Maternal health care worth fighting for
American mothers were dying at the highest rate in the developed world long before the COVID-19 pandemic began. In its wake, pregnant, birthing and postpartum families are navigating the ongoing consequences of financial instability, social isolation, political unrest, child care closures, and health scare spikes. The burden has been relentless, particularly for families living in urban areas like New Haven.
Chronic stress from poverty, racism and marginalization contribute to many maternal and infant health problems, leading to medical emergencies at the time of birth and even death. Addressing maternal and child health crises is more important than ever. So, for many dedicated health professionals and advocates in New Haven, the recent and sudden closing of the Maternal Child Health Division of the city’s Health Department came as a complete shock.
The decision to close the division was not made overnight. According to former and current employees, the division’s services have been slowly phasing out for the past five years. The division had housed vital programs for families, including HUSKY health insurance, M.A.N.O.S home visitation and more. Maria Damiani, the former division director, was a formidable leader who used her organizational wisdom and longstanding professional relationships to sustain the division. A former employee described how Damiani drove to Hartford and knocked on the doors of legislators when she thought funding might be at risk. This is how the division maintained vital programs and served the New Haven community until 2017 when she sadly passed away.
After that, the division director position was never posted or refilled. Without leadership and consistent funding, the programs operating under the Health Department umbrella were incrementally phased out. By 2020, home visiting was the only program left within the division. But Family Centered Services absorbed all home visiting responsibilities a few months ago, marking the end of the Maternal Child Health Division altogether. All but one of the remaining division staff were fired.
Some local health professionals and advocates argue that eliminating the division without a formal explanation sends the message that maternal child health does not matter at a time when the city’s families are overwhelmed and vulnerable. In a recent letter addressed to the Health Department from Black and Brown United in Action, the division was described as providing wellutilized, essential services in New Haven. They argued that eliminating programs promoting the health of Black and brown residents is contrary to state leadership’s commitment to addressing health equity and improving quality of life.
Others see closing the division as a necessary shift in New Haven’s maternal and child health service delivery. Public Health Director Maritza Bond led New Haven through the height of the pandemic when the department’s main initiatives included COVID-19 safety and immunization efforts. When asked about the future of maternal and child health in New Haven during a recent panel discussion at the Yale School of Medicine,
Bond discussed the importance of partnerships between the Health Department and social services to improve maternal and child health. Currently, department staff link residents to care by referring them to any of seven local agencies providing maternal and child health services.
Building partnerships to consolidate efforts may indeed be the appropriate evolution of maternal and child health service delivery in New Haven. However, this shift begs several questions:
With most division staff no longer employed by the department, are the professional relationships and knowledge acquired during the division’s almost 20-year history being maintained?
Is cross-sector communication strong enough to meet service demand?
And most importantly, are New Haven residents aware of this change in service provision?
Our city is home to many nonprofit organizations and social service agencies doing incredible work on behalf of New Haven families. The Yale School of Public Health recently announced the inauguration of a Maternal Child Health Promotion track, reinforcing the institution’s commitment to equitable, evidence-based maternal child health research and practice. Maternal and child health in New Haven remains a priority. But without a designated Maternal Child Health Division, the Health Department, collaborating non-profits, and community advocates must work together to assure collective action for mothers and children.