Lab of Sheree Boulet, DrPH, MPH

Racial disparities in maternal health in Georgia are stark and in need of systematic review, analysis, and intervention. This study combines a statewide assessment of racial disparities in adverse maternal health outcomes with an evaluation of Georgia’s Medicaid Inter-pregnancy Care Program and a randomized trial of a comprehensive postpartum care system in an urban safety-net hospital. By studying the complex array of individual, health care system, community, and societal level factors that culminate in women’s lack of access, this study will fill critical gaps in knowledge regarding policy and health system approaches for reducing disparities in maternal morbidity and mortality.

Black women in Georgia bear a disproportionate burden of the U.S. maternal health crisis with alarmingly high maternal morbidity and mortality rates. Very few studies have investigated the multifaceted ways that structural racism drives disparities in maternal morbidity and mortality for this population. This mixed-methods and multi-level study leverages population-level vital records and administrative data as well as physician and patient perspectives to document novel, potentially modifiable, structural associations elucidating the relationship between structural racial discrimination and severe maternal morbidity among Black women in GA that can inform future systems-level interventions.

The accumulation of stress and trauma exposure across the life course may drive poor perinatal outcomes for pregnant persons of color or socioeconomic disadvantage.  While empirical data supports this relationship for infant outcomes, evidence on the relationship between stress and maternal health is lacking. The goal of this project is to estimate effects of stress and trauma exposure across the life course on maternal cardiometabolic health during pregnancy, testing mediating pathways by prevalent posttraumatic stress symptoms or preconception adiposity.

Hypertensive complications are a leading cause of hospital readmission during the postpartum period, suggesting a critical need for strategies that target women after they have been discharged from the hospital. To address this critical gap, we worked collaboratively with Emory’s Department of Biomedical Informatics and Morehouse School of Medicine to design and test a mobile health system (Moyo Mom) for postpartum persons to monitor and report their blood pressure values at home using a Smartphone application. In addition to serving as an “early alert” system for identifying and reporting signs of hypertensive complications, Moyo Mom also captures data on self-reported stress, depression, and social needs that can be used to characterize the behavioral and psychosocial profiles of women affected by perinatal complications.