'Maternal mortality, particularly for Black mothers, is a national emergency.' 📝 Kathleen Sebelius and Tommy Thompson
This emphasis on acute care is reflected in provider staffing and training that elevates the role of specialists, payment plans that don’t cover a full continuum of ancillary services, and regulatory structures that prioritize the needs of the hospital rather than of the patients. The result is a system that is failing parents and their babies.
That said, there are evidence-based alternatives that actually work. Midwives, who are far more common outside the U.S., can provide a host of prenatal and delivery services while staying vigilant to the possible need for interventionist obstetrical care. Community health workers, doulas, and other providers skilled at integrating family and social supports with appropriate healthcare also belong in the prenatal to post-partum continuum.
None of this will adequately reduce the toll of maternal mortality unless it is accompanied by affordable insurance that covers community-based services, guarantees continuity of care, and addresses the chronic medical and social conditions that often cause the greatest harms.
The national emergency of maternal mortality demands a multi-pronged response, and healthcare systems, third-party payers, regulators, accrediting organizations, and employers can all help by shifting care into the community. Populations capable of becoming pregnant should be integrated into any redesign effort and supported with adequate funding and training. Moreover, it is especially important to imbue organizations that serve Black women with the authority to lead.
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