Breastfeeding Initiatives 

Objective 2.1— By 2030, increase the rate of exclusive breastfeeding at 6 months by 2.5% annually through cross-sector breastfeeding policies, practices, and community supports/programs. 

 

Kansas Breastfeeding Infrastructure: While Kansas breastfeeding initiation (89.4%, 2023 Annual Summary of Vital Statistics) exceeds the national average, 6-month exclusivity rates (27.2%, National Immunization Survey, children born 2021) fall far below the national average and the Healthy People 2030 goals of 42.4% exclusive breastfeeding through 6 months. This requires continued focus on increasing families' access to strong community breastfeeding education, supports, and practices. To promote and support cross-sector breastfeeding policies, practices, and environments to increase breastfeeding duration and exclusivity, Title V will continue our strong partnership with the Kansas Breastfeeding Coalition (KBC) to continue existing effective strategies (e.g., Business Case for Breastfeeding, Communities Supporting Breastfeeding, Breastfeeding Welcome Here) and to broaden and strengthen the establishment of local breastfeeding coalitions.   

 

Breastfeeding initiatives should be available to all populations; however, Title V is specifically interested in removing barriers and addressing racial disparities noted in state-level breastfeeding data, such as among our non-Hispanic Black population. While significant work has been initiated with this focus, particularly through contracted KBC-supported projects, the continuation and advancement of these efforts will be a key focus for FY26. Examples of such efforts include: 

• Increasing access to lactation support by African American providers such as breastfeeding peer counselors, doulas, International Board-Certified Lactation Consultants, and Certified Lactation Counselors that represent high-risk populations. 

• Supporting the implementation and growth of community-centered, culturally relevant mother-to-mother, father, and grandparent breastfeeding support clubs for African Americans. 

• Supporting local breastfeeding coalitions that connect health care providers and the community to local information and resources. 

 

Support the Becoming the Lactation Support Provider You Want to Be program to increase the number of breastfeeding peer counselors, certified breastfeeding counselors, and International Board-Certified Lactation Consultants (IBCLC) available to provide culturally congruent breastfeeding support and clinical care. 

• Promote opportunities for doulas, home visitors, community health workers, and others to obtain mid-level or higher lactation support provider (LSP) certification as defined by the United States Breastfeeding Committee’s Lactation Support Provider Descriptor Table, through the Becoming the Lactation Support Provider You Want to Be program. 

• Provide training and support for mother-to-mother breastfeeding support groups in Kansas City, Topeka, and Wichita in communities whose breastfeeding rates are lower than the state average to support the implementation of community-centered, culturally relevant mother-to-mother breastfeeding support through the Becoming the Lactation Support Provider You Want to Be program. 

 

Supporting Local Breastfeeding Coalitions: Local breastfeeding coalitions bring together individuals and organizations. Ideal coalitions represent broad-based, cross-sector groups working to ensure that the systems mothers encounter every single day are designed in a fair and impartial way to promote, protect, and support breastfeeding success. They enable women, families, and community members to share ideas, break down institutional and cultural barriers, and solve problems related to breastfeeding, while also empowering and educating the public. By working together, coalitions can conserve resources by reducing duplication and sharing expenses, foster cooperation between multiple sectors, and increase the credibility and often the impact of their efforts. The work of breastfeeding coalitions involves identifying the barriers that families face and working to change the system within the communities they serve.

• Deliver specialized technical assistance to local breastfeeding coalitions led by and for communities whose breastfeeding rates are lower than the state average in Topeka, Kansas City, Wichita, Northeast Kansas, and Southwest Kansas. 

• Strengthen the capacity of local breastfeeding coalitions to enhance seamless lactation care delivery through cross-sector collaboration and integrated breastfeeding support services. 

 

KBC-MCH-WIC-Becoming a Mom (BaM) Program Collaboration: Assuring consistent, repeat, messaging around the benefits of breastfeeding (initiation and exclusivity) to both mothers and infants (as well as where/how to access breastfeeding support) across all MCH programs and services is a goal of Kansas Title V. To achieve this goal, collaboration must occur among the various programs. Training opportunities, curriculum content, and other resources must be shared and promoted across programs. Efforts in this area have been very successful over the past several years, and Title V is committed to continuing this work in FY26. Breastfeeding curriculum, presentations, lesson and activity plans, as well as other resources developed initially for the BaM group prenatal education program, will continue to be adapted and shared for implementation in different settings and with multiple populations. A special focus will continue to be given to developing versions of these resources for low-literacy and English language learners as part of the BaM Curriculum Adaptation project. Integration efforts among BaM, WIC, and MCH programs, such as home visiting, Teen Pregnancy Targeted Case Management, and the Pregnancy Maintenance Initiative, will continue to be a focus of the Perinatal/Infant (P/I) Consultant work plan in FY26. Accessibility of breastfeeding education and support will be a primary component of these efforts. 

 

Title V and KBC partnership will continue to focus on improving access to breastfeeding education for providers and MCH workforce development. Efforts will include continued support for the Childcare Provider Training, local MCH staff-focused webinars and training opportunities, as well as other, more broadly focused training opportunities. Title V encourages and supports staff participation in various breastfeeding education courses. It is essential to meet MCH staff where they are and provide information on all available options for breastfeeding education, including 1-, 3-, or 5-day courses. Tools such as the Massachusetts Breastfeeding Coalition's "Landscape of Breastfeeding Support," which provides staff with the various certification programs and the "Lactation Support Provider Training Directory" from the U.S. Breastfeeding Committee, are included in a comprehensive Breastfeeding Integration Toolkit, which will continue to be enhanced and promoted for use by providers across programs and services.

 

Safe Sleep Initiatives 

Objective 2.2— Promote and support safe sleep practices and cross-sector initiatives to reduce the SUID rate by 10% by 2030. 

 

KIDS Network Infrastructure & Family Support: To promote and support safe sleep practices and cross-sector initiatives to reduce the sudden unexpected infant death (SUID) rate, Title V will continue the strong partnership with the Kansas Infant Death and SIDS (KIDS) Network through organizational infrastructure support and to strengthen/enhance the KIDS Network Safe Sleep Certification Project which includes: Safe Sleep Instructor (SSI) Train-the-Trainer, Safe Sleep training for professionals and caregivers; Safe Sleep Community Baby Showers and Crib Clinics; Cribs for KIDS Safe Sleep Hospital Certification Program; and Safe Sleep Star Outpatient Certification Program. Program components use implementation science strategies that include didactics, PowerPoint presentations, hands-on demonstrations, a workbook with safe sleep educational activities, a World Café format is used in small group settings to address myths, barriers, infant products and best practices, Q&A sessions and pre/post-test evaluations as well as other resources developed initially by the KIDS Network to promote a consistent safe sleep message. Materials are updated and customized to meet the needs of the unique populations of Kansas, including those with disparate backgrounds, low literacy levels, and visual impairments.

 

The Network will accomplish the above by providing semi-annual train-the-trainer classes, quarterly technical assistance webinars, bi-monthly virtual office hours, advanced training opportunities for seasoned certified SSIs, and annual reporting requirements for recertification of all program models. During the COVID-19 pandemic and recovery period, little traction was made in expanding the Cribs for KIDS Safe Sleep Hospital Certification Program and Safe Sleep Star Outpatient Certification Program models throughout the State. Reenergizing these efforts will be an ongoing focus during FY26.

 

KIDS Network-MCH-BaM-KPCC Collaboration: While our efforts to provide training opportunities, curriculum content, and other resources across programs to ensure message consistency have been very successful over the past several years, we are committed to continuing this work in FY26. The safe sleep curriculum, presentations, lesson and activity plans, as well as other resources developed initially for the BaM group prenatal education program, will continue to be adapted and shared for implementation in different settings across all populations. A special focus will continue to be given to developing versions of these resources for low-literacy and English language learners through the BaM Curriculum Adaptation project. Integration efforts between BaM and MCH programs, such as home visiting, Teen Pregnancy Targeted Case Management (TPTCM), and the Pregnancy Maintenance Initiative (PMI), will remain a continued focus of the Perinatal/Infant (P/I) Consultant work plan in FY2026. Safe sleep education and support will be a primary component of these efforts. In addition, support will be provided to local KPCC to strengthen provider and birth facility partnerships, aiming to engage these entities in safe sleep initiatives such as the Safe Sleep Hospital Certification Program and the Safe Sleep Star Certification Program.

 

Safe Sleep Community Baby Showers: A Safe Sleep Community Baby Shower is an interactive event that invites new and expectant persons, their support people, and community service providers to gather for an educational "baby shower". It is different from a community fair in that it is based on Behavior Change Theory and involves data collection. During the Safe Sleep Instructor certification training, The KIDS Network trains instructors how to establish Safe Sleep Community Baby Showers from the very beginning: identification of priority population, collaborators, Baby Shower Committee (members and tasks), how to create a welcoming environment, event logistics, vendors, Safe Sleep Crib Demonstration, and data collection/evaluation. The primary outcomes of a Safe Sleep Community Baby Shower include knowledge and intention increase (safe sleep, breastfeeding, substance use prevention, and perinatal mental health) and access to safety-approved tools (portable crib and wearable blanket).

 

KIDS Network Infrastructure and Family Support: KDHE will continue to contract with the Kansas Infant Death and SIDS (KIDS) Network using Children's Cabinet and Trust Fund - Children's Initiative dollars to promote and provide a statewide support system to help families, relatives, friends, caregivers and all others who are affected by the sudden death of an infant based on the individual or family needs. They will conduct safe sleep education and bereavement services statewide. The KIDS Network serves individuals or organizations who strive to reduce the risk of infant death or sudden infant death syndrome (SIDS) by providing supportive services, community education, professional training, and supporting associated research.

 

The KIDS Network will ensure outreach, education, and ongoing support for pregnant women (especially underserved populations) and promote public-private partnerships. Title V will work with the KIDS Network to promote safe sleep and reduce infant mortality by providing culturally tailored safe sleep resources, toolkits, educational materials, and training for home visitors, healthcare providers, and childcare providers, with a focus on consistent messaging.

• Provide training and support resources for KPCC/BaM to address barriers to safe sleep, as requested. 

• Continue to assess behavior change from Community Baby Showers/Crib Clinics within frontier, rural, and urban counties.

• Train Certified Safe Sleep Instructors to provide respectful, client-centered education that honors cultural practices and offers practical, judgment-free guidance. Empower families with solutions that fit their unique realities while promoting safe sleep practices.

• Oversee the development, execution, and ongoing management of social media campaigns focused on safe sleep, stillbirth, miscarriage, and Infant Loss Awareness Month, ensuring consistent and compelling messaging across multiple platforms.

 

Kansas Perinatal Quality Collaborative Initiatives 

Objective 2.3— Maintain at least two quality cross-sector initiatives focused on improving maternal, perinatal, and infant health in partnership with the Kansas Perinatal Quality Collaborative (KPQC) by 2030. 

 

Role of State MMRCs and PQCs: State Perinatal Quality Collaboratives (PQCs) and Maternal Mortality Review Committees (MMRCs) play a crucial role in improving maternal and perinatal health, as they believe that investing in a mother's health leads to healthier birth/pregnancy outcomes.  

 

Roles are different but complementary.    

• PQCs: Focus on efforts during the maternal and perinatal periods intended to improve birth outcomes and strengthen perinatal systems of care for mothers and infants.
• MMRCs: Focus on reviewing maternal and pregnancy-associated deaths (pregnancy through one year after delivery) to identify gaps in health services and make actionable recommendations to prevent future deaths, improving maternal and perinatal health.    

 

 

As convener of the Kansas PQC and MMRC, KDHE Title V brings together the work of both entities to translate findings and recommendations to action, in partnership with other state organizations, such as American College of Obstetricians and Gynecologists (ACOG), American College of Nurse Midwives (ACNM), Association of Women's Health and Neonatal Nurses, Kansas Hospital Association (KHA), and others. As the KMMRC focuses on identifying gaps in health services and making actionable recommendations to prevent future deaths, the KPQC focuses on implementing these recommendations through data-driven, evidence-based practices and quality improvement processes (e.g., Patient Safety Bundles). This initiative aims to enhance birth outcomes and strengthen perinatal care systems for mothers and infants.  

 

The Title V State Action Plan aligns with collaborative efforts underway for the Kansas Perinatal Quality Collaborative (KPQC). The KPQC is a panel of experts working to improve the quality of care for mothers and infants, resulting in measurable improvements in statewide healthcare and health outcomes.

 

KPQC & MMRC Collaborative Efforts – Data to Action: According to Kansas Maternal Mortality Review Committee (KMMRC) data, from 2016 to 2022, there were 153 pregnancy-associated deaths, which translated to a pregnancy-associated mortality ratio (PAMR) of 59 deaths per 100,000 live births occurring in Kansas. 69.9% of pregnancy-associated deaths occurred during the postpartum period. The leading causes of death were motor vehicle crashes, followed by cardiovascular conditions (including hypertensive disorders of pregnancy), mental health conditions (including those contributing to suicide), homicide, and unintentional poisoning/overdose. Over one fourth (27.7%) were caused by homicide, suicide, mental health conditions, or unintentional poisoning/overdose. 

  

Based on KMMRC recommendations for improved care coordination and linkage to services for perinatal individuals, especially during the postpartum period, Kansas formally enrolled as an AIM state in October 2021. It implemented the Postpartum Discharge Transition (PPDT) patient safety bundle, known in Kansas as the Fourth Trimester Initiative (FTI). The FTI focused on quality care, provider communication, and collaboration related to the transition from pregnancy through the postpartum period, including chronic disease management and referral, behavioral health (including mental health and substance use disorder) screening and referral, breastfeeding, health equity, care coordination, and access to care. In December 2024, Kansas moved from the implementation phase of the FTI to sustainment.   

  

As discussion about what AIM bundle Kansas should implement next, the KPQC Advisory Committee made an intentional decision to enroll not only birth facilities, but to engage and partner with all hospitals across the State- especially those rural and critical access facilities that may not offer labor and delivery services but do serve pregnant and postpartum women through their emergency departments and outpatient clinics. 

  

Cardiac conditions, including hypertensive disorders in pregnancy, are the leading cause of pregnancy-related death, and the second leading cause of all pregnancy-associated deaths in Kansas. In response, the KPQC began implementation of the Severe Hypertension in Pregnancy patient safety bundle in January 2025. For more details, see the AlM Capacity Award. 

 

Additional public health campaigns will continue to be implemented targeting causes of deaths found to be “pregnancy-associated, but not related.” KPQC/KMMRC will continue to promote and incorporate screening, brief intervention, and referral to treatment (SBIRT) across MCH programming and perinatal service providers. The SBIRT process will be used as a comprehensive, integrated, public health approach for the early identification and intervention of MCH patients exhibiting health risk behaviors, such as substance use and mental health. Promotional efforts will also include integration of screening and education on IPV, utilizing resources from the Futures Without Violence CUES Initiative. For more information, see the Women/Maternal Plan. 

 

The KMMRC’s work and recommendations continuously guide the KPQC and MCH activities and initiatives. Title V will continue to advocate for policy changes, develop action alerts/bulletins, and identify and develop public and patient education initiatives for statewide implementation in response to data/findings. 

 

Community-Based Education and Engagement Through BaM and KPCC: As the Becoming a Mom® (BaM) program, implemented through the Kansas Perinatal Community Collaborative (KPCC) model, has provided a strong, integrated framework for community outreach and engagement over the past ten years, the plan is to continue to support, strengthen and expand both the program and the model in FFY26. Via this investment, there will be a continued focus on increasing community awareness of maternal health risks—including chronic conditions, behavioral health, pregnancy intention, and interpersonal violence—along with many other maternal and infant health topics that remain a priority. 

 

The BaM program provides a standardized yet adaptable prenatal education curriculum that can be tailored to address specific maternal health risk topics. While continuing to strengthen education on chronic disease management, mental health, healthy pregnancy planning, and recognizing and addressing interpersonal violence in BaM sessions, communities can ensure participants receive timely, relevant, and potentially life-saving information. Because the BaM curriculum is designed to be culturally responsive and linguistically accessible, it is well-positioned to meet the needs of communities across Kansas. Sessions will continue to be delivered in both in-person and virtual formats to increase accessibility and engagement, with numerous enhancements planned for FY26. One of these enhancements includes the completion of the Curriculum Adaptation Health Equity Opportunity Project, which was initiated in FFY25, making the curriculum more accessible to low-literacy and English language learners. Below is a snapshot of the transition from the original narrative format to the new, highly graphic format of the curriculum.  

 

 

 

In FY26, this adapted curriculum will be field-tested by local communities to gather participant input for the finalized version, which will then be translated and printed in both English and Spanish. The primarily graphic-based curriculum is expected to be more easily translatable into multiple other languages needed in growing communities across the State. While this project is coordinated by the Clinical P/I Consultant and BaM Program Manager, who are funded by Title V, costs of out-sourced graphic design and translation are being supported through Maternal Health Innovation grant funding. This blended funding approach leverages the strengths of both sources, creating a synergistic impact that enhances the project's reach, quality, and sustainability.

 

The KPCC model enhances the reach and impact of BaM by embedding the program within a collective impact framework that unites healthcare providers, local public health agencies, community-based organizations, faith-based groups, and other partners. This collaborative approach ensures that outreach is grounded in local context and informed by community needs. Through KPCCs, local Maternal and Child Health (MCH) programs can lead tailored engagement efforts, supported by shared community data, cross-sector partnerships, and coordinated strategies. By building strong, trust-based relationships with community partners, KPCCs help amplify maternal health messaging and extend the reach of educational and support resources.

 

State-level collaboration with the KPQC and KMMRC plays a critical role in aligning local efforts with broader maternal health initiatives. Consistent, coordinated messaging at the state level helps reinforce key messages shared across the inpatient and outpatient clinical sectors as well as across public health and other community-based organizations. Educational materials developed with state-level guidance can be distributed through community channels, including clinics, social media, and partner organizations, ensuring that messages are clear, consistent, and both far-reaching and locally relevant.

 

Robust evaluation mechanisms will continue to be embedded in the BaM program, while evaluation efforts will be explored that focus on the KPCC model and its impact. KPCCs will be supported to encourage local partners to collect and analyze community-level data impacting infant and maternal health outcomes, to monitor progress, and inform continuous improvement. By leveraging the strengths of both BaM and KPCC, and aligning with state and local partners, this strategy offers a comprehensive, community-driven approach to increasing awareness of maternal health risks and supporting healthier pregnancies and births across Kansas.

 

Expanding KPCC to Advance Perinatal Health Awareness: To advance the Title V objective of increasing community awareness of maternal and perinatal health risks—including chronic conditions, behavioral health, pregnancy intention, and interpersonal violence—Kansas is leveraging a powerful and innovative approach that blends Title V-supported state-level infrastructure with Maternal Health Innovation (MHI) funding to expand regional capacity for the KPCC model.

 

At the core of this effort, state-level Title V P/I Consultant staff provide strategic guidance, technical assistance, and coordination to sustain and advance the KPCC framework. These positions ensure consistency, fidelity, and alignment with broader maternal and child health goals. However, to truly scale and spread this model, local capacity is essential. The recent MHI-funded proposal will enable the hiring of eight Regional KPCC Coordinators across the State in SFY26. These positions will be strategically placed to build and sustain the local infrastructure needed to implement KPCC principles, expand stakeholder engagement, and deliver culturally responsive maternal health initiatives.

 

By combining Title V leadership with MHI-funded local implementation, Kansas is creating a sustainable, distributed infrastructure that can drive innovation in maternal health outreach and engagement. This blended funding model supports locally tailored strategies led by Regional Coordinators who convene coalitions, apply local data, build referral pathways, and partner with clinical providers, employers, and faith-based organizations. These Coordinators will expand access to resources, including the BaM program, Maternal Warning Signs (MWS) initiative, Perinatal Hypertension (PHTN) toolkit, and CUES intervention, while also integrating other relevant perinatal interventions to address locally identified risks and disparities.

 

This innovative, dual-investment strategy represents a scalable, high-impact model. It enables a more potent synergy between state and local action—ensuring that evidence-based programs and outreach to all Kansans are embedded at the community level, while remaining aligned with state priorities. The result is a more resilient and coordinated maternal/perinatal health infrastructure that not only increases awareness of maternal health risks but also builds the foundation for sustained impact across Kansas.

 

 

Alliance for Innovation on Maternal Health (AIM) Capacity Award: In September 2023, KDHE was awarded a four-year funding opportunity from the Health Resources and Services Administration (HRSA) for the implementation of the Alliance for Innovation on Maternal Health (AIM) patient safety bundles.    

   

The AIM program is the national, cross-sector commitment designed to lead in the identification, development, implementation, and dissemination of maternal (patient) safety bundles for the promotion of safe care for every U.S. birth and assist with addressing the complex problem of high maternal mortality and SMM rates within the United States. The mission of AIM is to support best practices that make childbirth safer, improve the quality of maternal healthcare and outcomes, and save lives. Maternal safety bundles address topics commonly associated with health complications or risks related to prenatal, labor and delivery, and postpartum care.   

   

Through AIM capacity funding, Kansas will increase the number of hospitals and other birthing facility settings implementing patient safety bundles, increase the number of bundles being implemented and/or sustained by birthing facilities, support the fidelity of bundle delivery, and promote effective data collection and reporting.  

   

Based on KMMRC recommendations for improved care coordination and linkage to services for perinatal individuals, especially during the postpartum period, Kansas formally enrolled as an AIM state in October 2021. It implemented the Postpartum Discharge Transition (PPDT) patient safety bundle, known in Kansas as the Fourth Trimester Initiative (FTI). The FTI focused on quality care, provider communication, and collaboration related to the transition from pregnancy through the postpartum period, including chronic disease management and referral, behavioral health (including mental health and substance use disorder) screening and referral, breastfeeding, health equity, care coordination, and access to care. In December 2024, Kansas moved from the implementation phase of the FTI to sustainment.   

 

As discussion and planning about what AIM bundle Kansas should implement next, the KPQC Advisory Committee made an intentional decision to enroll not only birth facilities, but to engage and partner with all hospitals across the State- especially those rural and critical access facilities that may not deliver babies but do serve pregnant and postpartum women through their emergency departments and outpatient clinics. Additionally, the KPQC Advisory Committee also desired to include an infant health-focused component.

 

During the summer of 2024, the Kansas Perinatal Quality Collaborative (KPQC) in partnership with the Kansas Hospital Association (KHA) disseminated a survey to all current AIM enrolled birth facilities, birth facilities not currently enrolled in the AIM bundle, and to all critical access and rural hospitals (that are not birthing facilities) to gather input on the next AIM bundle. Responders were able to prioritize four patient safety bundles —Hypertension, Sepsis, Mental Health, and Substance Use Disorder —in order from the most pressing need to the least. Based on the data gathered from all of the facilities, Hypertension followed by Sepsis were the top bundles identified by hospitals across the State.

 

Survey results were provided to the KPQC Advisory Committee, along with the most recent KMMRC data and vital statistics, for review and input. According to KMMRC data from 2016-2022, cardiovascular conditions, including hypertensive disorders of pregnancy, were the leading cause of pregnancy-related death in Kansas. Additionally, in 2022, 10.5% of infants were delivered preterm (<37 weeks) in Kansas. Recognizing that maternal hypertensive disorders significantly increase the risk of preterm delivery and premature newborns face higher health risks, early maternal lactation is a critical, evidence-based intervention to support neonatal well-being.  

 

In January 2025, the KPQC launched the Severe Hypertension in Pregnancy patient safety bundle and began enrolling hospitals in Kansas. As of March 31, 2025, 38 birthing hospitals and 12 non-birthing hospitals are enrolled. 

 

 

Throughout 2025 and 2026, enrolled hospitals will ensure that all service lines- emergency department, outpatient clinics, labor and delivery- have implemented screening of all child-bearing age women for current or recent pregnancy status (within the past year), are accurately measuring blood pressures in the perinatal population, and are using accurate definitions of hypertensive disorders for diagnosis. Additionally, hospitals will review and update or implement evidence-based protocols for the treatment of hypertensive disorders in the perinatal population, participate in obstetric simulations, collaborate with emergency services on education and maternal transport, and work with community partners to improve care coordination and collaboration. 

 

In collaboration, Title V efforts will continue to focus on supporting this work in the public health/community setting by further developing resources to be included in the PHTN Provider/Patient Education Guide and its associated toolkit. Plans are underway to distribute these laminated educational guides in the fall of 2025, coinciding with the launch of the Kansas Cuff Kit Project. While much of this project will be supported by Maternal Health Innovation funds, it is through collaboration with Title V-supported staff positions at both the state and local levels that will enable the scale and spread of this project through engagement across the community setting. Educational resources will be integrated into existing Title V-supported programs such as HV, BaM/Cb prenatal education, Part C, and through partnerships with WIC and the State's Doula and midwife networks. One component of this education will be focused on raising awareness of the risks, signs, and symptoms of preeclampsia and other hypertensive disorders of pregnancy (HDP) and the postpartum period, as well as increasing awareness of the increased risk of subsequent cardiovascular disease for those who have had a HDP.

Additionally, there will be a focus on educating providers across all settings on their role in screening and addressing risks related to HDP, as one of the leading causes of maternal morbidity and mortality in our State. Promotion of self-monitoring of blood pressure and daily low-dose aspirin use (as indicated) is included in these education efforts. See the "Preeclampsia Risk Workflow" below, which has been created and added to the guide that will be disseminated this fall.

 

 

POST BIRTH Education: According to KMMRC data, over 50% of all pregnancy-associated deaths in Kansas occur during the postpartum period. Further, the KMMRC identified that some of these deaths could have been prevented had the woman, and/or her support persons, received education about maternal warning signs and known the appropriate action to take should they experience them.

 

In 2021, as part of the statewide Maternal Warning Signs Initiative, Title V invested in Association of Women's Health and Neonatal Nurses (AWHONN) POST-BIRTH education training seats for all FTI/AIM enrolled birth facilities, as well as local Title V, BaM, Title X, MIECHV, and WIC programs. POST-BIRTH training seats highlight the importance of educating pregnant/postpartum women, as well as their support persons, on maternal warning signs and the appropriate actions in response at every touchpoint throughout the perinatal period.

 

Recognizing the continuous need for training and education due to staff attrition and turnover, and leveraging HRSA AIM funding, POST BIRTH training seats and resources will continue to be provided to all birthing, and non-birthing hospitals enrolled in the Severe Hypertension in Pregnancy AIM bundle; and to all local Title V, BaM, Title X, MIECHV, and WIC programs during FY26.

 

Cuff Project: Maternal mortality remains a critical public health concern in the United States, with cardiovascular conditions, particularly hypertensive disorders, being significant contributors. Kansas reflects these national trends, highlighting an urgent need for targeted interventions. In Kansas, the Maternal Mortality Review Committee (MMRC) reported that cardiovascular conditions, including hypertensive disorders, were among the leading causes of maternal mortality in recent years. 

 

A pilot home blood pressure monitoring program is currently in the planning phase, with implementation slated for fall 2025. This project will align with national and State maternal health goals by enhancing early detection and management, reducing disparities, and contributing to Kansas MMRC recommendations. Pilot communities will be identified and selected based on having a hospital participating in the Severe Hypertension in Pregnancy AIM patient safety bundle, a strong Title V program, and having been identified through hospital discharge data as having higher rates of preeclampsia/hypertension compared with other communities. The pilot will focus on both urban and rural populations.   

  

KDHE will leverage HRSA AIM and MHI funding to partner with the Preeclampsia Foundation to provide the Cuff Kit, a pregnancy-validated blood pressure monitor for home monitoring, a blood pressure tracking log, and awareness and educational materials. Home blood pressure monitoring has been shown to improve the detection and management of hypertension during and after pregnancy. It empowers patients, facilitates earlier interventions, and reduces reliance on clinic visits, thereby addressing barriers such as transportation and healthcare access disparities. 

 

The Perinatal Hypertension education components outlined above will be delivered through AIM-enrolled facilities and all Title V, Title X, MIECHV, and WIC programs. Simultaneously, the KPQC and Title V are collaborating with the Medicaid Medical Director and Managed Care Organizations (MCOs) to enhance access to automatic blood pressure monitors, which are a covered benefit.

 

OB Simulations: To address barriers to healthcare in the State's more rural areas, MHI will support a collaborative project between RMOMS, the KU Care Collaborative, and leaders representing midwifery in Kansas. The KU Care Collaborative is conducting obstetric simulations and is seeking opportunities to scale up, as additional facilities have expressed interest. However, they currently lack the capacity and staff to provide simulations to all interested facilities. Additionally, RMOMS has developed an immersion training program and stenography training for providers and EMS. Leveraging funding from MHI, there is an opportunity to hire additional staff, which would allow the trainings to be cross-referenced and offered at a greater number of hospitals (additional non-birthing facilities and critical access hospitals) so that they have the tools that they need to be successful during any precipitous deliveries.

 

Other Perinatal/Infant Initiatives 

Statewide FIMR:  Fetal and Infant Mortality Review (FIMR) Committees are action-oriented processes aimed at improving services, systems, and resources for women, infants, and families to improve infant health outcomes. Much like the MMRC, FIMR brings a multidisciplinary team together to examine confidential, de-identified cases of fetal and infant deaths. Review of individual cases helps teams understand families' experiences and how those experiences may have impacted maternal and child outcomes, and to make actionable recommendations to improve infant health outcomes.

 

According to the 2022 Kansas Infant Mortality and Stillbirth Report, the 2022 infant mortality rate of 5.8 deaths per 1,000 live births was higher than the Healthy People 2030 objective of no more than 5.0 deaths per 1,000 live births.  

 

Kansas currently has three community-level FIMRs, all located in larger, urban communities. KDHE, in partnership with the KPQC, will explore advancing legislation needed for the establishment of a state-level FIMR Committee, so that a more complete picture of the drivers of infant mortality (especially in more rural/frontier counties) across the State can be established. The intent would be not to eliminate current community-level FIMRs, but to utilize the statewide FIMR to complement the work currently being done, allowing the State to adopt a more comprehensive approach to fetal and infant death prevention and response.

 

Birth Defects Surveillance (BDS): Continuation of verifying and referring core defects to internal and external partner groups: Kansas Special Healthcare Needs, Critical Congenital Heart Disease, and Kansas Early Childhood Development. This will ensure families and children affected by birth defects and other notifiable conditions receive proper education, outreach, and service navigation to care for themselves effectively. 

 

Quality improvement will be implemented to identify areas in the reporting process that require correction. The Kansas Birth Defects Coordinator is creating education material relevant to core birth defects in collaboration with the Education and Outreach Coordinator. Continuation of sending referral letters to families upon verification of the birth defect via traditional mail, to include information on the programs to which the family is being referred. Phone calls will be made to reach out to families for referrals to Special Health Care Needs. Outreach will continue to be delivered to subscribers of the Newborn Screening newsletter, which has been moved to govDelivery. Social media campaigns on specific topics, such as Birth Defects Awareness Month (BDAM), World Birth Defects Awareness Day, and Folic Acid Awareness Week (FAAW), are conducted in collaboration with the consultant section. To bring attention to resources and education provided by the State and other national organizations. Connection with local programs and families' resources will be established, beginning in June 2025, through Down Syndrome Innovation.