Step Up Together initiative supports rural maternal care
Guest Blogger: Amy Romano, Founder and CEO of Primary Maternity Care
Maternal morbidity and mortality rates in the United States are significantly higher in rural areas, where socioeconomic challenges and health disparities create barriers to quality care.1 Access to consistent maternity care, reproductive services, postpartum support and paid leave are among the challenges that individuals in rural areas face. UnitedHealthcare has taken steps to address these challenges by supporting Primary Maternity Care’s (PMC) Step Up Together Initiative, launched in 2023, to improve maternal and birth outcomes in rural communities.
Primary Maternity Care and the Step Up Together initiative
PMC is a service design and consulting firm focused on improving maternity care by working with health systems and key stakeholders.2 Its Step Up Together program fosters collaboration between community-based perinatal care providers and hospitals, creating a safer and more coordinated birthing process.
The Step Up Together program focuses on enhancing the skills and collaboration of community providers and hospitals by developing standardized transfer guidelines, conducting Full Transfer Drills for obstetric emergencies, and fostering interdisciplinary teamwork. These transfer drills, combined with policies and protocols for managing obstetric emergencies, aim to improve the efficiency and effectiveness of care. The Step Up Together program provides comprehensive support, including seven 1-hour sessions, group coaching, hands-on training and relevant resources to ensure perinatal providers are prepared for emergency situations.
Impact of the Step Up Together initiative
The program had strong participation in 2024, with 11 birth center/hospital dyads enrolling from across the country. Of these, seven completed their first Full Transfer Drills, successfully simulating emergency transfers from community birth settings to hospitals. This initiative has sparked widespread interest, with 172 providers registered for the upcoming Focused Action Cycle, a targeted drill program for obstetric emergencies starting in October 2024.
The drills are an important tool for addressing obstetric emergencies, which contribute to maternal morbidity and mortality. By equipping perinatal providers, both in and outside of hospital settings, with the skills and confidence to manage emergencies collaboratively, the program aims to significantly improve outcomes for new parents and newborns.
"Step Up Together is more than just a program, it’s a movement to transform maternal care. It empowers diverse clinicians and stakeholders with collaborative tools and a supportive community without incurring the cost to develop it from scratch every time. We are honored to have support from UnitedHealthcare for such a meaningful and impactful initiative," commented Amy Romano, founder of Step Up Together.
Health plans across the U.S. have a unique opportunity to advance maternal and perinatal care by partnering with initiatives such as Step Up Together. By providing network providers with the tools, training and resources needed to improve safety and outcomes, these collaborations can make a significant impact on the well-being of childbearing individuals and newborns. Through work with Step Up Together, UnitedHealthcare is actively working to improve maternal health outcomes, reduce disparities and ensure that every pregnancy is supported by skilled and confident clinical care providers.
UnitedHealthcare and PMC each additionally collaborate with American College of Obstetricians and Gynecologists which recently released their Community Birth Transfer Resource Kit. This kit offers best practices to facilitate smooth and timely transfers between community birth settings and hospitals. By supporting rural and critical access hospitals, UnitedHealthcare is helping to strengthen emergency obstetric care and foster collaboration between clinical and community partners to ensure better outcomes for childbearing individuals and newborns across the country.
