JB-LF Research Initiative

A continuation of our series highlighting the issues affecting the low-income moms gaining access to quality health care.

Arlington County has a wealth of resources, but data shows the percentage of women in the county who start receiving prenatal care in the first trimester of pregnancy has consistently fallen below the state average. In the county, only around 61% of women initiated prenatal care during the first trimester in 2018, whereas Virginia’s state average was around 78-79%. Many moms can’t access the kind of care they want – and deserve – for themselves and their babies. Through conducting research and funding innovative programs that increase access to care, the Jennifer Bush-Lawson Foundation aims to change Arlington County’s statistics.

The low-income women the foundation serves most often experience obstacles to care, including being underinsured, transportation issues, lack of willing healthcare providers, language barriers, childcare needs, and the consequences of missed work. These factors and more have led mothers to seek care outside of the county or start care well into their second trimester. Organized research can help us learn about our community, and to learn about the journeys many mothers embark on when preparing to have a baby. Conducting research can also inform long-term change, where we can care for prenatal and postnatal patients at a higher capacity to support overall health, while reducing the risk of complications that affect both mother and baby.

In 2022, the Jennifer Bush-Lawson Foundation began a multi-phase project that fully reviews the state of maternal health for low-income women in Arlington to help give insight into where additional needs exist throughout the county. This first phase includes a survey of this community to inform next steps and recommendation development. The challenge is uncovering why low-income, uninsured women in the county aren’t being served early in pregnancy, and what is keeping these women from initiating care in the first trimester.

There is an opportunity here: to better serve our low-income moms and increase access to health care. These goals can become a reality through our innovative programs and detailed research. JB-LF has successfully and consistently troubleshooted gaps in women’s health care in the Arlington County hospitals and clinics, as well as raised funds to introduce solution-based programs. In wanting to see better statistics for Arlington women initiating first trimester care, JB-LF is giving low-income pregnant women renewed hope by increasing access to much needed health care support. Our 2022 research has goals of sparking systemic change, and through the collection of feedback and data, we hope to accomplish just that.

Maternal Mental Health

Maternal mental health illnesses are the #1 complication of pregnancy and childbirth. Up to 1 in 5 women display symptoms of perinatal mood or anxiety disorders. In high-risk populations, the rate increases up to 1 in 3 women. Studies show that 75% of the women who experience symptoms go untreated. This increases the need for better access to and utilization of screening tools vital to the health of pregnant and new mothers. It’s also important to know what to look for and the signs of perinatal mood and anxiety disorders.

What to look for
Sometimes referred to as the baby blues, postpartum depression occurs after childbirth. However, recent research has expanded the time frame to include pregnancy in the development of symptoms. Women might experience symptoms of feeling sad, lonely, tired, and/or stressed. There also might be changes in energy, sleep, and appetite.

Although up to 1 in 3 moms are affected – vast racial inequities exist for treatment. There is a disproportionate number of Black and Latinx women who suffer from these conditions who do not receive adequate services. Importantly, white women are nearly twice as likely to receive mental health treatment. Low-income populations already have a higher chance of being exposed to toxic stress, like poverty, racism, trauma, food and housing insecurity, thus compounding the need for better treatment options.

The racial disparities in screening and treating maternal mental health illnesses have only increased since the beginning of the COVID-19 pandemic. The pandemic has, without a doubt, contributed to the stress, anxiety, and depression many pregnant women and new mothers experience. Maternal stress during pregnancy and the perinatal period can have lasting effects on child neurobehavioral development and health.

Expectant and new mothers are facing the uncertainty of today’s world on top of the already vulnerable transition into having a newborn. We envision a future when all states will have mandates requiring screening for perinatal/postpartum depression. Maternal mental health illnesses are preventable, treatable, and temporary conditions and no woman should have to face this road alone.

4 Questions with Bruce Bush

This post is part of a series where we pose questions on issues related to maternal and infant care for vulnerable populations to health professionals, community advocates, mothers, JBLF volunteers and other important voices. 

Bruce Bush is Jenn’s dad and is on the Board of Directors. He’s also an amazing supporter of the Foundation all year round.

1.If you could tell us one thing, what would it be?

To love one another…..thanks to all who knew Jennifer and continue to be genuine friends.   

2. What is your favorite memory of Jenn?

A life well lived. Jennifer’s favorite saying —- DIFFERENT – YET THE SAME. She was very successful in everything she did.

A phrase from one of her work associate’s letter, upon her passing, sums up what many individuals thought about her…..”she left a positive mark on dozens of people with whom she had only passing interactions….she was the kind of person whose kindness in small doses meant a lot, for many.”

3. What has been your best JB-LF moment?

The first 5k Race and Family Day. A beautiful tribute from Neal and the news media plus the Arlington community. Cooper won the first race in his age group.

4.  What are people surprised to find out about you?

That I was a professional musician…….played the drums in combos and large dance bands. 

Patient Profile: Sami

This post is part of a series where we highlight the lives of the moms we serve. Specifically we want to bring a face to the complex issues we have begun addressing in this blog – such as care in the first trimester.

All stories are compilations from conversations with actual patients and additional research. To protect identities, we have used stock photos.
By Lindsey Hill, Intern

Medicaid benefits end 2 months after delivery – leaving new mothers without health insurance during a very risky postpartum period. Meet Sami, a young African American mother, who began experiencing extreme fatigue and swelling of her ankles towards the end of her pregnancy. These symptoms can be very normal toward the end and were quickly forgotten after the uneventful delivery of her baby.

Yet a few months later, Sami went to the hospital multiple times for extreme shortness of breath. The doctors she saw mistakenly attributed the cause as her history of asthma and sent her home. In addition, Sami missed a postpartum doctor visit due to lack of transportation. It wasn’t until a third hospital visit that she was diagnosed with heart failure (postpartum cardiomyopathy). Cardiomyopathy is a form of heart failure that can be fatal and is the leading cause of maternal deaths during the period from 1 week to 1 year after delivery. With her diagnosis, Sami needed frequent medical visits, had a weakened heart muscle, and a prolonged recovery.

This heart failure is difficult to detect because its symptoms can mimic those of a third trimester pregnancy, such as Sami’s fatigue and swollen ankles. Sami’s diagnosis could have been prevented if she had been educated about postpartum health risks, if her hospital providers had asked if she recently gave birth, or attending her postpartum visit. These would have likely resulted in an earlier cardiology consultation, and with more personalized care, the risk to Sami’s health would have been minimized. 

Many pregnancy-related health complications, and even death, come from those who lose coverage or access to care after giving birth. This lack of access only magnifies the issues new mothers face – highlighting the importance of extending Medicaid coverage. Heart disease accounts for 1 in 4 maternal deaths and black women have a higher risk of heart-related maternal deaths. Developing nations like Southern Asia have achieved overall reduction in maternal mortality rates, yet the United States is the only developed country where the maternal mortality rate has been increasing since 1987.

2 out of every 5 U.S. births are through Medicaid and these poor outcomes many women and infants face could be addressed through expansion of Medicaid policy to extend the coverage period. State-led and federal initiatives can improve access to care and the quality of services pregnant women covered under Medicaid receive.

Even though she was left without health insurance after her Medicaid benefits ended, Sami was fortunate to catch her postpartum heart failure when she did. Sami and her baby are doing well today.

Expanding Access to Care

November 2021

A continuation of our series highlighting the issues affecting the low-income moms gaining access to quality health care.

By Lindsey Hill, Intern

Medicaid provides health coverage to 1 in 5 Americans, with many low-income pregnant women relying on the program to aid with delivery expenses. Expectant mothers can qualify for coverage in a couple ways – as a previous recipient of Medicaid services, meeting qualifications at the beginning of pregnancy, or through emergency coverage from delivery up to eight weeks postpartum. Due to life circumstances, many of the women we serve don’t qualify until emergency coverage sets in at delivery.  

For all moms using Medicaid, the ability to access postpartum care used to last for only 60 days postpartum – far to short to benefit the health of mom and baby. However, progress is being made. In 2020, the United States House of Representatives passed legislation allowing states to extend Medicaid coverage for new mothers from 60 days up to a full year postpartum. Why is this extension of Medicaid coverage for new mothers so important?

Extending Medicaid coverage will provide insurance for women at a medically vulnerable time in their lives while they are pregnant and after giving birth. Low-income women are disproportionately likely to face life-threatening conditions between 8 weeks and 1 year following their deliveries. This postpartum year is critical for women and extending Medicaid coverage could mean the difference between life and death for many new mothers.

This expansion is significant for low-income women by increasing their access to pre- and post- partum care. Virginia Governor, Ralph Northam, has expanded the Commonwealth’s Medicaid program, giving hundreds of thousands of Virginians access to medical care and the opportunity to lead healthier lives. Extending coverage for low-income pregnant women and new mothers will ensure continuous health coverage during some of the most important times of their lives. The previous coverage of 60-days postpartum was simply not enough because continuous health coverage is crucial for keeping women healthy during and after pregnancy. With these new opportunities for expectant and new mothers, we should hope to see an increase in access to quality maternal health care coverage. 

4 Questions with Elizabeth Ingram

This post is part of a series where we pose questions on issues related to maternal and infant care for vulnerable populations to health professionals, community advocates, mothers, JBLF volunteers and other important voices. 

Elizabeth Ingram is on the Board of Directors and serves as the race director for our annual 5K and Family Fun Day. She’s also an amazing volunteer outside of the 5K.

1.    What do you see as JB-LF’s biggest accomplishment to date?  

The impact of The Telemedicine Program is a huge bright spot for the Foundation. The fact that women can receive care without leaving work or home is so important. In addition, the fact that the Mom’s served by this program saw such a huge reduction in NICU admissions, 61%, and 25% reduction in C-sections is amazing.

2.    Has anything surprised you?

The continued support of this amazing community leaves me in awe each year….7 years later and it feels like the first time. People of all ages and walks of lives support the work of the Foundation through donations of time and money.  I love that for the past few years a young girl has asked friends and family to donate to The JB-LF as their birthday gifts to her.

3.    What is your favorite part of our 5K?

The people!  I love seeing the smiling faces so eager to run what may be the hilliest 5k course in Arlington. I love seeing friends and neighbors come out for the event year after year. I can’t wait for this year’s race!

4.    What are people surprised to find out about you?

I guess people would be surprised to know that I have run 5 marathons and 7 Ragnar relays.  My racing days are behind me, but I love to cheer other runner especially at the JB-LF 5k.

Patient Profile: Cora

This post is part of a series where we highlight the lives of the moms we serve. Specifically we want to bring a face to the complex issues we have begun addressing in this blog – such as Medicare.

All stories are compilations from conversations with actual patients and additional research. To protect identities, we have used stock photos.

By Lindsey Hill, Intern

In a previous profile, we described how the Jennifer Bush-Lawson Foundation helped an Arlington mom named Julie. Here is a story of how JB-LF and its contributors provided assistance to another mom during her pregnancy. After delivering her firstborn, Cora had a life-threatening blood clot – putting her in high risk during subsequent pregnancies. So when Cora became pregnant with her second child she was not only concerned for her baby, Cora was also anxious about her own health and being on medications to prevent blood clots.

With this high risk pregnancy, Cora needed regular check-ins with her physician to monitor her condition and the medications she would be on. On top of it all, going to routine doctor appointments seemed virtually impossible under the threat of firing due to missing work. How could Cora choose between her health and making money to support her family’s needs for basic food and shelter? Cora’s situation was further complicated by a lack of health insurance.

The telemedicine initiative funded by JBLF made it possible for Cora to consult with her physician from work. Now, she would not have to sacrifice her health or her job because JB-LF’s program could offer Cora weekly telemedicine visits. Cora could step into a closet at her job and connect with her doctors using her phone. This allowed Cora to have her questions and concerns answered on the spot.

With the help of the Jennifer Bush-Lawson Foundation and its contributors, Cora was able to stay in contact with her health care providers while continuing to provide for her family. JBLF’s telemedicine pilot program was revolutionary for Cora’s pregnancy. Thanks to the program, JB-LF, and all who contribute to the foundation, Cora and her baby are doing well today. 

Medicaid for Low-Income Moms

September 2021

A continuation of our series highlighting the issues affecting the low-income moms gaining access to quality health care.

By Lindsey Hill, Intern

Access to affordable health care is a basic human need yet in the United States, the future of a vital safety net remains uncertain. A report from 2018 revealed that 1 in 10 Arlington adults are living without health insurance. Given how affluent the Arlington community is, it’s a concerning statistic that 11% of Arlington residents do not have insurance. Thankfully there is a safety net for the uninsured – Medicaid. Medicaid covers essential health benefits, including pregnancy, maternity, pediatric care, chronic disease management, breastfeeding support, contraception, mental health and other behavioral health services.

Medicaid is a joint federal and state program that currently provides health coverage to 1 in 5 Americans, including children, pregnant women, parents, seniors, and individuals with disabilities. Medicaid is the single largest source of health coverage in the United States, with Virginia Medicaid offering low-cost and no-cost health coverage programs for citizens and legal immigrants based on financial status. 

Close to 50% of all U.S. births are covered by Medicaid, along with a large number of maternal, infant, and child health visits. Serving millions of U.S. pregnant women living in poverty, Medicaid expansion has increased access to coverage and services associated with improving the lives of mothers and infants. 

While there are multiple coverage options in the state of Virginia for children and pregnant women, more can be done for these frequent users of needed medical services. Medicaid expansion can and will continue to help low-income populations, specifically helping mothers in need to ensure healthy pregnancies and births. The Governor of Virginia, Ralph Northam, has prioritized Medicaid expansion and in our next Medicaid blog, we will detail how this expansion can have a positive impact for the moms and babies we serve.

Patient Profile: Julie

This post is part of a series where we highlight the lives of the moms we serve. Specifically we want to bring a face to the complex issues we have begun addressing in this blog – such as care in the first trimester.

All stories are compilations from conversations with actual patients and additional research. To protect identities, we have used stock photos.
By Lindsey Hill, Intern

We have talked about the importance of first trimester care and today will highlight the amazing story of an Arlington mom, Julie, whose complicated third pregnancy was made easier through the help of JB-LF and those who contribute to the foundation.

Julie was pregnant with her third child – an exciting addition to the family. In previous pregnancies, she had been diagnosed with gestational diabetes, which is a condition where blood sugar levels become high during pregnancy and requires daily blood sugar monitoring. Gestational diabetes affects up to 10% of women who are pregnant in the U.S. each year. Julie also suffered from chronic hypertension (high blood pressure) prior to pregnancy – a condition that increases the risks for heart attack, stroke, heart failure, or kidney disease.

Julie obviously had her own health concerns, but knew that a healthy outcome was possible with monitoring. That feeling changed during an appointment in her first trimester when doctors discovered Julie’s pregnancy would add on to her already serious health issues. In addition, doctors detected that Julie’s baby had a serious anatomical defect, which was treatable, but would require her baby to be in intensive care for a long period after the delivery. This news was devastating to Julie, who on top of her own health challenges became fixated on what to do for her baby.

Needing a lot of support for both herself and her baby, Julie was at a loss for what to do. She would have almost weekly appointments, need follow-up ultrasounds and tests, and ways to monitor blood pressure and blood sugar. As if this all wasn’t hard enough, the situation was made harder by Julie having no health insurance, no paid time off from work, no car, and no reliable child care for her other children. How was Julie going to make this all work?

Enter the Jennifer Bush-Lawson Foundation and it’s partners, who alongside its contributors, could help Julie in her pregnancy.

Through JBLF’s grant to help fund a telemedicine pilot program, the Virginia Hospital Center clinic could offer Julie telemedicine appointments where Julie’s doctors could connect with her to check blood sugar and blood pressure readings, as well as discuss changes to Julie’s diet, exercise, and medications. We also provided Julie with a home blood pressure monitor and transportation vouchers to get to and from doctors visits. In preparation for her newborn baby’s arrival home, we gave Julie a pack-n-play.

Today, Julie and her baby are alive and well, thanks to all who contribute to the Jennifer Bush-Lawson Foundation. Julie’s story is one of the many that illustrates the importance of early intervention.

4 Questions with Jennifer Myers

This post is part of a series where we pose questions on issues related to maternal and infant care for vulnerable populations to health professionals, community advocates, mothers, JBLF volunteers and other important voices. 

Jennifer Myers served as the Jennifer Bush-Lawson Foundation Executive Director from 2017 to 2020 and now serves as Treasurer of the Board of Directors.

1. You were JBLF Executive Director for 3 years, what are you proudest of?

It was really exciting to start expanding JBLF’s work. Our relationship with Virginia Hospital Center to support low-income moms and babies in Arlington has been extremely special and impactful, but so much need still remains in our county and region. I was glad to have the board’s support to explore other ways that JBLF could work in our community to lift up our most vulnerable members. While I was executive director, we launched a Prize for Prenatal Innovation, we held our first thought-leader event at Duke University’s DC offices, and we began making plans for research projects that have the potential to lead to better solutions. It was a groundbreaking time to be at the helm of JBLF and I can’t wait to see where our work goes under our current executive director. 

2. What JBLF program has surprised you the most

Our thought-leader event exploring innovative solutions to solve the maternal mortality crisis blew me away. The panelists spoke before a packed, engaged audience that included participants from the Arlington County board, DC government, nonprofits, foundations, businesses and more. When you launch a new program, in some ways it’s always a leap of faith. Seeing the interest by so many in such varied fields, all wanting to help moms in need, made it clear that JBLF was on the right path. 

3. What are you most excited about for 2021?

I can’t wait to have a normal 5K again in November! It’s hard to match the community love that I sense each and every year at that event. It’s wonderful to see so many faces coming back, and I’m always excited about the new people who join us after hearing about our mission. 

4. What are people surprised to find out about you?

I’m not a runner! The annual 5K is one of JBLF’s largest fundraisers and it’s an event I love, so I think most people assumed when I was the executive director that I was an avid runner. Thanks to two back surgeries, running is not in the mix for me (you can catch me at the pool swimming laps, though!). But JBLF’s mission and the community spirit at the 5K pulled me in.