Combating Pregnancy-Related Mortality in the US

By Toutou Moussa Diallo, DBA

If women’s health is a priority and if it is true that more than half of pregnancy related deaths occur after pregnancy, and 53% occurs after seven weeks of birth, within a year threshold, therefore, I am calling everyone to be a part of the solution in improving maternal health and increasing health equity.

I call to action every legislator to break the chain of inequity and racial disparities in passing laws for postpartum home care to all birthing mothers.

My first article advocated for 40 or more days to care for mothers after birth at home.

Now that President Joe Biden signed the Appropriations Act 2022 on December 29, 2022 to increase the number of days for postpartum care to 12 months, this landmark bill will open ways to adequately care for birthing mothers and their newborns.

It is worthy to note that this permanent health coverage increases access to healthcare, however, it does not increase health equity nor decrease racial disparities, and nor provide ways to understand the whole woman and the chains of events leading to maternal mortality.

The latter is where the problem lies because it is not well known or understood. Having a home postpartum care (recovery), funding evidence based research, and having experienced specialists can help us understand some of the issues related to maternal mortality.
(https://ccf.georgetown.edu/2023/01/04/permanent-medicaid-postpartum-coverage-option-maternal-health-infrastructure-investments-in-2022-year-end-omnibus-bill/). (https://www.kff.org/medicaid/issue-brief/medicaid-postpartum-coverage-extension-tracker/).
(https://www.kff.org/medicaid/issue-brief/medicaid-postpartum-coverage-extension-tracker/).

According to New York State Medicaid Maternal and Child Health Policy Unit, “Previously New York State’s postpartum period of Medicaid coverage started on the last day of pregnancy and ended on the last day of the month in which the 60th postpartum day occurred. Under the new law, the length of the postpartum period of Medicaid coverage is now 12 months.

The 12-month postpartum period of Medicaid coverage begins on the last day of the pregnancy and ends on the last day of the 12th month.

The change in length of the postpartum period of Medicaid coverage in state statute ensures all pregnant consumers, who are state residents, will receive the same length of coverage at the conclusion of a pregnancy, regardless of their immigration status.”

This is a stepping stone to undertake a postpartum home care.
It would be best to see every state in the United States to (1) pass laws for postpartum home care, (2) pass laws to minimize unnecessary C-Sections, (3) to initiate a reimbursement system for home care, (3) have a certification training program for home visiting technicians on postpartum care, (4) have funding available for establishing a home care service, and (5) make funding available to understand the physiology of women reproductive systems and the chains of pregnancy related events leading to maternal mortality.
After an extensive research, I have found that Massachusetts is leading all states in perinatal and postpartum mental health (https://www.umassmed.edu/lifeline4moms/).

Also, Postpartum Support International is a national perinatal and postpartum mental health program that supports the whole family, including dads (https://www.postpartum.net/). Moreover, Borom Postnatal Retreat is a fee for service place for mothers to recover in New York City (https://boramcare.com/).

Those on Medicaid or without any insurance could not afford the Borom Postnatal Retreat, unless instituted by the State of New York.

Though, some states adopted the new law for 12 months of postpartum care to increase health equity and reduce racial disparities. However, It is vital that postpartum recovery becomes available and accessible to every girl and women.

I commend those who had adopted the 12 month postpartum care and recognized the importance of the health of a mother.