referral services for telemental health sessions with trained mental health professionals across the state and also refer to the UDOH Maternal Mental Health Resource and Referral website to help clients find providers.