Improving Maternal Health
A free public service for a better community
Why Are We Advocates?
Because we all deserve to live in a country where we can make the country, and healthcare work for all of us.
Comments, suggestions, and research topics are greatly appreciated via comment the button.
How to Improve Maternal Health
Approximately 41 percent of all U.S. births are covered by Medicaid, ranging from 17 percent in Utah to 61 percent in Louisiana. Additionally, Medicaid covers between 58 percent and 66 percent of births for individuals who are non-Hispanic Black, American Indian or Alaska Native, Native Hawaiian or other Pacific Islander, and Hispanic.
Recall that Medicaid is 51 mostly different ways to deliver healthcare in the States and D.C. Maternal mortality has been rising after many years of steady decline. A recent investigation into how different Medicaid programs address the problem is our topic. Here is a link to the investigation.
The maternal mortality rate for 2021 was 32.9 deaths per 100,000 live births, compared with a rate of 23.8 in 2020 and 20.1 in 2019. The number in 2021 is almost 70 per 100,000 live births for Black women and almost 29 for Hispanic women
What Works
The report identified 23 different policies being implemented - not everywhere, of course, since we have different programs in different states. Of those, 12 are related to covering known good practices that improve health.
Which State Does What
The report breaks out which states are implementing which programs in their dataset (get it here).
They also simplify reviewing the data by using an interactive US map where you can select the different categories of improvements and then click on a state to see what they are doing. Click on the map below to go to the interactive maps.
Highlights of the Policies
If you peruse the list, or go to the linked full dataset, you’ll see that a lot of the policies are aimed at making sure that women have health insurance coverage and that the coverage includes specific practices. Other polices are related to making sure there is sufficient data collection to ensure we understand what needs to be addressed.
Here are some of the important coverage issues
Postpartum Coverage Extension
In 2022, Congress passed legislation proposing an extension of Medicaid coverage from 60 days to 12 months postpartum and allowing the policy to be implemented through a state plan amendment or Medicaid waiver. To date, 40 states and the District of Columbia extended coverage to 12 months postpartum. Thirty-seven states and the District of Columbia have implemented the extension through a state plan amendment and three have CMS-approved waivers.
Doulas
A state option for doula services is part of the preventive services benefit provision of the Affordable Care Act. States have other approaches to cover doula services through Medicaid, including the state plan amendment. To date, 11 states and the District of Columbia have exercised this option to receive federal financing for doula services.
The doula benefit can help provide comprehensive services to pregnant and postpartum people. Doulas are considered a key component of person-centered care and associated with lower rates of postpartum depression.
Postpartum Depression
Twelve states require caregiver and maternal depression screening at well-child visits; 28 states and the District of Columbia recommend it, and eight allow it. Forty-two states and the District of Columbia also cover postpartum depression treatment through Medicaid.
Long Acting Reversible Contraception
Making sure that that if they are desired, they are covered. These can be implants or IUDs.
Summary:
Many of the states are taking maternal mortality more seriously. That’s good - but it could be so much better. Remember Medicaid only covers about 40%. of births
These 23 policies to improve women’s health that need to be in place for women in the entire country. They are a start at treating women as full citizens and ensuring they get the medical care they deserve. At the very least the insurance coverage changes should be implemented to improve women’s health.
Action:
Universal healthcare is a start, but let’s make sure our representatives know that women across the US need to be accorded full access to needed medical care.
You can call / email your Member of Congress and Senators and let them know you want all health insurance in the US to include long postpartum care, treat postpartum depression, cover doulas, and cover long acting reversible contraception. Their email/phone is in the Resources section below.
Or you can use RESISTBOT to send them the email below by texting SIGN PXGUNU to 50409.
“I am your constituent and I want you to know that there is a crisis in maternal health in this country and you can help.
In 2021 the now rising maternal mortality rate was 32.9 deaths/100,000 live births. For Black women it was almost 70. The Commonwealth Fund has identified 23 practices that some states are implementing to improve maternal health.that improve maternal health.
They are at this link https://www.commonwealthfund.org/blog/2023/state-policy-trends-improve-perinatal-health-outcomes?
I want you to make sure that important services are covered. These include long postpartum care, treat postpartum depression, cover doulas, and cover long acting reversible contraception. So please enact legislation so that every health insurance policy covers those.
The most important recommendation was making sure that women have health insurance. You can do that with Universal Healthcare like HR 3421. Thank you.”
RESOURCES
Healthcare Advocacy (Us)
Website
Our Newsletter resources including reproductive healthcare
Healthcare Advocacy Reading List
Find My Elected Officials
Contact the White House https://www.whitehouse.gov/contact/
Contact State and Federal Representatives
By phone: (202) 224-3121
By email: democracy.io
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Program
One Payer States
Healthcare Now
Reproductive Health
NARAL - Pro Choice America
Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision
Appeal/Negotiate a Hospital Bill
Disinformation Management
Cybersecurity Infrastructure Security Agency
Save Democracy
Chop Wood, Carry Water by Jessica Cravens
RESISTBOT
Link to the RESISTBOT site to learn more
Link to Chop Wood, Carry Water RESISTBOT write up
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