Flourish Care works to reduce maternal mortality rates

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After struggling with postpartum depression in the wake of the birth of her first child, Flourish Care founder Melissa Bowely realized she needed support that went beyond her doctors at the hospital.

"I struggled as a new mom and had little guidance on how to take care of myself, my postpartum body and new baby," she told Rhode Island Inno. "I soon realized other families were struggling too, whether it was with sleep deprivation, postpartum depression and anxiety, breastfeeding challenges or recovering from birth. I was shocked by the statistics surrounding maternity care and outcomes in the US. Many people may not be aware, but we have some of the highest maternal mortality and morbidity rates in the world."

Postpartum depression occurs in about 15% of women, with symptoms ranging from general anxiety to thoughts of suicide.

Bowely started the Flourish Fund in August of 2022 to offer community-based support to expecting mothers. The organization began as a baby registry focused on wellness for mom and baby that enabled parents-to-be to register for vetted support services, such as doulas, breastfeeding support and newborn care.

At the time, Bowley tapped into a new program in Rhode Island that offered doula reimbursement as a new insurance benefit, which allowed the organization to grow and serve more families by partnering with health plans and health systems. 

Now, Flourish Care empowers families with wellness programs and insurance-reimbursed community care, including doulas, from pregnancy to parenthood. Families can still register for support not covered by insurance on the Flourish Care baby registry for free. 

Bowley said she was inspired by research that shows additions to a patient’s care team, including doulas, can lead to less painful births, fewer c-sections, lower NICU rates and higher patient satisfaction. 

This month, the National Center for Health Statistics released CDC data about maternal mortality which indicates the rate of maternal mortality has quadrupled since 1987.

"The statistics are alarming. Maternal mortality rates increased 40% in 2021, and the increase affects Black mothers the most," Bowley said. "So, we’re going backwards, and the unfortunate part is that these deaths can largely be prevented."

Bowley said lawmakers are now realizing the importance of community-based care in improving maternal health outcomes, as shown in the increase of state Medicaid doula reimbursement programs. According to the Georgetown University Center for Children and Families, at least 17 states are in various stages of consideration, planning, or implementation of doula reimbursements. 

"Our mission of Flourish Care is to fill the gap in maternal healthcare and to make sure that wellness is accessible to all families from pregnancy to one year postpartum," she said.

“Our company has always existed to improve maternal health outcomes. Lawmakers are finally realizing the importance of community-based care in improving maternal health outcomes, as shown in the increase of state Medicaid doula reimbursement programs. According to the Georgetown University Center for Children and Families, at least 17 states are in various stages of consideration, planning, or implementation of doula reimbursements. The movement is finally gaining steam. We’re determined at Flourish Care to help pregnant people access the community-based care they so desperately need."

Less than a year ago, Flourish Care, in partnership with Integra Community Care Network, announced a pilot program to improve health outcomes and equity for pregnant patients and parents-to-be at the Obstetrics and Gynecology Care Center (OGCC) at Women & Infants Hospital. Bowley said the goal of the wellness program is to improve maternal and infant health outcomes such as c-section rates, breastfeeding rates, preterm birth rates, NICU and emergency department utilization, mental health, patient satisfaction, and self-efficacy.

"We work with our healthcare partners to extend care beyond the clinic and into the community through wellness programs which improve maternal health equity and clinical outcomes for their members," she said. "For example, we have partnered with Care New England to connect eligible families to a range of resources, including community-based doulas, online education, and a wellness essentials care package to support them during pregnancy, birth and early parenthood. It is truly an innovative care model where every eligible pregnant patient has a provider at the clinic (their OB-Gyn or midwife) and a provider from their local community (a doula) dedicated to their health and wellbeing."

Bowley said data from the clinical study will be published soon about the impact the program has had on outcomes and maternal health disparities.  

"Thanks to the success of this program, we have had many health plans, hospitals and health systems interested in offering our solution to their members and we look forward to reaching many more families through these partnerships. Additionally, we are now in-network with United Healthcare RI, Blue Cross Blue Shield RI, Neighborhood Health, Humana and more," she said. 

Flourish Care is working with more than 50 community-based providers in Rhode Island and runs a mixed team of eight contractors and employees. 

"We hope to double our team by the end of March focused on technology development, provider outreach and healthcare partnerships," Bowley said.