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Giving birth in the US is dangerous for too many women. To counter the long-term rise in maternal morbidity, the Biden administration recently announced a “Blueprint for Addressing the Maternal Health Crises.”
According to the Centers for Disease Control and Prevention (CDC), the latest figures on maternal mortality show 861 women died from maternal causes in the US in 2020, or 23.8 deaths per 100,000 live births. Worldwide, the US ranks approximately 55th—behind Russia—in maternal deaths.  The statistics are disturbing and damning for a country with the type of healthcare resources present in the US.  The breakdown of those figures is equally appalling—Black women are three times more likely to die of complications of pregnancy. Native American women are twice as likely to die, and those in rural regions of the country are about 60 percent more likely to die from a maternity-related cause.

With the new initiative, the Administration aims to position the US as the “best country in the world to have a baby.”  Given that goal, there is a lot of work ahead.

Key points of the new Blueprint include:

  • Increase healthcare access:  The plan identifies gaps in maternity care that occur before and after pregnancy.  The Administration will encourage states to extend Medicaid coverage to 12 months after delivery, from 60 days at present.  “Maternity care deserts” are areas without adequate prenatal and postnatal care facilities or units. Obstetric readiness is a goal of the Blueprint, as well as launching a national hotline to support maternal behavioral health and support for perinatal addiction programs.
  • Funding review: The Blueprint proposes “revising the Conditions of Participation for hospitals to receive federal funding.” As well, the initiative proposes a designation for facilities that engage in improvement programs and recommended best practices.  These facilities would be identified as “Birthing-Friendly.”
  • Improving data access:  The Administration hopes to boost data collection to ensure research is less fragmented, reflects diversity, and addresses research needs around maternal morbidity.
  • Boost provider numbers:  The Blueprint suggests increasing those who work in the perinatal workforce including licensed midwives, doulas, community health workers, and physicians.  As well, the plan seeks to expand freestanding birth centers and boost insurance support for those providing qualified birth services.
  • Easing entry to social umbrella programs: The initiative hopes to reduce existing barriers to healthcare and other social services.  This includes workplace protections, screening for food insecurity, homelessness, and other socio-economic conditions.

The Blueprint is an ambitious wish-list with hopes of reforming maternal care in a way that reduces complications of pregnancy and smooths the economic environment for pregnant women and their families.  In late August, the US Department of Health and Human Services announced a $20 million investment in the Blueprint…a drop in the bucket if real change is expected.

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