As an influential congressional panel today examined the country’s maternal mortality crisis, March of Dimes again warned lawmakers that black mothers are three times more likely to die from pregnancy-related complications than their white peers, urging policymakers to continue supporting efforts to eliminate preventable maternal mortality and severe maternal morbidity (SMM).
In a statement submitted to the House Way and Means Committee hearing on “Overcoming Racial Disparities and Social Determinants in the Maternal Mortality Crisis,” March of Dimes President and CEO Stacey D. Stewart warned of the striking disparities that exist among the health of mothers and babies of different racial and ethnic backgrounds. Black women are 27 percent more likely to experience severe pregnancy complications that white women, and their children face the highest child mortality rates of any racial or ethnic group.
“We know the causes of maternal mortality and SMM are diverse; they include physical health, mental health, social determinants, and much more,” Stewart wrote. “They can be traced back to issues in our health care system, including quality of care, systemic problems, and implicit bias. They stem from factors in our homes, our workplaces, and our communities.”
Last year, lawmakers passed the Preventing Maternal Deaths Act of 2018, which helps state maternal mortality review committees (MMRC) review each instance of maternal death and develop recommendations to prevent them in the future. In FY 2019, Congress also provided $50 million in new funding to support state MMRCs and other activities to protect the health of pregnant women and new mothers.
“The effort to save women’s lives can’t just end with one bill,” Stewart stated, calling on committee members to work with their colleagues to draft comprehensive legislation that will improve the health of all mothers. To achieve this, Stewart called for:
- Every state to have a MMRC that can properly collect data on maternal mortality and SMM.
- Policies to address provider implicit bias and eliminating systemic barriers in health care.
- Access to inpatient obstetrical facilities and qualified obstetrical providers, including Certified Nurse Midwives (CNMs) and Certified Midwives (CMs), in underserved and rural settings.
- Support for state perinatal quality collaboratives working with hospitals to identify and review cases of SMM and implementing quality improvement initiatives to improve care and promote optimal maternal health.
- Support for efforts to ensure that all women have quality, affordable health insurance and health care to include but not limited to postpartum depression screening, mental health treatment, substance use treatment, affordable contraception, including long-acting reversible contraception (LARC), and access to health care providers who understand and meet their health needs before, during and after pregnancy.
- Extending health insurance coverage offered to new mothers through Medicaid and the Children's Health Insurance Program (CHIP) to a full year after pregnancy.
- Improving the social and economic conditions and quality of health care at all stages of a woman's life.
- Acceleration of policies and programs shown to provide preventive and supportive care for women during pregnancy and childbirth, including group prenatal care and coverage for doula services.
In the United States, 700 mothers die from pregnancy-related causes each year, and more than 50,000 other experience dangerous complications that could have killed them -- making the United States the most dangerous place in the developed world to give birth. Maternal mortality is also significantly higher in rural areas, where obstetrical providers may not be available, and delivery in rural hospitals is associated with higher rates of postpartum hemorrhage. Last year, March of Dimes released a report showing that 5 million women live in “maternity care deserts,” which are communities without a hospital offering obstetric services or providers. Each year, 150,000 babies are born to mothers living in maternity care deserts.
A recent report from The Centers for Disease Control and Prevention (CDC) estimates that up to 60 percent of pregnancy-related deaths are preventable.