While maternal mortality rates decline across other developed nations, the maternal mortality rate in the United States continues to rise — despite outpacing all other countries on health care spending per person.
In fact, more women die from pregnancy-related conditions in the U.S. than in any other developed country, according to the American College of Obstetricians and Gynecologists; about half are preventable.
This spring Illinois Congresswoman Robin Kelly and Senator Dick Durbin are proposing the "Mothers and Offspring Mortality and Morbidity Awareness" (MOMMA's) Act in the House and Senate, respectively, with the goal of improving maternal and postpartum care across the nation, and especially to address the persistent gap between Black and white mothers.
"It happens to African-American women three to four times as much across the United States than it happens to white women. In the state of Illinois, it's six times the rate," said Kelly, who is part of the Congressional Caucus on Black Women and Girls as well as the Congressional Black Caucus Health Braintrust.
"This should not be happening in the richest country in the history of the world, that moms die from having babies," she said. "That is crazy."
The bill intends to standardize data collection on maternal mortality rates nationwide by creating review committees to uniformly track maternal deaths; expand Medicaid coverage for postpartum care to a year instead of the current two months; ensure collaborative best practices between hospital systems and physicians; ensure maternal care is as prioritized as infant care at accredited hospitals; and improve access to culturally competent care.
It's the second time that Kelly and Durbin have worked together on this subject; they proposed the same bills to Congress last year, but did not gain enough traction. Kelly, who represents parts of Chicago's southern suburbs and central Illinois, said she hopes that election gains for Democrats in the House will help push the bill and gain bipartisan support. She said she and Durbin hope the MOMMA's Act can pass by Mother's Day.
City Bureau spoke with Kelly about the MOMMA's Act and its potential impact.
What is the MOMMA's Act and why is it important?
Unfortunately in the United States 700 women a year die [from pregnancy-related issues]. It would've been safer to have a baby 25 years ago than it is now, which is kind of hard to believe. You can be rich, you can be well-educated, you can be in good shape, it'll still happen. So what we're trying to figure out is why this happens. There is no complete answer, so we're trying to figure out through this legislation of data collection, creating review committees—Philadelphia put a review committee in place and [maternal] deaths went down 75 percent—and putting in place culturally competent care.
You introduced the MOMMA Act last May and it didn't pass. What are its chances this year?
The response in the House was good but of course we were in the minority, but now we're in the majority and there's even more of a [positive] response. It's not a red or blue thing or a Republican or Democrat thing, it's about women. All women.
What other groups and people are in support of this bill?
The March of Dimes, the American College of Obstetricians and Gynecologists, Black Mamas Matter Alliance, Black Women's Health Imperative, and Heidi Murkoff, the author of What to Expect When You're Expecting.
Doulas and midwives aren't often covered by insurance companies, though some say they are keys to helping Black mothers overcome racial biases in the health system. Have any organizations suggested doulas and midwives to support Black women's maternal health?
Doulas are a part of it. That's something health care organizations we've worked with think is important also. It's something we definitely will push for. The OB-GYNs I was with, they were comfortable with that idea.
Earlier you mentioned the importance of Black women physicians and nurses to care for Black women patients. How does the legislation address this?
It's hiring practices, and the other thing is we have to start from a young age to get our young people interested in STEM [Science, Technology, Engineering, Math] careers so they do become radiologists or nurses or nurse's aides. It doesn't just start from now, because there's not enough [women physicians of color] to go around, depending on where you are. In the state of Washington a doctor said that Native American women die 8 to 1 times compared to white women in pregnancy-related deaths.
You and Sen. Durbin have called for bipartisan support on this bill. What responses are you receiving across the aisle?
Medicaid expansion will cause some issues or might be a challenge [for Republicans], but we're hoping that people come around. When Congresswoman Jaime Herrera Beutler (R-Wash.) had her [Preventing Maternal Deaths] bill, which was more of a first-step act in this arena, it was bipartisan. I signed on and did what I could to help pass the bill, so I'm hoping the favor is returned because this [bill] will take it another step further. [Note: Herrera Beutler's bill pushed for review committees but did not include provisions for expanded Medicaid coverage or culturally competent care.]
Is there anything else you'd like to add?
We think it's a good bill, we think it's very important for the bill to pass. As we say, every mother deserves a chance to be a mom.
Want more info about maternal and infant health? "The Cord: Resources for Modern Mamas" is a free text-message service from City Bureau reporters about pregnancy and motherhood on the West Side. Sign up at http://bit.ly/thecordtext
This report was produced by City Bureau, a civic journalism lab. www.citybureau.org
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