Two Years On, The Biden-Harris Effort To Reduce Maternal Mortality Remains—A Start
Maternal mortality is shockingly high in the U.S. What exactly is being done about it?
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The U.S. presidential election has been, to put it mildly, head-spinning. A CNN debate nobody could stop talking about. An assassination attempt. A late-in-the-race drop-out. A conversation on X plagued by tech troubles. Standing ovations at the DNC. It’s certainly kept us on our toes.
This might explain, in part, why the White House’s sprawling update on efforts to combat the U.S. maternal health crisis—released on July 10—hasn’t been top of mind.
The progress report follows up on 2022’s Blueprint for Addressing the Maternal Health Crisis, a comprehensive endeavor from the Biden Administration, spearheaded by Vice President Kamala Harris, to lower America’s dismal maternal mortality rates. The report was something of a first—56 pages of dense research and policy suggestions, calling on Congress to invest millions.
It couldn’t come a moment too soon.
America’s overall maternal mortality rate of 22 deaths per 100,000 live births is fueled, in part, by scarce maternal care providers and a lack of paid family and medical leave. For Black people, who die at a staggering rate in the U.S. of 49.5 for every 100,000 live births, the same issues are compounded by centuries of racism.
Comparing these numbers with those of other high-income countries illustrates how awful they are. New Zealand has a maternal mortality rate of 13.6 per 100,000 live births, and Sweden has a rate of just 2.6 per 100,000 live births, according to data from the Commonwealth Fund, a research foundation.
Unpacking the Blueprint: The Good Parts
In the two years since the Blueprint was released, at least $37 million has been invested in diversifying and growing the perinatal workforce, and more than 37,700 people have called the National Maternal Mental Health Hotline, launched following the Blueprint.
Meanwhile, 46 states and the District of Columbia have instituted a provision within the American Rescue Plan Act of 2021 that allows states to expand Medicaid postpartum coverage from 60 days to 12 months. Two states are working on implementing an extension, and Wisconsin has executed limited coverage for up to 90 days.
No doubt, these are important. Expanding Medicaid addresses the 30% of pregnancy-related deaths that occur between day 43 and day 365 postpartum. Nearly 40% of births are covered by Medicaid, a figure that rises to 65% for Black people giving birth. A maternal mental health hotline potentially connects the nearly one in seven women who develop postpartum depression with support. A robust perinatal workforce increases the chance that patients of color and providers share a racial identity—which, research shows, reduces bias and improves patient-provider trust.
Bolstering this is a recent proposal announced by Harris for the first-ever baseline maternal health and safety standards, which will apply to 6,000 hospitals that provide maternal, emergency, and obstetric services. It will ensure these institutions have the equipment and training required for better outcomes for maternal patients.
Unpacking the Blueprint: The Less-Good Parts
Other parts of the Blueprint have missed the mark.
