Women, Infant and Community Wellness Section: Services

Care Management for High-Risk Pregnancies (CMHRP) is an outcome-focused care management program for pregnant and postpartum individuals in North Carolina who are eligible for Medicaid and are at-risk for an adverse birth outcome.  The program has an emphasis on improving birth outcomes through reducing the rate of preterm and low birthweight births and monitors the pregnant Medicaid population and prenatal service delivery system using data.  CMHRP applies systems and information to improve care and assist individuals in becoming engaged in a collaborative process designed to manage medical, social and behavioral health conditions more effectively.

Meeting the diverse and complex needs of individuals requires a holistic, person-centered approach that addresses social, physical and behavioral health. A holistic approach must consider the social determinants of health (SDOH), which are the "conditions in the environments in which people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks" (Office of Disease Prevention and Health Promotion, 2016). The more complex the needs, the more comprehensive the approach should be for assisting the individual with a care plan that addresses the whole person and collaborates with other systems that impact the individual’s well-being.

CMHRP care managers assist individuals in having healthy pregnancies and healthy babies by working in collaboration with the individual’s prenatal care provider to support their clinical care plan, providing information and education, and by helping families find the resources they need. This service is provided by local health departments to eligible, economically marginalized pregnant and post-partum individuals in all but 8 of 100 counties.

Family Planning and Reproductive Health Services are a wide range of preventive care services, critical to reproductive and sexual health. This service is available to all individuals regardless of income on a sliding fee scale, through their local health department.

This program empowers pregnant individuals and their families to address complex behavioral health and psychosocial concerns that have the potential to negatively affect the wellbeing of the family. Services are offered in several health departments to all clients, regardless of income, on a sliding scale fee.

Healthy Beginnings is North Carolina’s minority infant mortality reduction program. Program goals include improving birth outcomes among minority women, reducing minority infant morbidity and mortality, and supporting families and communities. This program serves women during and beyond pregnancy and their children up to two years after delivery. Utilizing a request for applications (RFA) process, eligible agencies are funded to implement programs that provide care coordination services to pregnant and interconception women that include conducting assessments and screenings, providing education and support, and coordinating referrals to community resources. Contact the Healthy Beginnings program at (919) 707-5700 for more information about program availability in your area.

This program provides funding for the state’s network of High Risk Maternity Clinics to assure that women with high risk conditions get the specialized care and support services they need. Local health department providers can refer pregnant women with a medically indicated high risk condition to the closest funded High Risk Maternity Clinics in the state.

The Improving Community Outcomes for Maternal and Child Health (ICO4MCH) initiative addresses three aims: (1) improve birth outcomes, (2) reduce infant mortality, and (3) improve the health status of children ages birth to five utilizing a collective impact framework with a health equity lens.

The ICO4MCH initiative currently provides funding to five lead local health departments (which totals 14 health departments) in FY20. The local health departments will implement one evidence-based strategy in each of the three aims (reducing infant mortality, improving birth outcomes, and improving the health status of children ages birth to five). The evidence-based strategies to be implemented include: using a Reproductive Justice framework to improve the utilization of Reproductive Life Planning (RLP) and access to long-acting reversible contraception (LARC), Ten Steps for Successful Breastfeeding, with a Focus on Steps 3 and 10; Tobacco Cessation and Prevention, Triple P (Positive Parenting Program), Family Connects Newborn Home Visiting Program, and Clinical Efforts to Address Secondhand Smoke Exposure (CEASE).

The ICO4MCH initiative seeks to reduce the rates of infant mortality, unintended pregnancy, preterm birth (including low birth and very low birthweight), child death (age 1-5), substantiated child abuse cases, and out-of-home placement for children (ages 0-5) and increase the birth spacing rates in North Carolina.

Contact the ICO4MCH Program Manager at (919) 707-5700 for more information.

The Infant Mortality Reduction program provides funding to local health departments in counties that have experienced the highest infant mortality rates in the state. This program implements evidence-based strategies that are proven to be effective to improve birth outcomes through addressing pregnancy intendedness, preterm birth, and/or infant mortality. Evidence-based strategies include the provision of 17P injections to help prevent repeated preterm births; Centering Pregnancy; doula services; infant safe sleep practices; Nurse Family Partnership program; reproductive life planning and increased access to long acting reversible contraception; and tobacco cessation and prevention. Contact the Infant Mortality Reduction program at (919) 707-5700 for more information about program availability in your area.

Research findings suggest that prenatal lead exposure can adversely affect maternal and child health across a wide range of maternal exposure levels. In an effort to address this, the US Centers for Disease Control and Prevention published “Guidelines for the Identification and Management of Lead Poisoning in Pregnant and Lactating Women.” To implement these guidelines, resources for clinicians and health educators include:

• CDC Guidelines for the Identification and Management of Lead Poisoning in Pregnant and Lactating Women
• Summary Chart of Public Health Actions Based on Maternal and Infant Blood Lead Levels (PDF, 297 KB)
• Lead and Pregnancy Risk Questionnaire
  • English (PDF, 146 KB)
  • Bilingual / En Español (PDF, 146 KB)
• Are You Pregnant? Protect Your Baby from Lead Poisoning
  • English
  • Spanish

The Maternal Health Program provides resources to local health department prenatal clinics to make sure that all pregnant women in the state have access to early and continuous prenatal care. This service is available to all women regardless of income on a sliding fee scale.

The Maternal Mortality Review (MMR) is a comprehensive state-based approach to reviewing and analyzing maternal deaths that occur in North Carolina. A maternal death is defined by when women is pregnant at the time of death or within 365 days after a pregnancy. The MMR Committee (MMRC) convenes to determine if the death was related to or aggravated by pregnancy. If so, the death is will be counted in the state’s pregnancy-related mortality ratio. The focus of the review aligns with the CDC’s recommendations to identify potential preventability, and contributing factors to maternal mortality at various levels, including patient/family, community, provider, facility and system. The overarching goal is to improve maternal health outcomes.

This program is designed to provide intensive nutrition intervention for pregnant women and those who have recently delivered a baby. Medical Nutrition Therapy is important for those mothers with chronic diseases and nutrition-related problems, such as diabetes. This service is available by referral from local health department maternity clinics.

The NC Baby Love Plus Initiative is supported by federal Healthy Start-Disparities in Perinatal Health funds from the Health Resources and Services Administration (HRSA)-Maternal Child Health Bureau. The aim of this program is to improve birth outcomes and the health of women of childbearing age (15-44 years) through the strengthening of perinatal systems of care, promoting quality services, promoting family resilience, and building community capacity to address perinatal health disparities. Services are currently offered in Edgecombe, Halifax, Nash and Pitt counties where perinatal health disparities are persistently high.

Baby Love Plus program services include outreach, care coordination for women during the interconceptional period, fatherhood involvement, perinatal depression screening and referral, and health education and training. Need more information? Contact the Baby Love Plus program (919) 707-5700 about program availability in your area.

North Carolina is one of 9 states to receive the Maternal Health Innovation (MHI) Grant from the Health Resources and Services Administration (HRSA). Funded in September 2019, this five-year federal grant is managed by the Maternal Health Branch in the Division of Public Health.  Focused on reducing maternal health disparities and creating systematic change to improve maternal health outcomes, this grant funds over a dozen contractors around the state to develop and implement innovative strategies to address disparities in maternal morbidity and mortality based on three main goals of the grant: 1) Establish a state-focused Maternal Health Task Force to create and implement a strategic plan that incorporates activities outlined in the state’s most recent State Title V Needs Assessment; 2) Improve the collection, analysis, and application of state-level data on maternal mortality and SMM; and 3) Promote and execute innovation in maternal health service delivery, such as improving access to maternal care services, identifying and addressing workforce needs, and/or supporting postpartum and interconception care services, among others.

The MHI Program works with existing and new initiatives and partners to create systems-level change to improve maternal morbidity and mortality in North Carolina. Please visit the MHI program webpage here.

NC Maternal Mental Health MATTERS program will augment and strengthen systems for pregnant and postpartum women associated with maternal depression and related behavioral health disorders.  For more information about the NC Maternal Mental Health Program, please contact us at 919-707-5700. 

The Perinatal Substance Use Project provides information and referral, training, and technical assistance to families and professionals in need of support for pregnant women and mothers, who are struggling with substance use. For more information on how to get help for a woman with a substance use disorder, call the Alcohol Drug Council of North Carolina 1-800-688-4232. Map of Service Locations in North Carolina 06/05/23

The Sickle Cell Syndrome Program promotes the health and well-being of persons with sickle cell disease and other blood disorders by providing them with genetic counseling, psychological and social support, medical referral and specialty care services. The disease prevention program also has a strong commitment to disease prevention through community education and the promotion of sickle cell trait testing. Contact the Sickle Cell Program at (919) 707-5700 for more information.

SIDS counselors help families after the loss of a baby due to Sudden Infant Death Syndrome (SIDS), providing information, grief counseling, and resource/referral services. The program seeks to reduce SIDS through public awareness and education focusing on risk reduction methods and safe sleep practices. SIDS Grief Counseling is available through your local health department. Contact the SIDS Program Manager at (919) 707-5700 for more information.

Teen Pregnancy Prevention Initiatives (TPPI) funds communities across North Carolina to implement programs that prevent adolescent pregnancy and support adolescent parents. Visit the TPPI website or contact TPPI at (919) 707-5700 for more information.

The purpose of this program is to reduce infant illness and death by helping women of childbearing age, including pregnant women, to stop tobacco use and to assist them in reducing their family's exposure to tobacco smoke. Contact your local health department to learn what programs are being offered in your area.