U.S. Senator Kirsten Gillibrand called on Senate leadership to strengthen maternal health policies in the next coronavirus relief package. Communities of color, especially those in rural areas, are being hit disproportionately hard by the coronavirus pandemic which has stressed the country’s maternal care system and intensified pre-existing racial disparities in maternal health outcomes. Senator Gillibrand, alongside U.S. Senators Cory Booker (D-NJ), Kamala Harris (D-CA), and Tina Smith (D-MN), is pushing to expand and extend Medicaid coverage for pregnant people and invest in funding and resources for states to provide adequate care, support mothers, and reduce maternal deaths during the COVID-19 crisis.
“Our country has the highest maternal mortality rate in the industrialized world, and this has been compounded by the crisis caused by COVID-19, especially in New York,” said Senator Gillibrand. “It’s painfully clear that we are not doing nearly enough to protect women of color and their babies, and we must do much more to end institutional racism in our health care system and ensure the resources are available to care for expecting and new mothers. Congress must solve this problem. That’s why I’m pushing for critical resources and investment in health care for women of color and high-risk populations to combat this epidemic. I will continue fighting to lower our high maternal mortality rate and ensure equality in our health care system during the pandemic and beyond.”
The maternal mortality rate in the United States is among the worst in the developed world and has been increasing in the last decade. Over the past decade, New York State alone has experienced a 60 percent increase in maternal mortality. The disparities in maternal health for American Indian and Alaska Native (Indigenous) people, African American communities, and rural communities are being compounded by reports that have emerged showing that the coronavirus pandemic has disproportionately ravaged these communities. Since the beginning of the pandemic expectant mothers have been forced to delay or forego check-ups and other needed care due to fears that they might contract COVID-19, which is particularly troubling for people of color, rural residents, and other medically underserved individuals who already face barriers to care. Additionally, due to the social distancing measures that hospitals have implemented, many pregnant people have had to give birth without their full support system, including family members and doulas, who often serve as invaluable advocates for proper care during labor.
Senator Gillibrand and her colleagues called for the following policy solutions in the next COVID-19 relief package:
- Extend Medicaid coverage for postpartum women from the current 60 day minimum requirement to one full year (Medicaid covers 43 percent of births each year, and the abrupt 60-day cut-off for postpartum women covered by Medicaid is harmful for new mothers, particularly as one-third of pregnancy-related deaths occur between one week and one year after delivery).
- Expand Medicaid coverage beyond simply “pregnancy-related services” to include full-scope care (the current restriction of care to “pregnancy-related services” only may prohibit individuals from receiving care for other health conditions and comorbidities that impact maternal health, including those related to COVID-19).
- Make Maternal Mortality Review Committees (MMRCs), which regularly review maternal health data, universal for all states, with consistent data collecting and reporting norms, and ensure they are representative of the U.S. population.
- Boost resources and support for states to implement maternity care telehealth services nationwide, particularly those covered under Medicaid.
- Improve access to doula and other perinatal support services, such as lactation counselors and childbirth educators (doula support has been linked to improved perinatal outcomes, particularly for people of color).
- Boost funding for midwifery education programs in order to grow, strengthen, and diversify the midwifery workforce, especially for midwives of color and those working in health professional shortage areas (midwifery care is associated with fewer unnecessary interventions, increased patient satisfaction, and lower health care costs).
- Provide dedicated funding to states and hospitals to help reduce maternal deaths, and prevent and respond to complications arising from pregnancy and childbirth.
- Improve access to freestanding birth center services for people with low-risk pregnancies (freestanding birth centers are evidence-based, safe alternatives to in-hospital birth, which can?help?relieve?pressure on the physician workforce, minimize COVID-19 transmission, and direct health system resources more effectively as the country continues to respond to the COVID-19 pandemic).
Full text of the letter can be found here.