In the US, programs at all levels of government – federal, state and local – aim to reduce maternal mortality and close the racial gap.
Many are making progress in their communities and paving the way for other places.
The Associated Press examined efforts to address individual patient needs and efforts to improve medical care overall. Here are the key findings.
Supporting vulnerable women through pregnancy helps keep them healthy
Healthy Start is a federal program that has worked with vulnerable populations for decades. This year, the federal government provided $105 million in grants to fund local projects. Officials say it’s a key part of the Biden administration’s plan to address maternal health.
It “guides women through their pregnancy,” said Corrina Jackson, who leads a local Healthy Start project in Tulsa, Okla. “You try to get them into their first trimester and then work with them through delivery day, and then we also work with the babies to make sure they’re hitting their milestones.”
Healthy Start programs coordinate prenatal and postnatal care, educate mothers about health and parenting, refer mothers to resources for issues such as depression or domestic violence, and assist with transportation.
In Jackson’s more than 25-year tenure in Tulsa, she said, there have been no maternal deaths among clients. The maternal mortality rate for Oklahoma as a whole, meanwhile, is higher than the national average.
Improving medical care can dramatically reduce maternal mortality
California, on the other hand, has the lowest maternal mortality rate in the country, at 10.5 per 100,000 live births. That wasn’t the case before it created a “maternal quality care collaborative” in 2006.
The partnership, founded at Stanford University Medical School, brings together people from all hospitals with maternity units to share best practices on issues that can lead to maternal harm or death, such as high blood pressure, cardiovascular disease and sepsis.
“If you look at the maternal mortality rate in the United States compared to California, they were basically neck and neck until it was identified,” said Dr. Amanda Williams, clinical innovation advisor for the collaboration. “At that point, they completely split up and California started to go down. The rest of the country started to go up.”
Hospitals will receive toolkits that describe what to do, how to set up medical teams and what supplies to have on the floor. The partnership also aims to improve obstetric care by integrating midwives and doulas, whose services are covered by the state’s Medicaid program.
Experts: Tailored solutions for individual communities work best
New York City has a goal of reducing maternal mortality overall and achieving a 10 percent reduction in Black maternal mortality by 2030. The city is targeting low-income residents, people living in public housing and others with its New Family Home Visits Initiative, which supports pregnant and new parents by offering visits from nurses, midwives, doulas and lactation consultants.
Jackson’s Healthy Start project in Tulsa is also rooted in her community. She and her staff understand the lingering effects of the city’s 1921 massacre, which left an estimated 100-300 people dead and homes, churches, schools and businesses destroyed. Jackson said health disparities persist and added that many Black women also distrust the health care system, so being relatable is valuable.
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
