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A​ccording to the Oregon Center for Health Statistics, there are about 40,000 births annually. The journey into parenthood is one of life’s most transformative experiences, and it begins well before delivery day. Perinatal health services cover the critical period before, during, and after birth. From prenatal care and education to postpartum support, Oregon’s Community Health Centers provide perinatal services to ensure families have access to compassionate, comprehensive care at every step of the journey, and for the rest of their lives.

Today, OPCA is illustrating Oregon health centers’ role in supporting maternal and infant health, and how our team is partnering with the Oregon Perinatal Collaborative to support FQHCs delivering care to this population.

Resources, tools, and upcoming learning opportunities mentioned in this blog are available in the CHC Toolbox section.

Conversation about Perinatal Services

To understand the importance of perinatal health, Silke Akerson, Executive Director of the Oregon Perinatal Collaborative, shared:

“[T]he reason that maternal and infant health are so important in primary care is that maternal and infant health are the center and the foundation of community health overall. When people receive the care that they need during pregnancy, birth and postpartum, and when infants receive the care and support that they need, that sets people and the community up for lifelong health. And when people don’t receive the care that they need in pregnancy, birth, and postpartum, that can set up problems intergenerationally for the whole life cycle.”

Silke Akerson, MPH, CPM, LDM, Executive Director, Oregon Perinatal Collaborative

About 13 Oregon FQHCs offer direct perinatal care through their providers, and 85% of these health centers deliver care throughout the full pregnancy. For a fuller picture of how Oregon FQHCs support expectant parents, I sat down with care teams from Multnomah County Community Health Centers and One Community Health.

Connie Serra, MD
Medical Director

Esther Mondragon, RN
Perinatal Manager

Response from Esther Mondragon, RN, Perinatal Manager, One Community Health

“I think everybody at the clinic has some sort of role in our OB care. Within our team, I work closely with three perinatal community health workers and the OB providers. The Community Health Workers let people know where they can get care, and if they want to get care with us. Then we start with maternity case management. So, that intake appointment is a needs assessment, where we go over housing, work, social support, mental health, and a lot of areas. [For] Oregon patients [who] have Oregon Medicaid, that [assessment] has to be done by a licensed provider. Whether that be a provider, a resident, or the nurse, so that would be me. If patients don’t have Medicaid, then we connect them with a Patient Care Advocate to sign them up for Medicaid. And then we do the internal referrals, like I said, for dental or behavioral health, and then the external referrals for, [Women Infant Care] and other community resources. From there, we start scheduling provider appointments. Our team is very much embedded into the OB care done here, so that patients can be seen, and be as well prepared as possible.”

Response from Connie Serra, MD, Medical Director, One Community Health

“We [providers] all have prenatal care blocks in our schedule to make sure we’re getting our pregnant patients in. Our Community Health Worker Team also helps get all of the labs ordered. By the time I see them in my exam room, all the blood work, urine cultures, and everything else are done, or they are scheduled to get done. And the community health workers schedule the appointments appropriately based on what the patient’s needs are. I have been working with my perinatal health care team for 23 years at One Community Health, and I can never do OB without them.”

Multnomah-County-Community-Health-Centers-logo

Charlene Maxwell, FNP DNP
Dep. Medical Director

Toni Kempner, BSN, MSN, RN, ACRN
Director of Nursing

Full scope preconception, perinatal and postpartum care for clinical low risk pregnancies. We use a team based care model of prenatal care that includes nursing, providers, behvioral health provider access, community health workers, dental referral and a prenatal case manager. Client engagement is tracked and outreach is done near delivery to ensure our clients return to care. 

  • Our nurses provide contraception care, prenatal intake including review of prior history and identifying any high risk conditions that may impact pregnancy to facilitate early identification and referral to a higher level of care. Nurses also track each prenatal client using a report in the EHR, and conducts outreach for those who have missed appointments are who have missed a part of the standard prenatal care journey.
  • Family practice providers provide prenatal care, transitions to delivery practices typically occur at the beginning of the third trimester. Our providers also provide postpartum care.
  • A prenatal case manager who tracks the prenatal population in our system and helps us to review any trends. This role also monitors a discharge report of new deliveries and newborns and conducts outreach to schedule postpartum and newborn visits.
  • Behavioral health providers are available to support pregnant individuals through any mental or behavioral health challenges, and are also available in the early days of parenting.
  • Community Health workers are also available to connect clients to community resources or coordinate transportation or address housing and food insecurity.
  • MAT providers are available to provide wrap-around services to support successful engagement in SUD/MOUD modalities for healthy birth options and recovery strategies for the birthing parent.
  • Our prenatal care coordinators which are our LPN’s truly embrace the concept of developing a relationship and delivering a culturally relevant approach in the prenatal nurse intake, that captures a broad stroke of who the birthing parent is, what are their birthing desires, what resources they are requesting and making the appropriate referrals including in house dental, WIC, Healthy Birth Initiative, Doula support, educational materials and community resources including partnering with our CCO’s (Care Oregon, Trillium) to ensure that they have access to SDOH needs.

Two years ago our health center started Prenatal Optimization Project. The goals were addressing access barriers, clinical workflows, team-based care, and population health. This involved deep analysis to pinpoint issues like late access, follow-up gaps, and low adoption of new guidelines. Strategies included robust nursing intake for earlier access, led by a licensed practical nursing team that utilizes a standing order to identify high-risk factors and follow up. The new role of nursing in the prenatal care model necessitated training for nurses on Epic tools such as the OB navigator, building a prenatal smartset, and documentation template guide risk identification and management. A prenatal and postpartum tracking program was developed using RWB, and Compass Rose.

So far, this optimization project has already improved visibility into prenatal care trends, increased access, and enhanced care coordination for high-risk clients. This process started with a PDSA project at East County spearheaded by an amazing LPN, Melissa Carino, who loves to work with pregnant birthing clients, who worked with the leadership team at East to standardize standing orders and workflows to provide a nurse intake visits to increase access for our prenatal clients and support a warm handoff to our OB/primary care providers for their OB care.

This was incredibly successful both for the nursing staff (increased joy in the workplace),  while increasing patient satisfaction, improving communication between the birthing parent and the provider which subsequently contributed to enhanced patient care and seamless care coordination, and increased patient retention (including newborns returning to the clinic). This process was ultimately spread throughout the seven primary care clinics using the prenatal optimization project with ongoing project support, guidance and support with efforts to provide an ongoing community of practice for the Prenatal Care Coordinators (LPN’s) across the system.

This will provide an infrastructure to refine, refresh, and allow for case discussions, update workflows, and share best practices amongst the prenatal providers, prenatal care coordinators, and teams.

In light of the media discussing L&D’s closing around the country, our efforts to support our prenatal community is clearly a shining example of how innovation can make a difference.

There is a common thread through all my conversations with One Community Health, Multnomah County Community Health Centers, and the Oregon Perinatal Collaborative: At the heart of perinatal care is trust.

For expectant parents and their families, finding a place to receive care is a deeply personal decision. Cultural values and lived experiences shape their decision, as well as whether they are confident that the health care provider will listen to their concerns. Federally Qualified Health Centers are well-positioned to deliver care to families because they reside in the communities they serve. Through compassionate, team-based care that honors the whole person, health centers build and cultivate trust.

Both One Community Health and Multnomah County Community Health Centers shared stories that reflect an eye for quality improvement, ensuring their patients received the best possible care. Because of their dedication to quality of care, their patients return time and time again, along with their children and loved ones. In addition to improving health outcomes during pregnancy and postpartum, health centers strengthen lifelong connections with the communities they serve.

Before ending our conversation, Silke Akerson expressed her excitement about working together with OPCA and FQHCs:

“[T]he Oregon Perinatal Collaborative started in this hospital-based, hospital-centered work, and at the time that made sense as a starting point because the peak of the iceberg issues that we needed to work on were at the time of birth in the hospital. But as we learn more from the Maternal Mortality and Morbidity Review Committee, so much of the prevention that can happen really needs to happen during prenatal care. And that’s with primary care providers, and that’s with Federally Qualified Health Centers. [Also] the majority of the maternal deaths that we have in Oregon and in the country happen in the postpartum period. And again, the people who are really touching on those lives in contact with those folks are primary care providers. “

Silke Akerson, MPH, CPM, LDM, Executive Director, Oregon Perinatal Collaborative

Federally Qualified Health Centers (FQHCs) are highly respected primary care providers. In addition to providing perinatal services, health centers enhance access to whole-person care. This access, in turn, promotes better health outcomes, which impact numerous aspects of the patient’s life. By establishing connections with individuals, their families, and the broader community, health centers deliver care to Oregonians throughout their lives.

Attend the Perinatal Health Summit

OPCA is hosting a Perinatal Health Summit on February 20, 2026, at the World Forestry Center in Portland, Oregon.

Whether your health center provides comprehensive prenatal care, primarily supports people during the postpartum period, or falls somewhere in between, this event is designed for you!

The Summit will explore Oregon’s maternal health landscape and offer practical, actionable strategies for improving outcomes across the perinatal continuum.

If your clinic serves people of reproductive age in any capacity, this Summit will offer tools, partners, and ideas to strengthen care and improve maternal health outcomes.

Questions? Contact Joanna Peterson at jpeterson@orpca.org.

CHC Toolbox

Maternity Case Management | OAR 410-130-0595

The primary purpose of the Maternity Case Management (MCM) program is to optimize pregnancy outcomes, including reducing the incidence of low birth weight babies. MCM services are tailored to the individual client needs. These services are provided face-to-face throughout the client’s pregnancy, unless specifically indicated in this rule.

Maternal Mortality and Morbidity Review Committee | Oregon Health Authority

The death of a woman during pregnancy, childbirth, or the year postpartum is a rare and tragic event. Maternal health experts are actively searching for answers about why the ratio of pregnancy-related deaths in the United States is higher than other developed nations, why it is increasing, and why the disparity by race/ethnicity is widening.

The economic cost consequences of suboptimal infant and young child feeding practices: a scoping review | National Library of Medicine

Breastfeeding is important for women and children’s health, but less than half of infants worldwide begin life with optimal breastfeeding. A growing literature shows consistently large economic costs of not breastfeeding, with global studies showing economic losses of around US$300 billion globally. However, existing studies are highly diverse in approaches, methods, data sources and country results. Building on a landmark 2012 UNICEF UK review focused on high-income countries, we conducted a scoping review to map and characterize the expanding literature and identify future research directions in this research area.

Heckman Equation | What is the Heckman Curve?

Investing early in children yields the greatest returns. The Heckman Curve demonstrates that the highest economic and social benefits come from early skill development. This investment leads to lifelong success, increased productivity, and reduced societal costs.

WIC (Women, Infants, Children) | Oregon Health Authority

WIC is a place where families like yours get healthy food and a lot more.  WIC is for pregnant people, new and breastfeeding moms, and children under 5. WIC helps improve the health of mothers and supports a healthy start for infants and children through:

  • Nutrition education
  • Breastfeeding support
  • Healthy foods 
  • Health screenings and referrals 

Center M, Maternal Mental Health App

Center M is designed with intentional focus on pregnant women’s expectations, needs, and preferences. The program is being piloted and tested at Oregon Health & Science University with interdisciplinary support and collaboration (psychology, obstetrics, family practice, women’s health nurse-midwifery, health equity).

The Center M app allows users to cultivate awareness of their own thoughts and feelings in the present moment through mindfulness exercises, breath work, and tools to decrease stress and promote wellness. The app also supports practice with the foundational principles of cognitive behavioral therapy, including recognizing the thoughts, feelings and behaviors are intertwined.

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