White House Maternal Health Day of Action Summit: What you missed

The United States continues to have the highest maternal death rate of all developed nations at a staggering 20.1 deaths per 100,000 live births.¹ The Centers for Disease Control and Prevention’s latest report found a total of 754 deaths in 2019 from maternal causes.² Although rates among peer nations have improved over the past 20 years, maternal mortality statistics in the United States have continued to plummet.

“When we know Black women are 3 times as likely to die from pregnancy-related complications, we should do something about that. When we know Native American women are more than twice as likely to die from pregnancy-related complications, we should do something about that,” Harris said in her opening remarks.

Harris also announced the administration’s newest commitments to improving maternal health and equity, supporting safe pregnancies and childbirth, and reducing complications and mortality in the year following birth.

Harris explained the Centers for Medicare & Medicaid Services (CMS) plans to implement “Birthing-Friendly” hospital designations, a rating system for hospitals according to their level of maternal health care. Designations will be awarded to hospitals participating in a collaborative program aimed at improving maternal outcomes and implementing patient safety practices. If designated as a “Birthing-Friendly” hospital, CMS will include the hospital in Medicare’s Care Compare database.

More than 20 companies and nonprofits have pledged to invest over $20 million domestically, and more than $150 million globally, to maternal health efforts, said Harris. These efforts include the use of remote care monitors for rural communities, innovative care models for the postpartum period, educational programs for maternal health providers, and more.

As a senator, Harris introduced the Maternal CARE Act, and the Black Maternal Health Momnibus Act, a comprehensive bill designed to improve maternal nutrition, expand affordable housing, and extend the maternal health workforce to include more doulas and midwives. “For so many women, doulas are literally a lifeline,” Harris said.

She also introduced the Uterine Fibroid Research and Education Act, as uterine fibroids are the cause of many underlying issues that impact maternal mortality. “This is especially of concern for Black women,” Harris said, “who are more likely to be hospitalized as a result of that condition.”

Together, these bills make up the foundation for the new Build Back Better Act, the single largest investment ever to address maternal mortality and morbidity, said Harris.

Once passed by the Senate, the Build Back Better Act will invest over $3 billion in new maternal health funding, with focus on:

• Growing and diversifying the perinatal nursing and doula workforce,
• Supporting the work from the National Center on Birth Defects and Developmental Disabilities,
• Increasing funding for maternal mental health research at minority-serving institutions,
• Improving data collection and maternal health risk monitoring,
• Addressing substance abuse disorders that impact maternal health, and
• Improving postpartum coverage and coordinating care.

The first component of the Build Back Better Act, Harris said, is new guidance for states to provide 12 months of continuous postpartum coverage through their Medicare, Medicaid, and CHIP programs. The current requirements require postpartum care for 60 days, despite evidence of complications and death occurring more than 60 days after delivery. The new guidance will become available in April 2022, although several states, including Virginia, New Jersey, and Illinois have already begun their expansion of postpartum coverage.

New research from the US Department of Health and Human Services found that, if adopted nationwide, the number of Americans getting coverage for a full year postpartum would roughly double, extending coverage for approximately 720,000 people a year.³ “We know that, when we invest in maternal health, economic productivity increases, and socioeconomic outcomes improve,” said Harris. “We know a healthy economy requires healthy mothers and healthy babies.”

References

1. Products - Health E Stats - Maternal Mortality Rates in the United States, 2019. Published 2021. Accessed December 7, 2021. https://www.cdc.gov/nchs/data/hestat/maternal-mortality-2021/maternal-mortality-2021.htm
2. Hoyert D. Health E-Stats. Published online 2021. doi:10.15620/cdc:103855
3. Medicaid After Pregnancy: State-Level Implications of Extending Postpartum Coverage. ASPE. Published 2021. Accessed December 9, 2021. https://aspe.hhs.gov/reports/potential-state-level-effects-extending-postpartum-coverage