OLO report: Black mothers, infants in Montgomery County face worse outcomes; committee asks HHS for 60‑day action plan
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Summary
The Office of Legislative Oversight presented evidence that Black mothers and infants in Montgomery County experience higher rates of severe maternal morbidity, preterm birth, low birth weight and infant mortality; the HHS Committee asked the Department of Health and Human Services to deliver a written action plan within 60 days with timelines, budgets and metrics.
The Montgomery County Office of Legislative Oversight presented a report on racial disparities in maternal and infant health to the Health and Human Services Committee on Feb. 20, finding Black mothers and infants in the county face consistently worse outcomes across multiple measures.
Natalia Carrizosa of OLO summarized national and local evidence, saying the United States "has the highest maternal mortality rate of any high income country in the world," and that Black and Indigenous mothers and babies experience the most adverse outcomes. OLO identified three drivers of racial disparities: the historical legacy of racist pseudoscience, contemporary medical racism (including biased treatment and care barriers), and structural determinants of health.
Chitra (OLO) presented county data showing Black women in Montgomery County experience higher rates of severe maternal morbidity, cesarean delivery, preterm birth, low birth weight and fetal/infant mortality than White women. OLO also reviewed three county maternal and infant programs: the Montgomery Perinatal Program (MPP), Babies Born Healthy (BBH) and SMILE. MPP serves about 1,600 clients annually, BBH served roughly 185 in FY24 and SMILE served about 254; OLO and HHS both noted that BBH and SMILE are small relative to county need and often have waiting lists.
During the HHS update, Dr. Nina Ashford and Dr. Kisha Davis described program adjustments, a move toward a standardized evidence‑based home‑visiting curriculum (MEHOW) and efforts to improve triage and data collection. Dr. Ashford cautioned that HHS had not yet undertaken outreach to doula companies because it lacks funding to pay doulas for clients: "We have not made any outreach to doula companies because we don't have any money to pay for doulas for our clients," she said.
Committee members pressed for concrete actions, funding and transparency. Council members discussed strategies with the department and OLO authors including standardizing home‑visiting models, expanding community‑based doulas and racially concordant midwifery care, implementing maternal safety bundles in hospitals and publishing maternal health metrics by facility. Council members also noted regulatory and financial barriers to establishing freestanding birthing centers in Maryland.
Chair Laurie Ann Sales formally requested that DHHS deliver a written action plan addressing the OLO report’s findings and recommendations within 60 days. The chair asked for specific, actionable steps with timelines, detailed budget estimates, implementation plans and measurable progress metrics rather than summaries of existing programs.
HHS and OLO emphasized that addressing maternal disparities will require multisector, sustained action that includes better data collection, targeted funding for programs that serve Black birthing people and partnerships with community birth‑worker organizations.
Next steps: DHHS to submit the requested 60‑day action plan to the committee and to follow up on requested documentation and program adjustments; committee members signaled support for funding and policy options to improve outcomes if resources are identified.
