Mississippi Today
New Health Department program puts nurses in the homes of high-risk moms, babies in Mississippi

Through a partnership between the state Health Department and the state Division of Medicaid, Healthy Moms, Healthy Babies program places registered nurse case managers in the homes of pregnant mothers undergoing high-risk pregnancies.
Since launching, it has expanded to 23 full-time nurses and 17 part-time nurses providing services to about 640 patients around the state.
State Health Officer Dr. Daniel Edney said the program is “plugging the gap” by bringing resources to small rural communities that aren’t there.
“With limited resources for mothers and babies, a lot of our efforts are going to be directed to our highest impacted areas to help the folks in the most desperate need the fastest,” Edney said.
The way resources are distributed across the state – sparsely in rural and remote areas but plentiful in certain others – means the program must take a targeted approach.
“We can not look at Mississippi as one organism. We are really six different regions when it comes to public health in terms of populations, demographics, resources available and challenges,” Edney explained. “I have to have different strategies for different areas. The one-size fits all strategy won’t work.”
Dr. Justin Turner, chief medical officer at the state Health Department, witnessed personally how important access to quality health care for mothers is.
Turner’s wife made 23 total visits to five different hospitals or emergency rooms during her last two pregnancies.
Seven out of 23 of those visits came during her pregnancy five years ago, and the remainder of the visits came during their second pregnancy in August 2022. During her last pregnancy, she experienced “uncharacteristic pain” around month five, requiring her to be supervised by her family 24 hours a day until she gave birth.
The pain would spiral out of control resulting in psychogenic nonepileptic seizures (PNES), previously known as pseudoseizures – emotional and stress-related episodes similar to epileptic seizures but not of neurological origin.
As the number of trips increased, Turner said he had a tough time reassuring his family and himself.
“I was thinking, 'how do I continue to do what I’m supposed to do as the chief medical officer and help assist the state as a whole, when I can’t even help my wife at home?'” Turner told Mississippi Today.
For Black women in Mississippi, the pregnancy-related mortality rate increased from 51.9 to 65.1 deaths per 100,000 live births, quadruple the rate of white women (16.2). With this data in mind, fears of the worst outcome flooded both Turner and his wife’s minds.
“It was natural for me to think that my wife was going to be another statistic,” Turner explained. “She would ask me things like, ‘Baby, am I going to die?’”
The pregnancy remained a challenge until the day that she delivered their child by cesarean section. Every day prior to her being pregnant was “a day of misery,” Turner said. After delivery, his wife never experienced another pseudoseizure episode.
Turner said fortunately for his wife, she had a husband who is a doctor, an OB-GYN, support from family and friends, and a great health care team.
However, he couldn't help but think of how many mothers in Mississippi lack support. Turner said the Healthy Moms, Healthy Babies program aims to add emotional support for mothers who may be in need of it.
“For a lot of women, they benefit from the nurturing and feeling like someone is listening,” Turner continued. “The more people that’s on their team, the better it helps them to endure the process of pregnancy itself.”
As services are being provided to participants, Turner said the health department, stakeholders, policy makers and community members must collaborate to improve outcomes for mothers and their babies.
“We need to find common ground in the areas that we can improve and make sure that we are providing our moms and babies a decent chance at having a healthy pregnancy and coming into this world,” Turner said.
As a Medicaid-reimbursed program, Healthy Moms, Healthy Babies allows mothers to receive monthly targeted case management, health education, and assessments by nurses, social workers and nutritionists at no direct cost to them.
For moms with Medicaid, the services are reimbursed. Edney said the program works with uninsured moms to help them enroll in Medicaid or, if they are not eligible, will provide the services for free.
The Mississippi State Health Department declined Mississippi Today's request to interview a mother who has participated in the program.
After making contact with a mom in need, the nurse consults with the mother’s doctor, who shares why she may be considered high-risk. Common high-risk conditions include preterm labor, diabetes, multiple pregnancy losses and starting prenatal care late.
The nurse then works to mitigate her symptoms by going to the mother's home and pairing her with a multidisciplinary team of resources, such as social workers and nutritionists.
The team of health care workers educate her on the importance of prenatal care, diet plans and how to limit her chances of becoming high-risk in the future. Edney said the program is “working aggressively” to support affected Medicaid moms.
“In our last reporting from the maternal mortality review committee, 87% of deaths were Medicaid moms, and out of all of our maternal deaths, 80% were preventable,” Edney told Mississippi Today. “That is unacceptable.”
Currently, 86% of the participating mothers are Medicaid beneficiaries.
Healthy Moms, Healthy Babies monitors not only high-risk mothers but also high-risk babies up to one year of age.

A baby is considered high risk if they are born prior to 37 weeks of gestation, weigh less than 5 pounds 8 ounces at birth, have genetic disorders, experience nutritional deficiencies, infections, or live in unsafe conditions among other factors as well.
The average age of infants enrolled in the program is less than one month old.
The goal of the program is to increase the infant's chances of survival, Edney said. Mississippi leads the nation in its rate of infant mortality.
“I know that if we continue doing what we are doing, nothing is going to change. So, if we all agree we have a problem, which I think everybody does, then this has got to change,” Edney stated. “I don’t have to convince anybody that being 50th in the nation for dead babies is a good thing, because it isn’t.”
The Health Department plans to expand the program so that more women and babies in rural communities have access to necessary care.
Around 35% of babies were born to women living in rural counties of the state, but only a quarter of maternity care providers practice there, according to the latest March of Dimes’ report.
Jillian Harper-Peavy, the state program director for Healthy Moms, Healthy Babies, said partnerships with different individuals and organizations are critical for the program to expand.

Those organizations include community health centers; hospitals; OB-GYN offices; pediatricians; managed care organizations; and other maternal and child health programs.
“We are prioritizing outreach and engagement of patients continually, as we do want to see the program serve more pregnant women and infants,” Harper-Peavy continued. “As additional patients are enrolled, we will continue to assess our staffing capacity and plan accordingly.”
However, financial constraints have hindered its expansion.
Earlier this year, Edney asked lawmakers to fund $9 million to hire nurses needed to fully staff county health departments and Healthy Moms, Healthy Babies. The request was denied.
Now, Edney said he is seeking to redirect the funding he has and cut back in every department possible to hire the 100 or so nurses he’s identified as potential job candidates.
“I’m trying to provide core public health services around this state with a battered workforce,” Edney explained. “I try to get people to understand that while everybody else may be over COVID-19, the health department is not. We were beaten to pieces, and we’re working hard to rebuild our workforce with the resources that we have.”
Susan Bates, nurse team lead in the northeastern region of the state, manages a team of nurses who serve patients in 11 counties, seven of which are maternal health deserts: Marshall, Benton, Tippah, Pontotoc, Prentiss, Tishomingo and Itawamba.
These counties have no hospitals or birthing centers that provide obstetric care, and no practicing OB-GYNs or certified nurse midwives.
Across the state, 51.2% of counties are defined as maternity care deserts, compared to 32.6% nationally.
Bates, who cares for an average of six to 10 mothers and babies each day, has encountered women experiencing preterm labor, preterm delivery, preeclampsia, anxiety and depression. She’s also cared for premature and low-birthweight babies.
With more than 26 years of nursing experience, Bates said she aims to make every patient feel respected, valued and heard. Her approach is to listen, understand and “not just focus on checking a box.”
“I feel that it is important to establish a relationship of trust between the mother and her doctors that way we can promote and foster communication. This allows us to provide a more comprehensive care and therefore improve our patients’ outcomes,” Bates continued. “So, when we meet our patients' needs, consistently and correctly, they develop trust in us as their caregiver.”
The Corinth native previously worked for the Mississippi State Health Department for 11 years as a public health nurse, promoting and protecting the health of populations using knowledge from nursing, social and public health science.
Bates, who is certified in pediatric advanced life support and neonatal advanced life support, said caring for high-risk mothers and babies requires a calm demeanor to help the family through what can be a scary time.
“If you look at the big picture, then it may seem overwhelming, but we can’t be stopped by that. We have to know that what we are doing makes a difference to each patient,” Bates explained. “One life at a time, we’re making a difference.”
Edney said that scoring poorly in maternal and infant mortality is a “heavy burden” that requires a “heavy lift” to flip the negative trend to a positive one.
“It’ll take years, but with the work that we’re going to do with the agency, I’m convinced that we will not only get off the bottom with infant mortality,” Edney stated, “we will get off the radar.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1857

March 6, 1857

In Dred Scott v. Sandford, the U.S. Supreme Court upheld slavery in a 7-2 vote.
Dred Scott and his family were enslaved, and when he tried to purchase their freedom, they were refused. He and his wife, Harriet, each filed separate lawsuits, calling for their freedom. They noted that they had lived for years in both free states and free territories.
A jury ruled in favor of Scott and his family. But on appeal, the Supreme Court ruled that Black Americans, whether slave or free, had no right to sue.
In a stinging dissent, Justice Benjamin Robbins Curtis wrote that the claim Black Americans could not be citizens was baseless: “At the time of the ratification of the Articles of Confederation, all free native-born inhabitants of the States of New Hampshire, Massachusetts, New York, New Jersey, and North Carolina, though descended from African slaves, were not only citizens of those States, but such of them as had the other necessary qualifications possessed the franchise of electors, on equal terms with other citizens.”
He noted that the Declaration of Independence didn’t say that “the Creator of all men had endowed the white race, exclusively with the great natural rights.
” The decision drew wrath from many, including future President Abraham Lincoln, who called it “erroneous.” Two months later, Scott won his freedom when the sons of his first owner, Peter Blow, purchased his emancipation, setting off celebrations in the North.
The court decision helped lead to the Civil War, and the 13th, 14th and 15th Amendments were adopted to counter the ruling. In 2017, on the 160th Anniversary of the Dred Scott decision, the great-great-grandnephew of Supreme Court Chief Justice Roger Taney apologized to Scott’s great-great-granddaughter and all Black Americans “for the terrible injustice of the Dred Scott decision.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Legislation to license midwives dies in the Senate after making historic headway

A bill to license and regulate professional midwifery died on the calendar without a vote after Public Health Chair Hob Bryan, D-Amory, did not bring it up in committee before the deadline Tuesday night.
Bryan said he didn’t take the legislation up this year because he’s not in favor of encouraging midwives to handle births independently from OB-GYNs – even though they already do, and keeping them unlicensed makes it easier for untrained midwives to practice. The proposed legislation would create stricter standards around who can call themselves a midwife – but Bryan doesn’t want to pass legislation recognizing the group at all.
“I don’t wish to encourage that activity,” he told Mississippi Today.
Midwifery is one of the oldest professions in the world.
Proponents of the legislation say it would legitimize the profession, create a clear pathway toward midwifery in Mississippi, and increase the number of midwives in a state riddled with maternity health care deserts.
Opponents of the proposal exist on either end of the spectrum. Some think it does too much and limits the freedom of those currently practicing as midwives in the state, while others say it doesn’t do enough to regulate the profession or protect the public.
The bill, authored by Rep. Dana McLean, R-Columbus, made it further than it has in years past, passing the full House mid-February.
As it stands, Mississippi is one of 13 states that has no regulations around professional midwifery – a freedom that hasn’t benefited midwives or mothers, advocates say.
Tanya Smith-Johnson is a midwife on the board of Better Birth Mississippi, a group advocating for licensure.
“Consumers should be able to birth wherever they want and with whom they want – but they should know who is a midwife and who isn’t,” Smith-Johnson said. “… It’s hard for a midwife to be sustainable here … What is the standard of how much midwifery can cost if anyone and everyone can say they’re a midwife?”
There are some midwives — though it isn’t clear there are many — who do not favor licensure.
One such midwife posted in a private Facebook group lamenting the legislation, which would make it illegal for her to continue to practice under the title “midwife” without undergoing the required training and certification decided by the board.
On the other end of the spectrum, among those who think the bill doesn’t go far enough in regulating midwives, is Getty Israel, founder of community health clinic Sisters in Birth – though she said she would rather have seen the bill amended than killed. Israel wanted the bill to be amended in several ways, including to mandate midwives pay for professional liability insurance, which it did not.
“As a public health expert, I support licensing and regulating all health care providers, including direct entry midwives, who are providing care for the most vulnerable population, pregnant women,” she said. “To that end, direct entry midwives should be required to carry professional liability insurance, as are certified nurse midwives, to protect ill-informed consumers.”
The longer Mississippi midwives go without licensure, the closer they get to being regulated by doctors who don’t have midwives’ best interests in mind.
That’s part of why the group Better Birth felt an urgency in getting legislation passed this year.
“I think there’s just been more iffy situations happening in the state, and it’s caused the midwives to realize that if we don’t do something now, it’s going to get done for us,” said Erin Raftery, president of the group.
Raftery says she was inspired to see the bill make headway this year after not making it out of committee several years in a row.
“We are hopeful that next year this bill will pass and open doors that improve outcomes in our state,” she said. “Mississippi families deserve safe, competent community midwifery care.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
New Mississippi legislative maps head to court for approval despite DeSoto lawmakers’ objections

Voters from 15 Mississippi legislative districts will decide special elections this November, if a federal court approves two redistricting maps that lawmakers approved on Wednesday.
The Legislature passed House and Senate redistricting maps, over the objections of some Democrats and DeSoto County lawmakers. The map creates a majority-Black House district in Chickasaw County and creates two new majority-Black Senate districts in DeSoto and Lamar counties.
“What I did was fair and something we all thought the courts would approve,” Senate President Pro Tempore Dean Kirby told Mississippi Today on the Senate plan.
Even though legislative elections were held in 2023, lawmakers have to tweak some districts because a three-judge federal panel determined last year that the Legislature violated federal law by not creating enough Black-majority districts when it redrew districts in 2022.
The Senate plan creates one new majority-Black district each in DeSoto County and the Hattiesburg area, with no incumbent senator in either district. To account for this, the plan also pits two incumbents against each other in northwest Mississippi.
READ MORE: See the proposed new Mississippi legislative districts here.
The proposal puts Sen. Michael McLendon, a Republican from Hernando, who is white, and Sen. Reginald Jackson, a Democrat from Marks, who is Black, in the same district. The redrawn district contains a Black voting-age population of 52.4% and includes portions of DeSoto, Tunica, Quitman and Coahoma counties.
McLendon has vehemently opposed the plan, said the process for drawing a new map wasn’t transparent and said Senate leaders selectively drew certain districts to protect senators who are key allies.
McLendon proposed an alternative map for the DeSoto County area and is frustrated that Senate leaders did not run analytical tests on it like they did on the plan the Senate leadership proposed.
“I would love to have my map vetted along with the other map to compare apples to apples,” McLendon said. “I would love for someone to say, ‘No, it’s not good’ or ‘Yes, it passes muster.’”
Kirby said McLendon’s assertions are not factual and he only tried to “protect all the senators” he could.
The Senate plan has also drawn criticism from some House members and from DeSoto County leaders.
Rep. Dan Eubanks, a Republican from Walls, said he was concerned with the large geographical size of the revised northwest district and believes a Senator would be unable to represent the area adequately.
“Let’s say somebody down further into that district gets elected, DeSoto County is worried it won’t get the representation it wants,” Eubanks said. “And if somebody gets elected in DeSoto County, the Delta is worried that it won’t get the representation it wants and needs.”
The DeSoto County Board of Supervisors on Tuesday published a statement on social media saying it had hired outside counsel to pursue legal options related to the Senate redistricting plan.
Robert Foster, a former House member and current DeSoto County supervisor, declined comment on what the board intended to do. Still, he said several citizens and business leaders in DeSoto County were unhappy with the Senate plan.
House Elections Chairman Noah Sanford, a Republican from Collins, presented the Senate plan on the House floor and said he opposed it because Senate leaders did not listen to his concerns over how it redrew Senate districts in Covington County, his home district.
“They had no interest in talking to me, they had no interest in hearing my concerns about my county whatsoever, and I’m the one expected to present it,” Sanford said. “Now that is a lack of professional courtesy, and it’s a lack of personal respect to me.”
Kirby said House leaders were responsible for redrawing the House plan and Senate leaders were responsible for redrawing the Senate districts, which has historically been the custom.
“I had to do what was best for the Senate and what I thought was pass the court,” Kirby said.
The court ordered the Legislature to tweak only one House district, so it had fewer objections among lawmakers. Legislators voted to redraw five districts in north Mississippi and made the House district in Chickasaw County a majority-Black district.
Under the legislation, the qualifying period for new elections would run from May 19 to May 30. The primaries would be held on August 5, with a potential primary runoff on Sept. 2 and the general election on Nov, 4.
It’s unclear when the federal panel will review the maps, but it ordered attorneys representing the state to notify them once the lawmakers had proposed a new map.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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