Delivering Excellence in Georgetown County: Tidelands Health’s Approach to Maternal Health
With nearly 500 deliveries a year and one of the lowest rates of severe maternal morbidity in the state – currently about 50% less than the national average – Georgetown County is doing something right in maternal health.
The CDC defines severe maternal morbidity (SMM) as “unexpected outcomes of labor and delivery that can result in significant short- or long-term health consequences.” These consequences can result in higher healthcare costs and longer hospital stays, and for some women, a lifetime of difficulty. The CDC has identified 21 indicators that when also present during delivery, are evidence of SMM. To identify SC’s prevalence of SMM, SCHA and SC Revenue and Fiscal Affairs Office identified aggregate claims data by county for women with deliveries whose claims also included at least one of the CDC indicators in 2023 and 2024. While it was notably a short time frame, we saw significant differences between counties and started to analyze the differences, such as the presence of birthing hospitals, number of Ob-Gyns, number of primary care providers, and presence of community programs, that may be impacting SMM across the state.
Georgetown County’s rate of SMM per 10,000 deliveries was 43, with the rate across the state going as high as 333 and averaging 88. Nationally, the rate of SMM per 10,000 deliveries was 93 in 2022. It’s great that – as a state – we’re doing better than the nation. The data are also indicative that we have some work to do! One of the things we can do is highlight factors that potentially lead to lower SMM.
To learn more, we spent some time talking with maternal health movers and shakers at Tidelands Health, the primary hospital system in Georgetown County. Their leadership team has made improving maternal health a priority for quite some time, and they have worked with their team members and community partners to enact evidence-based best practices. They were the first hospital system in SC to obtain Advanced Certification in Perinatal Care from the Joint Commission, for which they must demonstrate, among other things, integrated and coordinated patient-centered prenatal through postpartum care. We also learned that they are very good at identifying women at high risk for complications and wrapping services around them to better prepare for a safe delivery, including a lifestyle evaluation, Ob care coordination, transportation, and education in multiple languages and formats. They have developed a close partnership with their Regional Perinatal Center at MUSC in Charleston and avidly participate in the SC Birth Outcomes Initiative and SC DHHS’ Quality Achievement Program. Their midwives run a Centering Pregnancy model, which provides group prenatal care in four outpatient locations, and they provide 24/7 hospital coverage in partnership with physicians. And Tidelands Community Care Network, an AccessHealth SC affiliate, has been building solid connections with primary and specialty care and providing a slew of care coordination, navigation, and case management services for vulnerable people in Georgetown County for years. In relation to SMM, this network ensures care for women even before they become pregnant, which allows conditions such as high blood pressure and diabetes to be identified and controlled prior to pregnancy. This program alone has tremendous outcomes around health and utilization of healthcare services.
Tidelands Health does a lot to improve health in Georgetown County, focusing many initiatives on maternal health. While we don’t know which efforts have the most impact on their rates of SMM, their combination of hard work, community partnerships, and leadership have undeniably made a difference. If you would like any additional information, please contact Melanie Matney.