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RESEARCH EXAMINES PATIENT EXPERIENCES BEHIND DISPARITIES IN CAUDA EQUINA
SYNDROME OUTCOMES.

Funded by the Orthopaedic Research and Education Fund and the J Robert Gladden
Orthopaedic Society, our latest study is a mixed methods exploration of the
patient experience factors that underpin disparities in imaging in hopes of
developing a solution.

 

When I was a spine fellow at Washington University in St. Louis, MO, I met a
patient who changed my life. She was an African American woman in her mid-30s
who had visited multiple emergency rooms in the city seeking help with her back
pain. 


By the time she reached our team, she had full-blown cauda equina syndrome
(CES), in which a herniated disc in the lower back compresses a bundle of nerves
at the base of the spine. She had no control of her bowels and bladder, and
though we were able to repair her spine and relieve her pain, the incontinence
was permanent. This might have been avoided if she had gotten an MRI right away,
rather than being bounced from hospital to hospital to get care.

Now, I’m a spine surgeon and researcher at MedStar Washington Hospital Center.
I’m working with the MedStar Center for Health Equity and the National Center
for Human Factors in Health Care on a study funded by the Orthopaedic Research
and Education Fund and the J Robert Gladden Orthopaedic Society to understand
the experience of Black patients with CES.

Our goal is to learn how factors like bias, historical trauma, and social
determinants of health play a role in creating and perpetuating disparities that
result in poorer outcomes for Black patients than their white counterparts.



WHAT IS CAUDA EQUINA SYNDROME?

The cauda equina is a bundle of nerves at the base of the spinal cord in the
lower part of the spine. These nerves communicate to keep the lower limbs and
pelvic organs in contact with the brain. CES is relatively rare and can be
caused by spinal trauma such as a vehicle accident or a fall, or cancer of the
spine. CES causes symptoms such as:





 * Disturbances in sensation in the anus, genitals, or buttocks
 * Pain in the back and/or legs
 * Sexual dysfunction
 * Urinary or fecal incontinence
 * Urinary retention
 * Weakness and paralysis of the legs

When diagnosing CES, providers conduct a physical exam and talk with the patient
about their history and symptoms. An MRI can produce images of the spinal cord
and nerves, and help create a clear picture of the condition.


Emergency surgery is the best treatment for most patients with CES. Spine
surgeons work to reduce pressure on the compressed nerves and allow them to
recover. After surgery, continence and weakness can often be resolved. Left
untreated, CES can result in permanent paralysis or incontinence. 


BLACK PATIENTS HAVE WORSE OUTCOMES.

Our research has shown that Black patients have significantly poorer outcomes
from CES than their white counterparts. To understand why, we analyzed different
sets of published data on outcomes based on factors such as gender, race, and
ethnicity.

We found that Black patients were more likely than others to have higher rates
of complications and a greater likelihood of dying after a diagnosis of CES. New
York State data showed that Black patients had a nearly three-fold greater
chance of dying within 30 days of diagnosis than patients from other backgrounds
and a high risk of being readmitted to the hospital.

It is likely that many of these patients did not get proper imaging to diagnose
CES. Unconscious bias can influence treatment decisions, and social determinants
of health such as access to timely care can exacerbate disparities. 

To make a difference, we are partnering with our colleagues at the MedStar
Center for Health Equity Research to conduct a mixed-methods study and create a
data-driven clinical decision-support tool that flags patients who could have
early CES for proper imaging.


RESEARCH TO HELP REDUCE DISPARITIES THROUGH ACTION.

First, we’re examining MedStar Health’s extensive data set to identify patients
who have been treated for CES. We’ll then interview African American patients to
understand their interaction with the health system, experiences of bias (or
not), and outcomes, revealing opportunities for improvement.


Then, we’ll conduct a Delphi study to gather perspectives from nurses, emergency
room doctors, spine surgeons, and others involved in CES diagnosis and
treatment. Working with this combined information, we’ll develop a tool that
will help eliminate unconscious bias and inform important clinical decisions
like whether to seek imaging.

I’m a clinician first and a researcher second—talking with and examining
patients in the clinic provides enormous scientific value. MedStar Health
Research Institute is at the forefront of advanced research on spinal trauma
that will improve care for all patients.





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WHY THE TINY LP(A) MOLECULE IS BIG NEWS FOR HEART DISEASE.

Doctors have known for decades that a molecule called lipoprotein(a)—lipoprotein
little a or Lp(a)—is closely related to the risk of having a heart attack or
heart valve disease. This molecule runs in families, and people with high Lp(a)
levels have higher rates of cardiovascular events, such as heart attack, aortic
valve surgery, and possibly stroke. 


For years, scientists have sought an effective treatment to lower Lp(a) with the
hope that this would also lower cardiovascular risk. Statins, diet, and exercise
don't reduce Lp(a), and vitamins that modestly reduce Lp(a) don't seem to reduce
risk. Cholesterol-lowering statins and PCSK9 inhibitors reduce heart attack and
stroke risk by lowering LDL. So we work with patients with high Lp(a) to lower
their LDL. 


But all that is about to change. In 2025, researchers will complete LP(a)
HORIZON, a study that may lead to new class of drugs that appears to be very
effective at reducing Lp(a). While data from this study are not yet available,
we’re optimistic that research into this medication will prove that lowering
Lp(a) also lowers the risk of cardiovascular events.


About 1 in 5 people in the U.S. have elevated Lp(a) levels, making it more
common than diabetes. Being able to reduce this type of cholesterol at the
molecular level could put a significant dent in heart disease complications.


Until then, we recommend talking with your doctor about Lp(a) and how it may
influence your personal risk of heart disease. 



HOW HIGH LP(A) LEVELS CAN HARM HEART HEALTH.

Lipoproteins are made in the liver. They carry proteins and fats in the
bloodstream, as well as the low-density lipoprotein (LDL) and high-density
lipoprotein (HDL) cholesterols doctors commonly check when they measure your
cholesterol levels. 


Molecule size matters when it comes to heart risks associated with Lp(a).
Molecule size is determined by your genes, just like familial
hypercholesterolemia (genetic high cholesterol), which can raise your LDL
regardless of your lifestyle choices. 


Larger Lp(a) molecules are usually few in number. People with smaller and more
Lp(a) may be at increased risk of heart disease. Small Lp(a) molecules can cross
the walls of blood vessels more easily, resulting in:





 * LDL buildup in your blood vessels, causing plaques that can break free,
   decrease blood flow, and cause a heart attack or stroke.
 * Increased clotting, which can block blood vessels.
 * More inflammation, which makes it more likely plaques will rupture.
   
   


THE FUTURE OF LP(A) TREATMENT.

In preventive cardiology, we have some effective medications. There are statins,
a class of cholesterol-lowering medications. Aspirin is helpful, but only safe
for some patients. Newer drugs like Repatha and Praluent (both PCSK9 inhibitors)
can reduce your Lp(a) somewhat while lowering cholesterol.


In 2025, we expect completion of the phase 3 Lp(a) HORIZON study, which is
examining whether the medication Pelacarsen can help lower Lp(a) and reduce the
risk of major cardiovascular events like heart attack and stroke. If effective,
the medication will be a very exciting advancement. Similar studies are expected
in 2026 and 2027.

If you have a family history of heart disease, talk with your doctor about Lp(a)
screening. Because Lp(a) is genetic, you only need a simple, one-time blood
test. If your Lp(a) levels are high, you may require treatment for high LDL,
which can decrease your risk of having a heart attack.

The future is promising, and there are treatment options that can help today.
Lp(a) is just one biomarker among more than 400 that can impact your individual
level of risk. While we work together to build a future of personalized
medicine, my colleagues and I at MedStar Washington Hospital Center can work
with you to reduce your risk of heart disease today.





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RESEARCH: SPINE-INSPIRED EXOSUIT COULD HELP RELIEVE LOW BACK PAIN.

As part of our groundbreaking research funded by the National Science
Foundation, we are researching bio-inspired exosuits as a new, innovative
approach to assist movement and stimulate the recovery process for people
suffering from spine problems.

Low back pain is a common and costly condition in the U.S. With funding from the
National Science Foundation Convergence Accelerator award, we’re developing
bio-inspired exosuits that may help millions of people reduce the impact of low
back pain and improve rehabilitation after spine surgery.

Project TANDEM, which stands for Tensegrity-based Assistive aND rehabilitation
Exosuits to Complement Human BioMechanics, is not aiming for restrictive
outerwear like Iron Man’s comic book super suit. Our first device, which we are
developing in the TANDEM project is the Second Spine. It is inspired by the
design of the human spine. 

The device resembles a backpack, with straps that cross over the patient’s
shoulders and around their torso. It provides structural support while allowing
fluid movement to participate in daily activities. Other devices we will develop
in the future will be inspired by different body parts (e.g., shoulders, knees,
etc.)

Almost 65 million people in the U.S. report recent back pain, and about 8% of
all adults experience chronic lower back pain that limits their activities.
Healthcare and other costs due to these conditions amount to more than $12
billion per year in this country and low back pain is the leading cause of lost
productivity.



HELPING WORKERS IN PAIN-PREVALENT INDUSTRIES.

The National Science Foundation’s Convergence Accelerator awarded grants to 15
bio-inspired projects, one of which is TANDEM. We are currently in the first
year-long phase of the project. In August, we will apply to be one of the five
teams selected for the three-year Phase 2.


Phase 1 began with in-depth interviews with patients and providers to understand
which solutions for low back pain could be impactful. We developed the first
prototype of Second Spine, and we are currently testing it on healthy
participants while performing lifting and leaning tasks in the lab. 


During Phase 2, we will include sensors and smart motors and test the prototypes
in real life settings. At the conclusion of Phase 2, we hope to be ready to go
to market with a new device that changes the way we think about back pain. 


We believe our device could greatly help U.S. workers in emergency services,
manufacturing, agriculture, and healthcare—all fields that can result in
significant numbers of workers with lower back pain. 


Our device uses a proven architectural concept called tensegrity to reduce lost
working days due to low back pain, giving patients back time with their
families, freer movement, and faster rehabilitation after back surgery. 



TENSEGRITY: A STRUCTURE INSPIRED BY THE SPINE.

The spine is a remarkable piece of engineering. It comprises rigid vertebrae
separated by flexible discs and supported by supple ligaments and tendons. This
combination of stiff and bendable elements balances the entire body while still
allowing us to bend and twist. 


Engineers and architects were so taken by this design that they developed a
whole new architectural concept called tensegrity (a combination of the words
“tension” and “integrity”). Tensegrity has been used to create structures like
buildings and bridges. Rigid portions of the structure are held and connected by
a series of flexible cables under tension. The stiff portions appear to float
but are in fact very stable. 


With TANDEM, led by colleagues from the University of Alabama, we’re bringing it
back to the spine.


Our device is very light, very strong, and very flexible. Like the spine, it is
composed of rigid sections and flexible elastic elements. This means it can move
harmoniously with the body while reducing muscle activation at the spine,
supporting movement while assisting muscles to relieve pain. Future versions
could incorporate sensors and smart motors for even more impactful assistance. 


Multidisciplinary projects like TANDEM are one way we’re creating solutions to
some of the biggest health challenges in the U.S. Taking our inspiration from
the body itself, we’re opening new frontiers that could improve the quality of
life for millions of people.





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STREP THROAT: WHAT YOU NEED TO KNOW ABOUT SYMPTOMS, DIAGNOSIS, AND TREATMENT.

Sore throat is a common symptom for many different illnesses, from allergies to
viruses and bacterial infections. It's most frequently associated with strep
throat, or more specifically, group A Streptococcus, which is a contagious
bacteria that causes inflammation and pain in the throat. Because it’s a
respiratory illness that can spread through droplets in the air from coughing,
sneezing, or direct contact.


Although strep throat can affect people of all ages, we worry about it more in
children, who are more susceptible to complications if it’s left untreated.
That’s why it’s important to understand the signs and when to get tested for
strep throat. 






WHAT ARE THE SIGNS OF STREP THROAT?

A sore throat is the most common symptom of strep throat, but other signs may
include:





 * Fever
 * Pain when swallowing
 * White patches in the back of the throat
 * Swollen tonsils and glands

It’s also not uncommon for children to experience gastrointestinal issues as the
first sign of strep throat. Symptoms such as vomiting, diarrhea, and stomach
pain may indicate the contagious disease.


If you or your child are having difficulty swallowing or are drooling because
it’s too painful to swallow, it’s important to seek care and get tested. Because
strep throat is highly contagious, knowing whether or not you have it can help
you take caution to limit the spread of it to others at school, daycare, or
work.


HOW IS STREP THROAT DIAGNOSED?

To determine what kind of illness is causing your sore throat, a healthcare
provider will conduct a physical exam and ask about your symptoms. Depending on
your symptoms, your provider may recommend several different tests to determine
if you have strep throat, or another illness, such as RSV, COVID-19, or the flu.






THROAT CULTURE VS. PCR TESTING FOR STREP THROAT.

Traditional strep throat tests involve an antigen test called a throat culture,
which looks for a specific protein in the bacteria. However, the protein is only
discoverable when it’s found in high numbers, from about day two of your
symptoms through day five. In addition, you have to wait approximately three to
four days for results. Because there’s a narrow window for detecting the
illness, it’s about 80 percent accurate at diagnosing strep throat. This can
lead to missed diagnoses and an increased risk of spread and/or complications in
kids, such as rheumatic fever. 


In contrast, polymerase chain reaction (PCR) tests look for the DNA of the virus
with high sensitivity, making the test about 97% to 99% accurate. It amplifies
the number of bacteria present in your throat sample and therefore can detect
even the smallest amount of bacteria. As a result, PCR testing for strep throat
is considered the gold standard and more reliable than throat cultures. 


NEWER TECHNOLOGY ALLOWS US TO PROVIDE RAPID PCR TESTING FOR STREP THROAT.

At MedStar Health Urgent Care, we offer same-day, rapid PCR testing for strep
throat, which allows us to leverage the accuracy of PCR tests within a quick
time frame. Here, rapid strep test results are available within 12 to 18
minutes, which ensures you or your child receive prompt treatment and know
whether or not the child can go back to school.


Rapid results also ensure we’re only prescribing antibiotics for those with
confirmed group A strep. Studies show that about 37% of children who have come
in to test for sore throat actually have strep throat, but treatment is offered
for nearly 60%. In other words, sometimes providers are often treating patients
before it’s confirmed they have group A strep. By using rapid PCR strep tests,
we minimize the use of antibiotics for those who don’t actually need it. 


STREP THROAT IS TREATED WITH ANTIBIOTICS.

If you or your child are diagnosed with strep throat, you’ll need antibiotics to
treat it. While the length of time varies based on the specific antibiotic your
provider prescribes, antibiotics need to be taken for approximately ten days, on
average. It’s important to take the entire course of antibiotics to relieve
painful symptoms, shorten the illness duration, and prevent recurrence lor
future complications. In addition to antibiotics, home remedies may help to ease
symptoms, such as rest and hydration.






RAPID PCR TESTS AT MEDSTAR HEALTH URGENT CARE OFFER FASTER, MORE ACCURATE
RESULTS.

If you have strep throat symptoms or other signs of illness, our providers at
MedStar Health Urgent Care will use rapid PCR tests to determine the cause of
your symptoms. In addition to a throat swab to detect strep throat, you may
undergo a single, shallow nasal swab to also test for COVID-19, flu, and RSV. As
a result, you’ll know the root cause of your symptoms in less than 30 minutes,
without needing to send out a culture to the lab. By dramatically reducing the
wait time for your test results, we can minimize the amount of time you or your
child are missing work or school and also decrease the use of unnecessary
antibiotics and therefore any related antibiotic side effects. 


We’re here for you seven days a week, offering a full spectrum of timely
testing, treatment, and services to help you get the care you need, the moment
you need it.





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FIBROIDS ARE NOT CERVICAL CANCER: LEARN WHY AND HOW TO REDUCE YOUR CANCER RISK.

Beauty influencer Jessica Pettway died in 2024 at age 36 from cervical cancer—a
highly preventable and treatable disease when caught early. Pettway said she had
been misdiagnosed as having uterine fibroids, a very common condition among
women in their 30s and 40s. Fibroids affect up to 70% of white women and 80% of
Black women.


Since Pettway’s tragic death, patients have been calling with concerns that
their fibroids might be associated with cervical cancer. 


Advanced cervical cancer and fibroids share some symptoms, such as pain in the
pelvis and frequent urination. Advanced cervical cancer can also cause abnormal
bleeding or discharge from the vagina. Typically, cervical cancer is detected at
early stage because of early detection tool such as pap smear and HPV tests.


Without knowing the specifics of her case, it is difficult to understand how
Pettway’s misdiagnosis might have happened. Research shows people from
historically minoritized backgrounds are misdiagnosed more often, and face
healthcare challenges, including access, mistrust, and bias that could have
impacted her care.


Let me be clear: There is no connection between cancer of the cervix and
fibroids, which are benign growths in the uterus. Cervical cancer is one of the
few cancers we can prevent, with regular screenings and the HPV vaccine.



FIBROIDS ARE NOT CANCER.

Uterine fibroids, or uterine leiomyomas, are muscular tumors that grow in the
uterus, and most do not cause symptoms. Sometimes, they can cause heavy bleeding
or painful periods, pain and pressure in the pelvis, frequent urination, or pain
during sexual intercourse. 


Women with fibroids have a higher rate of cesarean section, and in rare cases,
the growths can lead to reproductive problems like infertility.


Fibroids are not cancer, and having fibroids does not increase your risk of
getting cancer. Cancerous fibroids, called leiomyosarcoma, are very rare and
aren’t caused by existing fibroids.


Most people with fibroids take a “wait and see” approach to monitoring with
their doctor. At MedStar Health’s National Center for Advanced Pelvic Surgery,
fibroids that cause severe symptoms can be treated with:





 * Medications: While medications that affect the hormones can regulate the
   menstrual cycle and shrink fibroids, they do not eliminate the growths.
 * Uterine fibroid embolization: This procedure involves injecting microscopic
   particles into specific blood vessels to cut off blood flow to the fibroids,
   shrinking them over time.
 * Laser removal: Endometrial ablation uses a laser to destroy the fibroids.
 * Surgery: In a myomectomy procedure, a surgeon removes the fibroids from the
   uterus. In severe cases, a hysterectomy to remove the uterus is considered.

If you have heavy bleeding during your period or pain and pressure in your
pelvis, talk with your doctor about fibroids.


Related reading: Think a Hysterectomy is the Only Solution for Fibroids? Think
Again.


CERVICAL CANCER IS PREVENTABLE.

Cervical cancer begins in the cervix, which connects the vagina to the uterus.
Most patients are over 30, and it is almost always caused by human papilloma
virus (HPV). Each year, about 11,500 new cases are diagnosed, and about 4,000
women die of the disease.

Cervical cancer can be prevented with regular screening tests (pap smear and HPV
tests) and the HPV vaccine. HPV is a sexually transmitted virus, and while half
of sexually active people will have it at some point, few will develop cancer.

Other factors that increase your risk of cervical cancer include:

 * Chlamydia
 * Exposure to the hormonal drug diethylstilbestrol (DES) given between 1938 and
   1971 to prevent miscarriage
 * HPV infection
 * Long-term use of birth control pills
 * Restricted access to healthcare and nutritious food
 * Smoking
 * Three or more full-term pregnancies or a first full-term pregnancy before age
   20.
 * Weakened immune system (due to HIV infection, for example)

Early-stage cervical cancer is one of the most treatable cancers. Treatment for
cervical cancer depends on how advanced it is and your age, health, and
preferences. MedStar Washington Hospital Center provides advanced treatment such
as minimally invasive and robotic-assisted surgery, radiation, and chemotherapy.
Our teams of experts work with you to choose the most effective options. 


Related reading: 4 Things to Know About Cervical Cancer and HPV.


PREVENT CERVICAL CANCER WITH SCREENING AND VACCINE.

The best way to make sure you don’t have cervical cancer in the first place is
to work with your doctor to make sure you’re getting regular screenings, and the
HPV vaccine. When it is detected and treated early, most patients have excellent
outcomes.

That’s why the United States Preventative Services Taskforce guidelines
recommend all women get a Pap test beginning at age 21:

 * The HPV test looks for HPV, the virus that causes the cells of your cervix to
   become cancerous. 
 * The Pap test (sometimes called Pap smear) looks for cells that could become
   cervical cancer if not treated. 

Both tests can be conducted in the doctor’s office or a clinic, and both are
very effective at preventing advanced cervical cancer. After age 30, your doctor
will talk with you about whether you should get an HPV test only, the HPV test
and Pap test together, or just a Pap test.


The HPV vaccine is safe and effective. Since it was first introduced in 2006,
infections that cause HPV cancers and genital warts have dropped 88% in teen
girls and 81% in young women. 


If you are vaccinated before exposure, typically in elementary or middle school,
the HPV vaccine is 97% effective in preventing cervical cancer. It is typically
given in two doses, six to 12 months apart. Teens and young adults who get the
vaccine later in life may need a third dose. If you are 27-45 and have not
received the HPV vaccine, talk with your doctor about whether it is appropriate
for you. 


Screenings and vaccines can significantly reduce your risk of cervical cancer,
but only if you use them. By keeping your gynecologic health appointments and
receiving the vaccine, you can do a lot to help yourself stay cancer-free.  



ARE YOU HAVING HEAVY PERIODS OR PELVIC PAIN?


OUR EXPERTS CAN HELP. CLICK BELOW TO LEARN MORE.

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NEW MOTHER-BABY INTENSIVE OUTPATIENT PROGRAM SUPPORTS MENTAL HEALTH IN PREGNANCY
AND BEYOND.

MedStar Health Research Institute’s work with the D.C. Safe Babies Safe Moms
Program informs the new Mother-Baby Intensive Outpatient Program, which provides
wraparound, holistic, intensive mental health services to help birthing people
thrive.

 

Pregnancy and the year after childbirth can be a time of overflowing joy, but
for some, it is a period of stress, loneliness, and even despair. Pregnancy and
the postpartum period can be a perfect storm of challenges related to
experiencing changes in identity, biology, relationships, sleep, and hormones
all while caring for a new baby. Together, these experiences increase the risk
of developing a perinatal mood or anxiety disorder (PMAD), such as:

 * Anxiety
 * Depression
 * Obsessive-compulsive disorder
 * Post-traumatic stress disorder
 * Postpartum psychosis

In fact, perinatal mental health conditions are the most common complication of
pregnancy, with 1 in 5 women experiencing symptoms in the year after giving
birth. Studies have shown Black mothers have a higher risk of perinatal
depression and more severe PMADs compared to white mothers, while Hispanic
mothers have a greater risk of postpartum depression. Tragically, maternal
suicide and overdose are the leading cause of death for women in the year after
pregnancy

EditSign
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These deaths are preventable, and while most patients are screened for mental
health conditions after childbirth, about 75% of women who experience perinatal
mental health disorders do not get the help they need.  

The MedStar Health Mother-Baby Intensive Outpatient Program (IOP) is taking
action to help more mothers live long, healthy lives with their children. It
starts by embracing an innovative model of care that places mothers and their
babies at the center of everything we do.


SCREENING IS ESSENTIAL, BUT IT’S JUST THE START.

In the last decade, obstetric care has embraced screening initiatives as
essential to helping pregnant and postpartum individuals stay healthy. We now
know that a mother’s mental health is just as crucial to the safe delivery of
her baby as her blood pressure. 

Important guidance from the American College of Obstetricians and Gynecologists
(ACOG) in recent years underlines the importance of screening, education,
referral, and treatment. It is recommended that women be screened at multiple
points during their pregnancy to learn if they have symptoms of a perinatal
mental health condition. Education, referral resources, and follow-up must
accompany screening.

Perinatal mental health conditions are treatable. An individualized combination
of self-care, peer support, psychotherapy, and, in some cases, medication can
help mothers recover and their families thrive.  

Yet, there are too few specialists in perinatal mental health and even fewer who
participate with Medicaid and commercial insurance, and intensive treatment
options are limited. Inpatient psychiatric treatment and traditional day
hospital care require the birthing patient to be separated from their baby,
meaning some patients can’t or won’t choose these treatments.

High-quality treatment requires clinicians experienced in perinatal mental
health and reproductive psychiatry to help patients recover during this critical
life transition. 


A NEW MODEL OF PERINATAL MENTAL HEALTH CARE.

The Mother-Baby IOP is designed to provide a higher level of care to mothers and
pregnant people in crisis. Our team of experts provides treatment and guidance
as new mothers build the coping skills they need to feel better and to develop
competence, confidence, and independence as caregivers. 

The Mother-Baby IOP multidisciplinary team includes experts who specialize in
helping birthing people, including:

 * Perinatal Mental Health Clinicians (psychologists, clinical social workers,
   and therapists)
 * Reproductive Psychiatrists 
 * Infant Mental Health Clinicians
 * Care Coordinators
 * Postpartum Doulas
 * Physical Therapists
 * Arts & Expressive Therapists
 * Mothers Helpers Volunteers

We encourage new mothers to bring their babies to treatment for three and a half
hours per day, three days a week. Supportive, holistic care includes:

 * A diagnostic psychiatric assessment
 * Treatment with individual and group therapies, psychiatry, and perinatal
   health and wellness services to help build coping skills, regulate emotions,
   bond with the baby, and practice self-care
 * Mother-baby relationship support and parenting skills to promote healthy
   attachment and child development
 * Perinatal and infant health and wellness classes on topics like
   breastfeeding, nutrition, sleep, preparation and recovery from childbirth,
   and more.
 * Care coordination to access health care and community resources

This super-sized support is available to adults who are pregnant or within one
year after giving birth who are having new or worsened mental health symptoms.
With a commitment and focus on increasing access to care, MedStar Health has
ensured that D.C. Medicaid and many private insurance plans are accepted.


For too many women in our communities, socioeconomic challenges present barriers
to getting the care they need. The Mother-Baby IOP addresses equity issues by
building on the vital work of MedStar Health’s D.C. Safe Babies Safe Moms
Program (SBSM).

Related reading: Chatbot Connects New Moms with Timely Infant and Maternal Care.


ADDRESSING EQUITY WITH CARE COORDINATION AND MORE.

MedStar Health’s SBSM collaborates with the hospital system and community
organizations like Community of Hope and Mamatoto Village to address disparities
in maternal and infant care. 

Research shows that social determinants of health, such as access to healthcare,
education, healthy food, transportation, and a clean environment, can impact 80%
of health outcomes. Yet, they occur outside the hospital and beyond patients’
control. So, the best way to screen for mental health conditions and provide
treatment is by integrating these into settings where people are already getting
care. 

A critical part of our work to integrate mental health in more pediatric and
obstetric settings is to combat stigma by normalizing these important
conversations. Sometimes, asking for help can be seen as a sign of weakness,
especially in communities with generational mistrust of the healthcare system.
Patients can also minimize or dismiss mental health symptoms that should be
treated.

The Mother Baby IOP prioritizes conversations about mental health early during
pregnancy. I often remind patients that how they’re feeling and coping are just
as important as their blood pressure and the baby’s growth. That’s why we ask
about patients’ psychological, social, and physical health during the same
prenatal visit.

For four years, SBSM has been screening low-income mothers of color before,
during, and after childbirth and throughout their child’s first three years of
life. We’ve incorporated many lessons learned into the Mother-Baby IOP; making
expanding mental health treatment options, supporting community resources, and
coordinating care cornerstones of the program. 

Care coordination offers scaffolded support to help patients follow through with
recommended treatment services. When a pregnant or postpartum patient needs
mental health care, the coordinator will schedule an appointment with the
Mother-Baby IOP. Before that appointment, the coordinator will reach out to ask
important support-focused questions such as:

 * Do you need childcare or transportation?
 * Do you need a virtual (telehealth) visit instead?
 * Is your housing situation secure?
 * Do you need a connection to an assistance program like WIC?

In this way, care coordination helps new mothers address their safety and
security needs so they can get the mental health care they need. If our program
is unsuitable for them, our care coordinators will help patients connect with a
better-fit program. 






NEXT STEPS: MEASURING IMPACT AND MAKING CHANGES.

This is an exciting time to work in the perinatal mental health field. There are
many challenges, but incredible momentum exists, locally and nationally, toward
making impactful changes for mothers and families in need. 

When the Mother-Baby IOP opened in April, our team was ready to begin evaluating
the feasibility, acceptability, and impact of each program’s elements. With
collaboration from patients and providers, we’ll continue revising and expanding
our offerings to suit their needs. We hope to be able to offer a virtual version
of this IOP program, a track for Spanish speakers, and additional support for
co-existing perinatal substance use disorders in the future. 

The Mother-Baby IOP is the first-ever intensive psychiatric treatment program
for birthing people and their babies in the DC Metro region. This program is
poised to make an impact, thanks to support from MedStar Health leadership,
clinical leaders in Psychiatry and Obstetrics at MGUH, and the tireless support,
advocacy, and donations from mothers and families in our community determined to
prioritize the health and wellbeing of mothers so they, in turn, can build
loving, stable, and healthy families in our community.  

What affects mothers in our communities affects us all. Healthy mothers play a
central role in the health and social wellbeing of the next generation. MedStar
Health’s Mother-Baby IOP will be a critical resource to help birthing people
access treatment and support when they and their families need it most,
strengthening our community in ways that will benefit everyone.





ARE YOU EXPERIENCING DIFFICULTY WITH PREGNANCY OR NEW PARENTING?


CONTACT US TO LEARN MORE ABOUT THIS PROGRAM.

CALL 202-944-5400

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