Integrating Lawyers into the Perinatal Health Care Team: Initial Findings From an Innovative Medical–Legal Partnership [ID: 1377957

Abstract

INTRODUCTION: Health-harming legal needs (HHLNs), social determinants of health that have a legal remedy, are drivers of poor health outcomes for Black women and children. HHLNs include inadequate access to safe housing, employment accommodations, and income supports. A medical–legal partnership (MLP) adds an attorney to the health care team to address patients’ HHLNs in a variety of health care settings. The Perinatal LAW Project (P-LAW), an MLP between the Georgetown University Health Justice Alliance and MedStar Washington Hospital Center Women’s & Infants’ Services, addresses perinatal patients’ HHLNs in an obstetrics and gynecology practice. METHODS: Perinatal LAW Project attorneys record client and case data in a legal case management system. The research team analyzed data for the first 18 months of the program (March 2021 to September 2022). RESULTS: One hundred thirty-one patients were referred for legal assistance, primarily by social workers and health navigators. Most patients were in their second and third trimesters. The majority of patients were Black or African American, aged 20–34, and lived under 200% FPL. The most common legal issues were in the areas of employment (parental leave, discrimination), housing (conditions, eviction), public benefits (food stamps, disability benefits), and family law (child support, domestic violence). The P-LAW addressed 150 legal issues and served 117 patients. CONCLUSION: Medical–legal partnership is a novel approach to addressing maternal health disparities. In our experience, legal services have a high utilization rate and patients often have more than one legal need. Future efforts to measure patient outcomes, including reduced maternal stress and medical appointment attendance, will build the evidence base for MLP in the perinatal context.