Maternal mortality rates are climbing in the United States, according to the new CDC report released Mar. 16. The pregnancy-related mortality rate in Washington, D.C. has exceeded the national average for years, but research shows that almost all pregnancy-related deaths in 2017-19 were preventable.
The same report shows that the maternal mortality rate for Black mothers in the United States is 2.6 times higher than that of white mothers, highlighting an alarming racial disparity. But there are organizations working to close this health equity gap to reduce maternal harm.
MedStar Health’s D.C. Safe Babies Safe Moms (SBSM) initiative wants to turn these preventable deaths into prevented deaths. The initiative works with D.C. mothers to provide improved interdisciplinary, multigenerational health and support services for birthing people and their families, and their primary goal is to reduce maternal and infant mortality in the District by 25% in the next five years.
“In partnership with the A. James & Alice B. Clark Foundation, MedStar Health’s D.C. Safe Babies Safe Moms initiative is designed to improve the health, welfare and lifelong outcomes of mothers and infants in Washington, D.C,” Christine Laccay, senior director of operations of D.C. SBSM, said in an interview with The Hoya.
SBSM researches five different areas — health equity, health economics, implementation science, data science and the mother’s voice — to study the interventions that are most impactful in reducing adverse maternal outcomes, according to Laccay. The project puts each individual family at the center of their care from before pregnancy until the child reaches age three, combining the expertise of professionals at MedStar Health, evidence-based healthcare and proven community-centric support services.
SBSM has been successful so far, having served more than 25,000 people with almost 3,000 visits per month. The project also received national designation in April 2021 as a HealthySteps site, joining a national network of pediatric practices advocating for health equity. The initiative also opened in March 2022 the first O.B. Specialty Services at MedStar Washington Hospital Center to offer comprehensive perinatal care services in one integrated clinic.
Karey M. Sutton, Ph.D., scientific director of health equity research at the MedStar Health Research Institute, said that the recent increase in maternal deaths may be a result of overall heightened risk of death due to catching the coronavirus, the widespread misinformation regarding the effects of the COVID-19 vaccine for birthing persons and the prohibition of doulas, professional labor assistants who provide support to birthing mothers, from aiding mothers.
Sutton said that while the maternal health crisis appears to be worsening each year, it is important to recognize the available solutions that can help reduce pregnancy-related deaths.
“Many of the most preventable factors are provider-related or healthcare system-related, e.g., low quality of care, delays in recognizing ailments, inadequate medical intervention,” Sutton said.
Maggie Clark, program director at the Georgetown University McCourt School of Public Policy’s Center for Children and Families, said one solution to the maternal death crisis may be expanded access to Medicaid, a health-coverage program that is funded jointly by states and the federal government. As a HealthySteps site, SBSM is also dedicated to increasing the accessibility of Medicaid by serving children with Medicaid coverage and saving coverage costs.
Clark said that about half of U.S. pregnancies are covered by Medicaid, making it a critical source of health coverage that may be leveraged to generate population-level improvements in maternal health.
States were required during the throes of the COVID-19 pandemic to keep people enrolled in Medicaid until March 31, 2023, in exchange for increased federal funding under the Families First Coronavirus Response Act (FFCRA).
“For pregnancy coverage, this was transformative,” Clark said.
Pregnant mothers received coverage only until 60 days after the end of pregnancy before the COVID-19 pandemic, which can be dangerous as the months following pregnancy are when high levels of postpartum complications and deaths are reported, according to Clark.
The District is currently making improvements for maternal crises.
First, D.C. officially lengthened the postpartum Medicaid coverage period in 2021 to one year after the end of pregnancy, regardless of the FFCRA.
Second, D.C. decided to provide Medicaid coverage for the cost of doula services. This is important, as numerous studies have found that doulas play a critical role in improving pregnancy outcomes, especially for Black and low-income mothers.
The U.S. has faced a worsening maternal health crisis, but there is hope — and there are solutions. Projects like SBSM and resources like Medicaid are bringing us one step closer to a healthier future, but Sutton says the most effective way to produce meaningful change is through collaborative power.
“Our solutions must be multi-level, multi-sectored and centered on the wisdom of those affected most by injustice,” Sutton said. “This work cannot and should not be completed in siloes.”
Leave a Reply