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Mississippi moms and babies are dying. This training teaches first responders how to save their lives.

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Mississippi moms and babies are dying. This training teaches first responders how to save their lives.

by Isabelle Taft, Mississippi Today
December 19, 2022

Matt Greer of Brookhaven was driving home from his shift at the Mississippi Center for Emergency Services, where he works as a flight nurse, when he got a call from his younger sister. A few days earlier, she had given birth to a healthy baby girl after an uncomplicated pregnancy. Now, she told him she had a headache.

He asked her to check her blood pressure: 140/90.

For most patients, that reading isn’t concerning. For a pregnant or postpartum woman, however, it’s an indication of preeclampsia. Greer told her to go to the hospital and eventually she did, getting treatment to prevent seizure and stroke.

But Greer thinks things might have gone very differently had he not completed a new training run by the Mississippi Center for Emergency Services just a few weeks before his sister called.

The STORK Program equips first responders and medical professionals without specialized obstetrics training – including emergency room doctors and nurses – to handle pregnancy and delivery complications like hypertension and hemorrhage. Doctors at the University of Mississippi Medical Center recognized that in a rural state with dwindling options for obstetrical care, women are likely to deliver outside of dedicated labor and delivery wards, and to need care from people who don’t see pregnant patients every day. So they created the STORK training.

Greer has years of experience as a nurse, and his sister is a nurse, too. But without STORK, he would not have known how to interpret her blood pressure reading.

“I would have blown it off,” he said. “Without that fresh on my mind … I would have said, ‘that’s not too bad. You’ll be alright.’”

Chronic health conditions like obesity and diabetes plus poor access to prenatal care contribute to Mississippi’s worst-in-the-nation outcomes for moms and babies, and can’t be treated during a single interaction with a health care provider. But potentially lethal hypertension and hemorrhage are not complicated to manage – if a provider knows what to watch for and what to do.

And even inside hospitals, that can be a big “if.”

“Obstetrics is most people’s kryptonite,” said Dr. Rachael Morris, associate professor of maternal fetal medicine at UMMC, who created and leads the training. “Unless you’re an obstetrician, even a well-trained E.R. physician or mid-level provider is going to tell you that you bring a pregnant lady into my E.R., and everyone’s going to freak out.”

The STORK Program’s half-day training includes lectures and simulations to change that dynamic. (STORK stands for Stabilizing OB and Neonatal Patients, Training for OB/Neonatal Emergencies, Outcome Improvements, Resource Sharing, and Kind Care for Vulnerable Families.) The training is funded with a grant from the W.K. Kellogg Foundation, which also allows participants to receive a bag of supplies they can use during deliveries. The program is run by MCES, a division of UMMC that houses critical care transport services – including helicopter teams – and the state’s communications system for hospitals and first responders, Mississippi MED-COM.

“In Mississippi, infant and maternal mortality rates for people of color are among the highest in the nation and many families have to travel considerable distance to access care, creating obstetric emergencies,” said Wesley Prater, Kellogg Foundation program officer. “Our support of UMMC ensures providers across the state have the proper training to stabilize mothers and babies who need critical care.”

So far, about 150 people from around the state – a mix of registered nurses, physicians, medical residents, firefighters and paramedics – have completed the training over 11 classes since it launched in June. The team has 18 more trainings on the calendar.

With the state likely to tally an additional 5,000 births annually thanks to the abortion ban that took effect in July, obstetric services in the state are actually shrinking. The labor and delivery ward at Greenwood-Leflore Hospital closed in the fall. The Delta lost its only neonatal intensive care unit this summer. The NICU at Merit Health Central, which serves predominantly Black and low-income Jackson neighborhoods, also closed.

Already, more than half of the state’s counties are maternity care deserts: No labor and delivery ward. No OB-GYNs. No certified nurse midwives.

Women in rural areas face long drives to the nearest labor and delivery ward. Sometimes, that means they can’t make it there at all. Instead, they may give birth in an emergency room, at home while waiting for first responders to show up, or on the side of the road.

The STORK program staff hope training participants will be able to handle those situations effectively, saving lives along the way.

“These patients are going to be coming into really small hospitals and delivering or having problems,” said Dr. Tara Lewis, assistant professor of emergency medicine at UMMC and a former labor and delivery nurse.

Lewis joined the program to help tailor it to the needs of emergency room staff in small, rural hospitals.

“If providers don’t know how to make the diagnosis of what problem is going on, then they’re not going to know how to take care of them.”

PHOTOS: First responders trained on how to deliver babies

“You look like a really good uterus,” Morris told a burly Flowood firefighter and paramedic who had joined three of his colleagues to attend a STORK training at MCES on a recent Wednesday morning.

She had just given a presentation on managing hypertension and hemorrhage, and now it was time to demonstrate how to assist during a delivery.

The paramedic held a rubber baby as Morris demonstrated how a baby’s head will generally turn to one side as it leaves the birth canal, and how to use a finger to gently loosen the umbilical cord if it has looped around the neck.

In addition to the Flowood firefighters, attendees included a pediatric emergency room nurse at UMMC, a women’s health nurse in Meridian, and an emergency room nurse at Magee General Hospital who has assisted with three deliveries in the last year alone.

“That’s a lot considering it’s a small hospital with no labor and delivery resources,” she said.

There are regular STORK trainings at MCES open to people from all over the state. But the free training is also conducted at hospitals, so participants don’t have to travel and can see how to apply what they learn where they work.

After Morris finished her presentation, Emily Wells, a nurse practitioner and member of UMMC’s neonate transport team, explained how to care for newborns in the moments after birth. Since Jan. 1 of this year, the team has transported 390 babies to higher levels of care, and participated in 20 emergency room deliveries.

She described the recent delivery of a “rest stop baby,” who was born in a Toyota Camry en route to a hospital during a cold snap.

“Cold babies die,” she said, so the team had cranked up the heat inside the car and done everything they could to keep the baby warm.

In a hospital, the baby would be placed in an incubator. But in a pinch, any kind of plastic bag – maybe one that had been used to hold supplies now in use – could be placed around the baby’s body to conserve heat.

Health professionals and emergency responders practice with helping a simulator breath after delivering a baby during a training called STORK at Mississippi Center For Emergency Services in Jackson, Miss., Wednesday, December 7, 2022.

A woman had just delivered a baby at 26 weeks in her car, and now both had made it to the emergency room of their small-town hospital. She had delivered the placenta, too, but was still bleeding.

What should happen next? Half of the training participants gathered around their patient – a life-size mannequin lying on a hospital bed shouting “I’m bleeding” – and discussed what to do.

“At 26 weeks, I think the placenta abrupted,” Morris explained.

Blood trickled from the mannequin’s vagina, soaking a pad underneath her body. This was an important lesson, Leslie Cannon, now an educator with STORK after 25 years as a labor and delivery nurse, pointed out: In patients who aren’t pregnant, life-threatening hemorrhage often looks like a dramatic gush.

“Hemorrhage postpartum, it’s this trickle,” she said. “It’s a huge deal, because that trickle just keeps going.”

That’s important to keep in mind especially because it’s often not obvious when a woman is at serious risk because of bleeding.

“A young, healthy pregnant lady is going to look really good — until she’s about dead,” Morris had warned of hemorrhaging patients.

The students administered tranexamic acid to slow the bleeding.

As Morris had explained during her lecture, a student reached an arm into the uterus to sweep for pieces of retained placenta, which can cause life-threatening bleeding. (“It’s not a comfortable thing to do,” Morris warned.) Another student massaged the mannequin’s belly to cause the uterus to contract.

Eventually, the trickle slowed and stopped. Morris estimated the patient had lost a liter of blood.

Before everyone left, Morris and Wells gave out their cell phone numbers. Kace Ragan, project manager for STORK, explained that participants get supply bags that include QR codes they can scan to request refills — as long as the grant funding holds out — and report their experiences during deliveries.

Morris urged the attendees to text or call her with questions any time. Morris treats some of the most challenging pregnancies in the state and serves as obstetric COVID director at UMMC, meaning she’s spent the last two years witnessing devastating loss.

And yet, she told the training participants, she has “the luxury” of working in a hospital with plenty of resources and specialized training.

“Y’all are in the trenches doing things that I have to do, too, but with so much less,” she said.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Stories: Michael May of Lazy Acres

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January 21, 2025

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mississippitoday.org – rlake – 2025-01-21 14:51:00

In this episode of Mississippi Stories, Mississippi Today Editor-at-Large Marshall Ramsey takes a trip to Lazy Acres. In 1980, Lazy Acres Christmas tree farm was founded in Chunky, Mississippi by Raburn and Shirley May. Twenty-one years later, Michael and Cathy May purchased Lazy Acres. Today, the farm has grown into a multi seasonal business offering a Bunny Patch at Easter, Pumpkin Patch in the fall, Christmas trees and an spectacular Christmas light show.  It’s also a masterclass in family business entrepreneurship and agricultural tourism.

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This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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On this day in 1921

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January 21, 2025

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mississippitoday.org – Jerry Mitchell – 2025-01-21 07:00:00

Jan. 21, 1921

George Washington Carver Credit: Wikipedia

George Washington Carver became one of the first Black experts to testify before Congress. 

His unlikely road to Washington began after his birth in Missouri, just before the Civil War ended. When he was a week old, he and his mother and his sister were kidnapped by night raiders. The slaveholder hired a man to track them down, but the only one the man could locate was George, and the slaveholder exchanged a race horse for George’s safe return. George and his brother were raised by the slaveholder and his wife. 

The couple taught them to read and write. George wound up attending a school for Black children 10 miles away and later tried to attend Highland University in Kansas, only to get turned away because of the color of his skin. Then he attended Simpson College in Indianola, Iowa, before becoming the first Black student at what is now Iowa State University, where he received a Master’s of Science degree and became the first Black faculty member. 

Booker T. Washington then invited Carver to head the Tuskegee Institute’s Agriculture Department, where he found new uses for peanuts, sweet potatoes, soybeans and other crops. 

In the past, segregation would have barred Carver’s testimony before Congress, but white peanut farmers, desperate to convince lawmakers about the need for a tariff on peanuts because of cheap Chinese imports, believed Carver could captivate them — and captivate he did, detailing how the nut could be transformed into candy, milk, livestock feed, even ink. 

“I have just begun with the peanut,” he told lawmakers. 

Impressed, they passed the Fordney-McCumber Tariff of 1922. 

In addition to this work, Carver promoted racial harmony. From 1923 to 1933, he traveled to white Southern colleges for the Commission on Interracial Cooperation. Time magazine referred to him as a “Black Leonardo,” and he died in 1943. 

That same year, the George Washington Carver Monument complex, the first national park honoring a Black American, was founded in Joplin, Missouri.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Legislative recap: 2025 tax cut battle has been joined

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January 20, 2025

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mississippitoday.org – Geoff Pender – 2025-01-20 12:00:00

After relatively brief debate and questioning given its magnitude, the state House passed the first meaningful legislation of the new session: House Bill 1, a measure that would eliminate the state income tax, trim taxes on non-prepared food and raise sales and gasoline taxes.

It would mark a sea change in state tax structure, a shift from income to consumption taxation.

“We are at a place where we can finally tell the hard-working people of Mississippi we can eliminate the tax on work,” House Ways and Means Chairman Trey Lamar, HB1’s author, told his colleagues.

The measure passed the House 88-24. It gained some Democratic support in the supermajority Republican House, with nine Democrats voting in favor, 24 against and 12 voting present.

The proposal garnered some bipartisan support because it includes at least a couple of items Democratic lawmakers have championed in the past: A gasoline tax to help fix crumbling roadways, and a reduction in the “grocery” tax, or the sales tax levied on unprepared food, of which Mississippi has the highest overall rate in the nation.

It still met with some Democratic opposition in part because it is a sea change toward more “regressive” taxation. Proponents say this is just, people should pay more for state services they use, such as roadways, and for things they buy as opposed to taxing income. Opponents say this places a proportionately higher tax burden on people of modest means.

“I would say the people hurt the most with this would be working people who have to put gas in their car to go to work or those who have to purchase materials to do a job,” House Democratic Leader Robert Johnson said.

Beyond that concern, opponents or skeptics worry that the foundation of the proposed tax overhaul would be built on shifting sands — a state economy that has been so rosy primarily from the federal government dumping billions of dollars in pandemic spending into Mississippi. With the federal spigot being cut off, some worry, the state economy could slump, and the massive tax cuts in this new plan could provide a state budget crisis, of which Mississippi has much experience, and underfunding of crucial services such as schools, roads, health care and law enforcement.

The largest hurdle Republican House leaders face in seeing their tax plan through to law is not in garnering bipartisan support. It’s internecine disagreement with the Senate Republican leadership, which still appears to harbor abovementioned concerns about overhauling tax structure in uncertain economic times and betting on growth to cover massive tax cuts.

Senate leaders have said they want to enact more tax cuts, but their plan has not yet been released. Lt. Gov. Delbert Hosemann has provided some details of what he wants to see, but it would appear he wants a more cautious approach on cuts. He has not publicly opined on the tax increases in the House plan.

Quote of the Week

“Have you ever worn a belt and suspenders, lady? It’s a belt and suspenders approach.” — Rep. Trey Lamar, R-Senatobia, to Rep. Omeria Scott, D-Laurel, during floor debate on Lamar’s bill to eliminate the state income tax and raise other taxes.

“No. I have not worn a belt and suspenders. I don’t know anyone who has worn a belt and suspenders,” Scott replied.

In Brief

House will renew push to legalize mobile sports betting

House Gaming Committee Chairman Casey Eure, R-Saucier, told Mississippi Today he plans on taking another crack at legalizing mobile sports betting in the state. In 2024, the House and Senate passed versions of legislation to permit online sports betting, but never agreed on a final proposal. Some lawmakers raised concerns that gambling platforms would have no incentive to partner with smaller casinos, and most of the money would instead flow to the Mississippi Gulf Coast’s already bustling casinos. Proponents say legalization would undercut the influence of illicit offshore sports betting platforms.

“I’ve been working on this bill for many years and I’m just trying to satisfy any concerns that the Senate may have so we can pass this and start collecting the tax dollars that the state deserves and not allowing everyone to place bets with these offshore accounts,” Eure said. “I feel like the state is losing between $40-$80 million a year in tax revenue.”

Sports wagering has been permitted in the state for years, but online betting has remained illegal amid fears the move could harm the bottom line of the state’s brick-and-mortar casinos. Mobile sports betting is legal in 30 states and Washington, D.C.,  according to the American Gaming Association. — Michael Goldberg

Hosemann makes Senate committee chair changes

Republican Lt. Gov. Delbert Hosemann last week named new chairmen of committees, after former state Sen. Jenifer Branning was sworn into office as a new justice on the Mississippi Supreme Court. 

Sen. Chuck Younger, a Republican from Columbus, previously led the Senate Agriculture Committee and will replace Branning as chairman of the Transportation Committee. Sen. Neil Whaley, a Republican from Potts Camp, previously led the Senate Wildlife, Fisheries and Parks Committee, but will now lead the Senate Agriculture Committee. 

Here are the other changes to Senate committees: 

Sen. Ben Suber, a Republican from Bruce, will be the new chairman of the Senate Wildlife, Fisheries and Parks Committee 

Sen. Bart Williams, a Republican from Starkville, is the new chairman of the Senate Public Property Committee

Sen. Scott DeLano, a Republican from Gulfport, will lead the Senate Technology Committee 

Sen. Robin Robinson, a Republican from Laurel, will chair the Senate Labor Committee 

Sen. Angela Turner Ford, a Democrat from West Point, will lead the Senate Drug Policy Committee.  — Taylor Vance

What’s in a name? Democratic Rep. Scott hopes GOP majority will pass ‘Donald J. Trump Act’ bills

Perhaps tired of seeing many measures she authors ignored or shot down in flames by the Republican supermajority in the Mississippi Legislature, Democratic Rep. Omeria Scott of Laurel is trying a new strategy: naming bills after Republican President-elect Trump.

For this session, Scott has authored: House Bill 61, the “Donald J. Trump Voting Rights Restoration Act;” House Bill 62, the “Donald J. Trump Ban-The-Box Act … to prohibit public employers from using criminal history as a bar to employment;” and House Bill 249, the “Donald J. Trump Early Voting Act.” — Geoff Pender

More bills filed to criminalize abortion

Since the 2022 Dobbs Supreme Court decision overturned the constitutional right to an abortion, Mississippi lawmakers have proposed bills to criminalize workarounds to the state’s strict abortion ban – including criminalizing the abortion pill and out-of-state abortions. The 2025 legislative session is no exception. 

Rep. William Tracy Arnold, R-Booneville, filed House Bill 616 that would make it a felony to manufacture or make accessible medication abortion. Anyone convicted of the crime would be subject to a fine between $1,000 and $5,000, as well as imprisonment between two and five years. Last year, about 250 Mississippians each month requested medication abortion from Aid Access, the only online telemedicine service supplying medication abortion via mail in the U.S. 

Helping a minor receive an abortion would also be criminalized under House Bill 148 filed by Rep. Mark Tullos, R-Raleigh. That would include transporting a minor out of state to undergo an abortion, as well as helping a minor procure a medication abortion – both of which would be punishable by not less than 20 years in prison or a fine of not less than $50,000. — Sophia Paffenroth

By the Numbers

$1.1 billion

The estimated net annual cost of the House plan to eliminate the state income tax and raise sales taxes, once fully phased in. Proponents say economic growth would allow the state budget, currently about $7 billion a year, to absorb the cut. Eliminating the income tax would cost the state $2.2 billion in revenue, but the House plan would raise about $1.1 billion in other taxes in offset.

0

The amount of income tax Mississippians would pay after a 10-year phased in elimination of the state income tax. With previous cuts being phased in, state income taxes next year will already be reduced to 4%, among the lowest rates in the nation.

8.5 %

The new Mississippi sales tax, up from current 7%, under the House tax plan assuming most local governments would not opt out of adding a new 1.5% local sales tax.

13 cents more a gallon

The cost of the House’s proposed new 5% gasoline tax, based on last week’s average cost of gasoline in Mississippi of $2.62. The new 5% tax would be on top of the flat 18.4 cents a gallon current state excise on gasoline.

4%

The tax on unprepared food once a reduction of the current 7% would be phased in over a decade under the House plan. The state would over time reduce its sales tax on such groceries to 2.5%, but local governments would add a 1.5% sales tax to such items unless they opt out.

Full Legislative Coverage

Lawmakers must pass new legislation to improve access to prenatal care

Lawmakers will file another bill this session to help low-income pregnant women get into the doctor earlier – after the federal government rejected the program set up under last year’s law, because of discrepancies between what was written into state law and federal regulations for presumptive Medicaid eligibility. Read the story.

Proposal: eliminate income tax, add 5% tax on gas, allow cities, counties to levy local sales tax

House leaders last week unveiled a sweeping tax cut proposal that would eventually abolish the state income tax, slash taxes on groceries, increase local sales taxes and shore up funds for state and local road work. Read the story.

A new Mississippi law aims to limit jailing people awaiting mental health treatment. Is it working?

Officials say a new law to decrease the number of people being jailed solely because they need mental health treatment has led to fewer people with serious mental illness detained in jails – but the data is contradictory and incomplete. Lawmakers plan legislation to make more counties report the data. Read the story.

How soon we forget: Mississippi House push for record tax cuts revives fear of repeat budget crises

Eight years ago, from a combination of dozens of tax cuts the Legislature approved and a slumping economy, the state saw a budget crisis that resulted in severely underfunded schools, government layoffs, a near halt to building new roads and highways and problems maintaining the ones we have, too few state troopers on the highways and cuts to most major state services. Read the story.

NAACP legislative redistricting proposal pits two pairs of senators against each other

The Mississippi chapter of the ACLU has submitted a proposal to the courts to redraw the state’s legislative districts that creates two new majority-Black Senate districts and pits two pairs of incumbent senators against one another. Read the story.

Legislation to send more public money to private schools appears stalled as lawmakers consider other changes

Some top lawmakers in Mississippi’s Republican-controlled Legislature are prepared to make it easier for students to transfer between public schools but remain skeptical of sending more public money to private schools. Read the story.

House passes $1.1 billion income tax elimination-gas and sales tax increase plan in bipartisan vote

A bill that phases out the state income tax, cuts the state grocery tax and raises sales taxes and gasoline taxes passed the House of Representatives with a bipartisan vote on Thursday. Read the story.

Tate Reeves and other top Mississippi Republicans owe thanks to President Joe Biden

The tremendous cash surpluses that some state Republicans cite when defending their plan to eliminate the state’s income tax would not exist if not for the billions of dollars in federal funds that have been pumped into the state during Biden’s presidential tenure. Read the story.

Podcast: Mississippi transportation director discusses proposed new gasoline tax

Mississippi Department of Transportation Director Brad White tells Mississippi Today’s Geoff Pender and Taylor Vance he’s staying “in his lane” and out of the politics of a House tax overhaul that would eliminate the income tax and raise sales and gasoline taxes, but that he’s pleased lawmakers are trying to address the long running need for a steady new stream of money to help cover highway maintenance needs. Listen to the podcast.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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