The United States is facing a maternal health crisis. Our country’s maternal mortality rate is the highest of any developed nation in the world and more than double the rate of peer countries, and most pregnancy-related deaths are considered preventable. Beyond maternal mortality, severe maternal morbidity impacts far too many families. Each year, thousands of women experience unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to their health such as heart issues, the need for blood transfusions, eclampsia, and blood infections.
Systemic barriers, together with a failure to recognize, respect and listen to patients of color, has meant that Black and American Indian/Alaska Native (AI/AN) women, regardless of income or education, experience a greater share of these grave outcomes, as do rural women. The challenge in front of us extends beyond healthy pregnancy and outcomes. For far too many mothers and families, pregnancy and childbirth are traumatic experiences, lacking in dignity and respect, and too often resulting in complications, mistreatment, and high medical bills. For too long, we have allowed preventable deaths, life-altering complications, and untreated mental health and substance use disorders to persist. And the continued attacks on women’s fundamental rights, including restrictions on abortion and family planning, are undermining the ability for women to be safe and healthy.
This crisis is longstanding, but has been exacerbated by the COVID-19 pandemic and recent trends in hospital obstetric unit closures in rural areas. Mothers and families across our country need an urgent response. The Biden-Harris Administration is committed to cutting the rates of maternal mortality and morbidity, reducing the disparities in maternal health outcomes, and improving the overall experience of pregnancy, birth, and postpartum for people across the country. Our vision for the future is that the United States will be considered the best country in the world to have a baby. This will require bold, unprecedented action through a whole-ofgovernment strategy, including coordinated efforts from multiple federal agencies.
Essential to this effort is for Congress to act and close the Medicaid coverage gap to help the nearly 4 million Americans living in Medicaid non-expansion states gain access to affordable and comprehensive Medicaid coverage. Congress should also require all states to provide continuous Medicaid coverage for 12 months postpartum (currently, states are only required to provide pregnancy-related Medicaid coverage for 60 days postpartum) and make significant investments in other efforts that reduce maternal morbidity and mortality, including the $470 million in the Fiscal Year (FY) 2023 President’s Budget. This funding will expand maternal health initiatives in rural communities; implement implicit bias training for health care providers; create pregnancy medical home demonstration projects; address the highest rates of perinatal health disparities, including by supporting the perinatal health workforce; strengthen data collection and evaluation; and address behavioral health disorders.
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