Introduction

Early in my career, I moved into a street lined with sycamore trees. These trees were not only easy to exhale with, but they also were my entrance into learning about Title V programs as a mom, not as a professional. If you get to know me, I will talk a lot about trees and a federal program called Early Intervention (EI), as it changed the trajectory of my son’s well-being. As a toddler, he had been diagnosed with significant developmental delays. What I learned and experienced as my child received EI services from Title V programming would link me into changing the rest of my professional work into public health. So when at the last Lamaze Advocacy + Collaboration Committee meeting, we were sharing about regional resources, some exciting elements emerged about Title V and the role of fostering deeper roots with Lamaze educators in each state.

What is Title V?

As one of the largest Federal block grant programs, Title V (verbally called “Title 5”) is a key source of support for promoting and improving the health of the nation’s parents and children. The Title V Maternal and Child Health (MCH) Services Block Grant Program is a federal/state partnership, authorized under Title V of the Social Security Act to ensure the health and well-being of women, mothers, infants, children (including children with special health care needs), adolescents and their families. Originally authorized in 1935, Title V is the oldest public health program in our nation. 

An Opportunity for Lamaze International Principles to be Represented for Title V Inclusion 

Each state’s Title V Director must submit a needs assessment and action plan to the federal government by July 15, 2020, that outlines their priorities and strategies for achieving optimal health and well-being for all of his/her state's mothers and children for the next five years. Title V Directors are working on their needs assessments now and are seeking input from their states’ key stakeholders to make these decisions. 

During this needs assessment period, Lamaze International members can play a critical role in informing the TItle V Director that Lamaze International’s Six Healthy Birth Practices and evidence-based childbirth education programs can help each state to meet their Title V goals. Members and advocates can share Lamaze International parent and advocacy resources. It is critical to get involved because 86 percent of all pregnant women, 99 percent of all infants, and 55 percent of children benefit from a Title V service in the United States.

North Carolina’s Action Plan Currently Cites Lamaze International

The North Carolina Perinatal Strategic Plan incorporates the Lamaze Six Healthy Birth Practices as specific recommendations under Point 3G-1: Provide evidence-based culturally competent patient education and anticipatory guidance.

Tonya Daniel, a current Lamaze International Advocacy & Collaboration committee member and Tara Owens Schuler, former Lamaze International Board President should be acknowledged for their substantial efforts to have the Six Healthy Birth Practices included in North Carolina’s Strategic Plan. Tonya also noted that the North Carolina Medicaid program covers childbirth education and lists Lamaze certification as the preferred accreditation standard for delivering this education to its citizens. 

Reducing Cesarean Births for Low-Risk Pregnancies

Seven states - LA, MD, WV, KY, MO, ME and  CO, have focused on reducing the Nulliparous, Term, Singleton, Vertex (NTSV) cesarean birth rate which is Performance Measure 2 in the National Performance Measures established for the Title V Maternal Child Health Services Block Grant Program. Lowering the NTSV cesarean birth rate can be accomplished through several different means. The chart below indicates how each participating state plans to accomplish their goals. Readers will note that West Virginia’s measure is the number of Labor & Delivery nurses who have participated in the Lamaze International Evidence-Based Labor Support Workshop. Look for an up-close examination of West Virginia’s efforts in a future blog post.

How Can Lamaze International Members Get Involved

So how do you start building partnerships with your state’s own Title V personnel? Find your state’s Title V office listed under the program’s state contacts. Set up a meeting to offer evidence-based resources for inclusion in your state’s action plan. Let your state’s Title V personnel know that it is imperative that the Lamaze International Six Healthy Birth Practices and our quality childbirth education programs that Lamaze Certified Childbirth Educators offer should be key components included in any future perinatal needs assessment and state plan. You can highlight the partnership of Lamaze International with both North Carolina and West Virginia, where their state strategic plans have successfully included Lamaze International resources.

Conclusion

Building relationships takes time and trust. I have found that the research from Lamaze International has helped me foster partnerships even if my credentials differ from the other individuals sitting around the table. When we gather to build trust and craft partnerships, I return to the wisdom of trees. Peter Wohlleben has written so much on the interconnection and reciprocity of trees to each other as opposed to competition--which is a parallel to our work and communities for health and well being. 

"But isn't that how evolution works? you ask. The survival of the fittest? Their well-being depends on their community, and when the supposedly feeble trees disappear, the others lose as well. When that happens, the forest is no longer a single closed unit. Hot sun and swirling winds can now penetrate to the forest floor and disrupt the moist, cool climate. Even strong trees get sick a lot over the course of their lives. When this happens, they depend on their weaker neighbors for support. If they are no longer there, then all it takes is what would once have been a harmless insect attack to seal the fate even of giants."

Humbled and inspired by Wholleben’s words, I will continue to show up with handouts and an open heart, bringing the hope of being part of a new paradigm where we build partnerships and provide support so each family--from pregnancy to early parenting--navigates the journey within their communities. I know first hand that Title V programs support families at vulnerable and important touchpoints and provide services that can change the trajectory of youth. That fragile toddler is now a tall teenager, riding bikes and playing video games. I think of sycamore trees, the symbol of strength and protection, along with the imprint of a Title V program, and invite the entire Lamaze community to find an opportunity to integrate our resources into the components of these valuable programs. 

Have you already had success in collaborating with your state’s needs assessments and priority planning committees?  Please share your experiences in the comments below. For questions or more information about Title V Action Plans, please contact the Lamaze Advocacy & Collaboration Committee Chair, Jill Wodnick.

About Jill Wodnick

Jill Wodnick, M.A., LCCE, facilitates Lamaze prenatal workshops for expectant parents at Montclair State University. Jill continues to be invited to give testimony on maternal health to NJ Senate hearings and to write op/eds for regional media outlets on maternal health, weaving in the critical role of respectful, family-centered maternity care. Prior to MSU, Jill led a Community Doula Program in Hudson County, NJ  and was the Expert Doula for Pregnancy Magazine. She has been part of the United Nations Commission on the Status of Women's Global Prenatal Initiative as well as on local and statewide programs for improving maternity care, dismantling racism and the intersection of early childhood well being through birth. Earlier this year, Jill led webinars for Lamaze International on the first 1,000 days and grassroots advocacy for maternal health. Jill can be found at @JillGW, #SpeakingofBirth or JillWodnick.com 

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