Maternal health awareness: Indiana physicians work to improve outcomes for mothers and babies

January 23 is Maternal Health Awareness Day, an opportunity to acknowledge the importance of supporting mothers before, during and after pregnancy. Maternal health does not just affect one person — it shapes the well-being of families, communities and future generations. At the Indiana University School of Medicine and Riley Children’s Health, physicians and care teams work every day to improve outcomes for mothers and newborns across Indiana, recognizing that social factors affecting access to high-quality care can limit a woman's ability to manage conditions that increase maternal risk, such as high blood pressure or diabetes.

Mortality rate

According to the Centers for Disease Control and Prevention (CDC), more than 80% of pregnancy-related deaths are preventable. A death is considered preventable if there is at least some chance it could have been avoided, with changes to patient, family, provider, facility, system and/or social factors. As reported by the CDC in 2023, Black women in the U.S. face much higher maternal mortality, with 50.3 deaths per 100,000 live births versus 14.5 per 100,000 for white women. In Indiana, Black women have a mortality rate of about 156.3 per 100,000 live births, versus the rate of about 90.7 per 100,000 for white women (as-of 2021).

A physician’s perspective

Patrick Clements, MD, is an assistant professor of clinical pediatrics at the IU School of Medicine, and serves as the medical director for well-newborn care at Riley Hospital for Children; the well-newborn care team provides care to babies and mothers together, in the Riley Maternity Tower. Clements was awarded the Chanice Wallace Award for Advocacy and Equity in 2024, and in December 2025, became the interim division chief for the pediatric hospitalist group, a team that cares for babies, children and teenagers at five Indiana University Health hospitals. Below, he shares his perspective on the challenges and opportunities in maternal health and what gives him hope for the future. 

Question: What are some warning signs new mothers and families should be aware of after delivery, and when should they reach out for help?

Clements: As the baby doctor, we must trust our obstetric providers to talk about specific warning signs, such as signs of severely high blood pressure or postpartum bleeding. One thing that is important for us as pediatricians to discuss along with the OB team would be perinatal mood disorders. These include postpartum depression, anxiety, or what is sometimes called the “baby blues.”

I always talk with families about intense feelings of sadness or hopelessness or a disconnect from the things that used to give them a lot of support; those are always warning signs. Anxiety is also quite common. Thinking about scary invasive thoughts, things that are constantly racing through the mind that are preventing you from being able to sleep at night or function during the day. Also, thoughts of harm towards yourself, someone else or towards the baby are signs that we would want to get mom or dad immediately referred to care.

Q: Maternal health disparities continue to affect some populations more severely than others. What steps are being taken by your team to address these inequities?

Clements: In the hospital setting, we have a lot of different quality and outcome measures we track, which helps us make sure we are delivering on our promise to provide great care to all we serve. These measures include looking at how often a mom can have a vaginal delivery compared to needing a C-section, the rate of families who breastfeed, and looking at the patient experience in the hospital. It is important for us to always make sure that we collect demographic information on each of these rates because we want to make sure that every intervention we do is raising the boat for all patients equally. We want to make sure our data is telling us that we are doing the job we think we are doing.

Disparities moms in Indiana face are certainly related to access to healthcare, which affects populations differently across the state. We know that about 27% of moms in Indiana do not receive early prenatal care, care in the first trimester, which is an area of opportunity to make improvements. Currently, the number one cause of deaths in moms within one year after delivering her baby is overdose. Some disparities in terms of access to care relate to where you live, or what your financial or socioeconomic status is. When we look at Indiana we also see racial disparities exist in our outcome measures. For instance, our rate of infant mortality, the number of babies that die before their first birthday, is much higher for our Black families as compared to our non-Hispanic white families. Similarly, we also see disparities in terms of exclusive breastfeeding rates being lower for our Black moms and babies than for our non-Hispanic white families. Here at Riley we have specific programs that help to provide wrap-around services to families to help support them throughout pregnancy, childbirth and the time after they go home with baby. Ultimately, tackling health disparities means collaborating with communities. For those from marginalized communities, success also means building trust through sometimes difficult conversations.

One program that we are enrolled in is called Communities and Hospitals Advancing Maternity Practices (CHAMPS), a three-year quality improvement program which we are over halfway through. The project is funded through the Centers for Disease Control, and it looks at ways to improve breastfeeding rates while reducing disparities. Our work in this program is focused on making sure that our unit is offering the best practices around breastfeeding. While we always want to respect a family's choice when it comes to how they want to feed their baby, we also want make sure that in the hospital we are not making things more difficult for families to start breastfeeding or continue breastfeeding successfully. We standardize our practices to offer early skin-to-skin care after birth for babies, because we know doing this helps promote better latching. We know that babies that do great breastfeeding right after birth are more likely to breastfeed successfully the rest of the time in the hospital. When babies breastfeed well in the hospital, they are more likely to breastfeed successfully after they leave the hospital. What we do in the hospital is incredibly important.

Another area we are working on is the promotion of exclusive rooming-in for families. We try not to take the baby from the room unless medically needed, because we know that babies do better when they are in the same room with parents. Breastfeeding goes a lot better when the baby is in there, and the family learns to follow the hunger cues the baby is showing them.

Q: What is one message you would like readers to take away from Maternal Health Awareness Day?

Clements: For any of us who are taking care of children, we know the health and well-being of that child is directly tied to the health and well-being of their parents. It is a package deal – and everything we do to advocate for parents will only improve the well-being of their children. That is why here at Riley and in the Riley Maternity Tower, we take a whole-family approach to care.

Q: What resources does your team provide for families, and why is it important for care teams to support both mothers and their babies together?

Clements: We do a lot of projects looking at mom's health and well-being in general at the maternity tower. We know that when we are taking care of the mothers or taking care of the child's parents, the outcome of the parents well-being is directly tied to the baby's overall health. Some of the things that we do related to maternal health awareness include:

• Promoting our doula program as an amazing resource. Doulas are specific navigators and advocates for families for both pregnancy and childbirth. Our doula program enrolls families towards the end of their pregnancy, and then the doula program also follows families in the immediate postpartum period not only at the hospital but also checking in with them after they go home. The program does a lot of interventions about not only things like birth planning, but also when families are in the hospital, doulas focus on labor coaching, advocating for the best practices for whatever mom prefers for things like pain control. They also are lactation experts and can work with moms after birth, along with the lactation consultant teams. They can also check in with moms after going home to make sure they are not concerned about high blood pressure or difficulties with bleeding or mental health or just any other kind of resources they might need.
• Partnering with Indiana University Health in a program called WeCare, that pairs families with a community health model, like a health coach. WeCare can enroll families during pregnancy or enroll moms and babies, and at the time of delivery as well. Our WeCare health coaches can check in with families by phone or in person. WeCare coaches have a lot of experience in breastfeeding, in understanding resources for things like perinatal substance use, postpartum anxiety and depression, and it also can really just help to pair families with resources in the community should they have challenges with housing or food insecurity. Our coaches can just be an extra advocate and a trusted person in the family's circle that they can reach out to in the first full year after baby is born.

Steps toward equal maternal health in Indiana

As Clements shares, maternal health is a community effort — one that depends on awareness, compassion and collaboration. By supporting mothers during every stage of pregnancy and beyond, a stronger foundation is built for families and children across Indiana. During Maternal Health Awareness Day, we encourage everyone to learn more, check in with new parents, and advocate for accessible, equitable care for all.