CARE2 Quality Improvement Project Designed to Improve Maternal and Infant Health

Care2 is a quality improvement project (QIP) designed to improve maternal and infant health during the interconception period. Care2 builds on the quality improvement science established by the IMPLICIT Network¹, and is modified to meet the priorities and treatment needs of Ohio families.

The Ohio Infant Mortality Annual Report reveals Ohio’s infant mortality rate is significantly higher than the national average. In 2020, the infant mortality rate in Ohio was 13.6 deaths/1,000 live births for Black infants and 6.7 deaths/1,000 live births for all races,² in comparison to the same year infant mortality rate in the United States of 5.4 deaths/1,000 live births for all races.³ Data as far back as 2009 show no significant change in the infant mortality rate for Black infants in Ohio.

Risk factors among 2020 infant deaths in Ohio revealed:

• 1/3 of infants born less than 24 weeks gestation were conceived less than 18 months after a prior birth;
• 20% of mothers smoked during their first trimester of pregnancy; and
• 38% of infants who died and were born before 24 weeks gestation were born to mothers who did not have first-trimester prenatal care.²
• Among women with Medicaid, 28% and 38% reported prepregnancy depression and anxiety, respectively.⁴

The effect of these high-risk health behaviors on future pregnancies and limited access to care urges the need to provide medical care for women of childbearing age during the interconception period.

Care2 focuses on the following areas:

• Depression and Anxiety
• Tobacco Use and Vaping
• Family Planning and Multivitamin/Folic Acid Use
• Infant safe Sleep

Clinical Experts Include:

• Dr. Kate Tobin: Assistant Professor, Clinical, Department of Medicine, The Ohio State University (OSU) College of Medicine; Associate Director of Clinical Informatics, OSU Division of General Internal Medicine; Clinical Informatics Lead, OSU Maternal-Infant Dyad Primary Care Practice. Dr. Tobin is a clinical informaticist and combined Internal Medicine and Pediatrics primary care physician with a passion for population health and improving maternal perinatal and postpartum care and infant health. She specializes in helping pregnant women with complicated pregnancies, pre-existing conditions, and postpartum health issues in the primary care setting concurrent with pediatric care for their babies.
• Dr. Amythest Gauthier: Assistant Professor, Department of Family and Community Medicine The Ohio State University, Wexner Medical Center. Dr. Gauthier specializes in general primary care and focuses on preventive medicine, mom and baby care, and managing chronic conditions.
• Dr. Monique Katsuki: Obstetrician/Gynecologist, Cleveland Clinic Women’s Health Institute. Dr Katsuki is an OB/Gyn Hospitalist at the Cleveland Clinic and works with the Institute's Center for Infant & Maternal Health, where she works on programming and research to improve equity in maternal and infant outcomes and experiences with healthcare.