The country still faces a health crisis for new and expecting mothers, despite progress in recent years, members of the congressional Black Maternal Health Caucus said Monday in Joliet. [Health News Illinois]

Rep. Lauren Underwood, a Democrat from Naperville and caucus co-chair, highlighted increased funding for the National Institutes of Health to support research and develop solutions to address mortality rates.

But, she said the U.S. still has the highest maternal mortality rate of any high-income country, and the COVID-19 pandemic exacerbated long-standing issues.

“It's devastating and it's tragic," she said. "Moms across America are demanding a comprehensive solution."

Underwood renewed her call for Congress to pass the caucus’ maternal health package, which would boost funding for community-based organizations, the perinatal workforce, data collection and efforts to address social determinants of health.

“(The package) is not a Band-Aid, it's not a messaging bill, it's not a commemorative resolution and it is not a study,” Underwood said. “It is the comprehensive solution to end preventable maternal death across the United States."

An Illinois Department of Public Health report released last year found Black women are three times more likely than white women to die from medical complications during pregnancy and childbirth.

Dr. Monica Bertagnolli, director of the National Institutes of Health, said that many deaths occur during the year after delivery of an infant. Four of five deaths are deemed preventable.

The agency is supporting 12 organizations that are implementing “culturally appropriate research projects (that address) factors that can lead to pregnancy-related complication and death.”

“In short, they are charged with addressing all of the complicated variables that contribute to poor survival for women,” Bertagnolli said.

The caucus highlighted efforts in Illinois to address the crisis, including a recently signed law that requires insurers to cover all pregnancy, postpartum and newborn care provided by perinatal doulas and licensed certified professional midwives. 

Sen. Lakesia Collins, a Democrat from Chicago who sponsored the legislation, said the law provides access to culturally sensitive care workers who can relate to Black women as they go through their pregnancies.

Coverage for midwives and doulas will also be crucial to non-Black individuals, especially those in rural communities who may not have easy access to maternal care.

“No matter what your economic status is, what race you are, women will have access to good maternal healthcare,” Collins said.

Federal leaders discuss steps to improve maternal health

Medicaid coverage and bolstering the workforce are key steps that the federal government can take to improve maternal health outcomes, officials said Monday at a panel hosted by the Black Maternal Health Caucus in Joliet.

Chiquita Brooks-LaSure, administrator for the Centers for Medicare and Medicaid Services, said Medicaid and the Children's Health Insurance Program cover nearly 40 percent of the births in the country. 

That's one reason President Joe Biden’s administration pushed to expand postpartum coverage for women to 12 months after birth, which 46 states now provide.

“We were seeing many women fall off of coverage,” Brooks-LaSure said of the previous standard policy of covering two months after birth. “Many of the deaths in maternal health happen postpartum … It's been a priority of the caucus, and certainly our administration, to cover women postpartum.”

Additionally, Brooks-LaSure said they have seen buy-in from providers on a designation launched last year identifying hospitals and health systems that participate in a perinatal quality improvement collaborative program and implement evidence-based care to improve maternal health.

“Many private companies liked this concept and have partnered with us to really encourage hospitals to meet the standards that we are setting forth of having a collaborative of implementing best practices,” she said.

Carole Johnson, administrator of the Health Resources and Services Administration, said they are “laser-focused” on getting services for those who have historically struggled to access healthcare, which makes maternal healthcare a priority. That includes supporting education institutes that train doulas and midwives and expanding wraparound programs for pregnant individuals and new parents.

“Being a new parent is hard,” Johnson said. “Being pregnant is hard. Having someone you can trust, who can be your voice, who can help be your advocate in a system that, frankly, is too hard to navigate, we can make a real difference with that.”

Another key to addressing maternal health is public-private partnerships, Brooks-LaSure said. They work with state Medicaid programs to build relationships with community providers and organizations that can “move the needle” on maternal health. 

Johnson said partnerships with local organizations can help agencies like HRSA identify promising models and practices, which can then be added to their grant programs and replicated in other parts of the country.

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