Respect and Relationship Building Program Provides Better Outcomes for Mothers

August 18, 2025

This year, HAP released an action plan for Pennsylvania hospitals and policymakers to improve maternal health quality, equity, and access. Ahead of our inaugural maternal health summit, we’re spotlighting promising practices and innovations that Pennsylvania hospitals have implemented to improve care for moms and babies.

Healthy outcomes for mothers, particularly in rural settings, are often a matter of collaboration, according to Rebecca Couch, RN, inpatient nursing operations manager of labor and delivery for Geisinger Lewistown Hospital. With that in mind, Geisinger Medical Center and Geisinger Lewistown Hospital launched a program aimed at improving maternal care in their communities by strengthening relationships with midwives and other community-based birth workers.

The hospitals serve patients in rural counties, including some counties designated as maternal health deserts that have plain sect populations. Acknowledging that serving these populations often requires special considerations, hospital leaders worked to improve maternal and neonatal outcomes from home birth—including among patients transferred to the hospital—by forging trust and improving dialogue among hospitals, home-birth workers, and plain communities.

“We were seeing a disconnect between community birth workers and inpatient opportunities,” said Couch. “There were cases where we were not seeing some patients until a devastating point in the pregnancy and we wanted to bridge that gap.”

Here are some key takeaways:

A Basis for Better Care:  Creating an open dialogue with caregivers allows everyone to learn about each other and determine how best to help the patient, whether that involves visiting the hospital or not, according to Couch.

Program Fundamentals:  The program involves training for home-birth workers about obstetric emergencies, creating feedback loops, implementing education to bridge cultural divides, hosting monthly workgroup meetings, and establishing workflows to refer home-birth patients to Geisinger for prenatal imaging. The team is expanding this process throughout the Geisinger system, where appropriate.

Yielding Results:  Hospital leaders have received positive feedback about the program since its inception about five years ago. Often mothers are returning for care after delivering, said Couch.

Quotable:  “It’s important for some mothers to deliver at home,” Couch said. “If that is their wish, we support their choices and traditions safely by giving them the birth experience that they envision. We offer options and resources to make that happen.”

HAP’s Maternal Health Summit, September 24 in Harrisburg, will bring together health care leaders and community partners to share current strategies, programs, and innovations driving maternal health improvement within their organizations and communities. Learn more and register online.