Our approach

Lasting change takes coordinated action.

Maternal and infant health in North Carolina is at a critical tipping point. Too many families face barriers to care, and persistent disparities continue to put Black, Indigenous, and rural mothers and babies at higher risk.

Nurture NC brings together cross-sector partners, data, and innovative solutions to address these urgent challenges. Our approach focuses on three interconnected priorities:

  1. Strengthening the maternal health workforce
  2. Closing gaps in rural healthcare access
  3. Driving smarter public policy optimization

Together, these strategies build a foundation for healthier outcomes statewide.

Want to read our Framework for Action©?

Our core implementation actions

To achieve our mission, Nurture NC uses seven interconnected actions that guide our work and ensure sustainable impact. These core implementation actions represent the practical, evidence-based strategies we employ to turn vision into results.

ADVOCATE

Champion maternal and child health through strategic approaches to increase investments, promote policies, and build cross-sector buy-in with bipartisan support.‍

IMPACT: Greater visibility, increased funding, meaningful policy change, and stronger legislative relationships while establishing Nurture NC as a trusted information source.

ENGAGE

Convene, catalyze, and facilitate collaboration with stakeholders to create connections between diverse partners and foster community commitment to change.

IMPACT: Amplified collective impact, coordinated action across sectors, identification of key partners, and creation of a dedicated space for meaningful progress.

ANALYZE

Systematically evaluate and focus efforts to maximize impact through comprehensive inventory, analysis, and strategic prioritization of interventions.

IMPACT: Essential situational awareness, coordinated actions, clear focus for maximum impact, and identification of achievable wins that build momentum.

COMMUNICATE

Strategically share knowledge to drive understanding and action by highlighting successful approaches, ensuring data transparency, and amplifying authentic voices.

IMPACT: Improved knowledge base, increased shared understanding, evidence-based messaging, and broader public support for maternal health initiatives.

INVEST

Strategically identify and seek public and private fiscal resources to support maternal and child health goals while building long-term capacity and sustainability.

IMPACT: Rapid cycles of change, continuous learning, responsive programming, and leveraging investments for improved outcomes.

STRATEGIZE

Develop a focused, evidence-based action plan that identifies 2–5 strategic priorities under each Focus Area with the highest potential impact and diversified funding support.

IMPACT: Enhanced coordination, greater sustainability, simplified messaging, and increased likelihood of success.

AMPLIFY

Strategically elevate and strengthen existing maternal health initiatives, creating greater visibility and eliminating unnecessary duplication.

IMPACT: Increased shared understanding, broader engagement, identification of critical gaps, and strengthened relationships between stakeholders.

SELECT ONE:

MATERNAL HEALTH WORKFORCE
RURAL healthcare ACCESS
PUBLIC POLICY OPTIMIZATION

Maternal health workforce

To improve outcomes for mothers and babies, North Carolina must grow and sustain a strong, culturally responsive maternal health workforce. This means not only increasing the number of providers but ensuring families have access to care teams who understand and meet their needs.

KEY OPPORTUNITIES

Address the critical shortage of high-quality providers to improve maternal outcomes in all communities across North Carolina.

  • Priority 1: Increase the number of midwives across North Carolina.
  • Priority 2: Increase access to doula services in all NC counties.

IMPACT SNAPSHOT

Why this matters: Expanding the workforce has measurable benefits for maternal and infant health.

  • Doula support reduces Cesarean delivery risk by 47% (Falconi et al., 2024).
  • NC has only 6.5 CNMs per 1,000 live births, below the national median.
  • Rural counties face provider shortages, compounding barriers to prenatal and postpartum care.

Rural healthcare access

Geography should not determine a mother or baby’s chance at a healthy start. Yet in many parts of North Carolina, families live far from critical services. Our work focuses on closing these gaps to bring high-quality care closer to home.

KEY OPPORTUNITIES

Reduce geographic disparities in maternal health outcomes by expanding access to high-quality care and support services in rural communities in North Carolina.

  • Priority 1: Increase access to early and longitudinal routine prenatal care in rural communities across North Carolina.
  • Priority 2: Using available data sources, identify the top 5% of NC counties with cross-sectional indicators that contribute to poor maternal-child outcomes and mobilize philanthropically supported community action coalitions.
  • Priority 3: Seek to understand models for innovative perinatal services to identify opportunities for expansion across NC.

IMPACT SNAPSHOT

The data highlights how critical rural access is for healthy starts:

  • 21% of NC counties lack a birthing hospital within a 30-minute drive.
  • Over 50% of maternity care deserts in NC are in rural counties.
  • Rural mothers experience higher rates of preterm birth (11.2%) compared to urban areas (10.1%).

Public policy optimization

Sustainable progress requires smart, evidence-based policies that support maternal and infant health. We advocate for state-level changes that remove barriers, increase access, and invest in healthy futures for North Carolina families.

KEY OPPORTUNITIES

Drive smarter public policy to sustain improvements in maternal and infant health statewide.

  • Priority 1: In partnership with NC Medicaid managed care plans, increase utilization of Value Added Benefits across all plans and in all Medicaid regions for perinatal and infant-specific benefits.
  • Priority 2: Decrease the incidence of congenital syphilis mortality and morbidity across North Carolina.
  • Priority 3: Endorse and support the deployment of Levels of Maternal Care in North Carolina.
  • Priority 4: Protect existing access to the full array of Medicaid-covered benefits in the pregnancy and postpartum period.
  • Priority 5: Expand access to telehealth behavioral health and substance use services for pregnant women into rural communities by reducing technology barriers.

IMPACT SNAPSHOT

These policy shifts can dramatically improve maternal and infant outcomes:

  • NC Medicaid covers 55% of all births, making state policy a critical driver to improve health.
  • There has been a 7,200% increase in congenital syphilis cases from 2012 to 2023.
  • 27% of North Carolina households do not have high-speed internet subscriptions.