During Black Maternal Health Week, the news that Illinois became the first state to extend Medicaid coverage from the former standard of 60 days postpartum to now 12 months postpartum marks a major victory for women of childbearing age, especially women of color. In Illinois alone, Black women are six times more likely to die of pregnancy-related conditions when compared to their white counterparts. This extended period of coverage is critical for preventing and treating the myriad of conditions that may not manifest themselves early on during any phase of the childbearing experience. While pregnancy-related deaths could occur anytime during a pregnancy, the majority of pregnancy-related life-threatening conditions and deaths occur one week up until one year post-delivery. Thus, this lifesaving legislation supports early identification, intervention, and access to care in the event a mother experiences precursors of or sudden life-threatening conditions such as hemorrhage, stroke, infection, heart disease, and others.
The United States has the worst rates of maternal mortality in the developed world. Maternal death rates are double that of countries such as Australia, Switzerland, or the United Kingdom, to name a few. Sadly, according to the Center for Disease Control and Prevention, approximately 700 women die each year in the USA due to a number of pregnancy or delivery complications. Black women are 3 to 4 times more likely to die from pregnancy-related causes compared to white women. In a country known for its excess spending on health care, it is unacceptable that American women and women of color are losing their lives during pregnancy, childbirth, and during the postpartum period.
As health care providers committed to eliminating health disparities, we are heartened that women residing in Illinois will benefit from such lifesaving legislation. However, this sorely needed response to the maternal crisis must be coupled with improved access to safe, equitable, and trusted maternal care. Identifying and addressing the intersections of inequitable systems, maternity care deserts, and support for social needs are critical to ensuring the protection of pregnant and postpartum women and their infants from tragic yet preventable outcomes.
The loss of a mother is a void indescribable – for her infant, her family, and her community. This we know and feel intuitively. But our society would calculate this in wages lost, and whether that is offset by the costs of prevention and access to care. We take for granted when mothers survive and then carry on the life’s work of mothering. We forget to place value on it. We must feel intuitively and place the just value of gaining a mother – a stabilizing center for her infant, family, and community, a generational value that is propagated long into the future.
From a national perspective, we need federal legislation that will incentivize other states to follow suit like Illinois. While some states are considering similar legislation, there is an urgent need to find solutions to our maternal crisis now.
Having access to essential maternal health care coverage during a very vulnerable time is a human right. Our commitment to saving our mothers and babies should always be the right thing to do. The data are clear that we need to save the lives of mothers now. We must remain vigilant in ensuring that all mothers can benefit from the extended essential maternal health care coverage. Until this gap in maternal care coverage is eliminated, our efforts will be akin to taking baby steps. Important but not enough.
Janice Phillips is a public health advocate. Gina Lowell is a pediatrician.
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