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Federal Government Pledges to Reduce Deaths and Complications Due to Pregnancy

The maternal mortality rate in the United States–the death of the mother due to complications of pregnancy or childbirth–was 35 deaths per 100,000 live births in 2020, the last year for which statistics are available.

This rate is higher than it was in 2019 and is higher than in most developed countries in the world, according to the Centers for Disease Control and prevention. The actual number of women who died of causes related to pregnancy or childbirth in 2020 was 861.

In comparison, the maternal mortality rate in France is 6 deaths per 100,000 live births and in the United Kingdom it is 5 deaths per 100,000 live births. The maternal mortality rate for high income countries, like the United States, France, and the United Kingdom, is 19 per 100,000 live births, which means that the United States is doing badly compared to other high-income countries.

What is worse, the rate in the United States is higher for women of color. For Black women, the maternal mortality rate is 55.3 deaths per 100,000 live births, compared to 19.1 deaths per 100,000 for White women. That is almost three times as many.

Maternal morbidity rates in the United States are also high. This is the rate of unexpected problems caused by labor and delivery that have significant consequences to a woman’s health, either short term or long term. Between 50,000 and 60,000 women in the United States each year have severe health problems that start in during childbirth.

Most cases of maternal morbidity or maternal mortality can be avoided. Many bad outcomes of pregnancy and childbirth can be prevented by appropriate care.

Because so many of these deaths and serious health problems can be prevented, in June, the White House released the Blueprint for Addressing the Maternal Health Crisis. The blueprint is a set of programs that are being put in place in many segments of the federal government to reduce the high rates of maternal mortality and morbidity. The federal government will work to get state governments to launch similar programs.

There are five priorities to the blueprint:

  • Increased access to and coverage for high-quality maternal health services, including behavioral health services.
  • Making sure that women who are giving birth are decisionmakers in their care and that they are listened to.
  • Advancing data collection, standardization, transparency, and research.
  • Increased the number and diversity of people who work with women who are pregnant, giving birth, or have a new baby.
  • Strengthening economic and social support for people before, during, and after pregnancy.

One goal is to extend Medicaid coverage for women and babies from two months to one year after birth and to ensure that women don’t lose or have changes in their insurance coverage during or soon after their pregnancies. However, extending this coverage will require action by Congress and by state legislatures. About 40% of births in the United States are covered by Medicaid.

The Department of Health and Human Services (HHS), which oversees and Medicaid and Medicare systems in the United States, has announced that it is investing $8.5 million to reduce pregnancy-related deaths and complications. The Centers for Medicare & Medicaid Services (CMS) has created a Maternity Care Action Plan to support maternal health blueprint. The action plan is coordinated across CMS to improve health outcomes and reduce inequities for people during pregnancy, childbirth, and the postpartum period.

CMS is working to improve access to comprehensive health coverage, including for those eligible through Medicaid and the Children’s Health Insurance Program, the Health Insurance Marketplace at healthcare.gov, and Medicare coverage. These proposed increases in health insurance coverage are expected to improve coverage before, during, and after pregnancy.

The federal government will work to with state governments to expand women’s access to doulas and midwives and encourage health insurance companies to cover their services. Doulas are aides who provide women with emotional and physical support before, during, and after childbirth. Midwives are trained healthcare professionals who provide care to women during pregnancy and childbirth and also offer well-woman care.

Women who live in rural areas are at greater risk of complications during childbirth because obstetrical and gynecology care may not be located conveniently. The blueprint calls for more funding for the Rural Maternity and Obstetrics Management Strategies Program and greater training for rural health care providers.

In addition, a Maternal Mental Health Hotline has been set up at 1-833-9-HELP4MOMS (1-833-943-5746).  Pregnancy and the tie after childbirth can be a time of greater risk for mental health problems in women such as postpartum depression.

“Strengthening maternal health is key to strengthening the health and wellbeing of communities across America,” said HHS Secretary Xavier Becerra in a statement.

CMS is also proposing a “birthing friendly” designation for hospitals. This designation would be added to a CMS website so that consumers can find hospitals with a commitment to quality maternity care quality. These hospitals would use the best practices that advance health care quality, safety, and equity for pregnant and postpartum women.

Valerie DeBenedette
Valerie DeBenedette is an experienced health and medical writer who lives about an hour north of New York City with a dog that is smaller than her cat. Her work has appeared in magazines, newspapers, newsletters, and on websites. She is a member of the National Association of Science Writers.

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