Off to a Strong Start

Date: March 1, 2014

From left, La’Yon Porter, patient navigator Catalina Humphrey, Whitney Porter and case manager Sherry Jones.

Whitney Porter has expressive brown eyes, chin-length curls tied back with a sparkly ribbon and a smile that lights up her face. A bright pink sweatshirt stretches across a belly ballooned by 38 weeks of pregnancy. The 25-year-old glows with health and hope during a December Gyn/Ob appointment at the Bayview Medical Offices. She has a place to live, her 7-year-old son is enrolled in first grade and day care is lined up for her baby. 

“I am so grateful,” she says. “There’s nothing that I or my child need right now.”

Things were very different in September, when Porter arrived at Johns Hopkins Bayview Medical Center for her first Gyn/Ob appointment. A native of Chicago, she moved to Baltimore in 2012 for a sales job with IDT Energy. She rented a basement room from a friend, but she was left homeless after the friend was evicted. And she was having trouble enrolling her son, La’Yon, who has Down syndrome, in a Baltimore school.

The solution to all these problems, says Porter, was participation in the Strong Start for Mothers and Newborns Initiative, a program launched at Johns Hopkins in August 2013 to ensure that pregnant women at risk of preterm births and pregnancy complications have access to the resources they need.

Strong Start is available to women enrolled in Priority Partners, the managed care organization of Johns Hopkins HealthCare that provides free or low-cost health care to low-income or qualified Maryland residents. 

When Porter arrived at the Gyn/Ob department for her first prenatal appointment, Catalina Humphrey, the Strong Start patient advocate at Johns Hopkins Bayview, quickly enrolled her in Priority Partners. Then Humphrey made phone calls to get the birth certificate and immunization records that Porter needed to enroll La’Yon in school, scheduled an appointment for him at the Kennedy Krieger Institute, and arranged Porter’s transportation to and from doctor’s appointments.

One of 27 Strong Start grant recipients, Johns Hopkins Medicine received $2 million from the Centers for Medicare and Medicaid Services for the four-year program made possible by the Affordable Care Act. So far, about 300 women have enrolled at the Johns Hopkins Bayview location, the East Baltimore Medical Center and the Johns Hopkins Outpatient Center, says Shari Lawson, the medical director for Strong Start at Johns Hopkins. “The goal of our award is to coordinate and create efficiency of care for these women at risk,” she says.

Pregnant women in Strong Start get attention from a case manager, patient advocate, social worker and, if needed, a nutritionist and a diabetes educator, who meet regularly to discuss and manage patient care.

One of the main goals of Strong Start is to reduce the risk of preterm births, which are linked to long-term negative health consequences, by ensuring weekly doses of the hormone progesterone, which can help pregnant women carry to term.

According to the March of Dimes, about 12 percent of babies nationwide are born before 37 weeks, but Lawson says the preterm birth rate in Baltimore may be as high as 16 percent. Risk factors include a previous preterm birth, homelessness, partner violence, obesity, smoking, a short cervix, high blood pressure, being younger than 17 or older than 35 and being African-American.

Whitney Porter says she likes that Humphrey is honest with her and pushes her to succeed. “I’ve learned as long as you have one person in your corner, you can make it,” she says. “That’s what the team here at Bayview did for me.”

Postscript: Porter delivered Londyn, a 7-pound, 2-ounce girl, on Dec. 30.

 —Karen Nitkin