If a global pandemic makes any lasting, collective change, I personally really hope it has to do with health care, and specifically, the cost of health care and the impossibility of access here in the United States. No matter how hard certain people (Republicans) don’t want to acknowledge it, the pandemic has highlighted all of the ways our country is behind when it comes to basic rights, protections, and opportunities, whether that’s linked to affordable child care, paid sick leave, or (gasp) affordable, safe, accessible health care for all.
With this in mind, though, it’s important to remember that we have more than one pubic health crisis at play here in the U.S. As Vice President Kamala Harris marked on Tuesday, Dec. 7, for example, reforming and centering maternal health in the U.S. is an “urgent” challenge. She’s introducing the very first White House Maternal Health Day of Action, attempting to rally both public and private sectors in a nationwide action, and the overall push for the Senate to pass the Build Back Better Plan ASAP.
"In the United States of America, in the 21st century, being pregnant and giving birth should not carry such great risk," Harris stated during her opening remarks in Washington, D.C., noting that pregnant people die not only during childbirth but both before and after. Harris went on to describe maternal mortality and morbidity as a “serious crisis” that affects both public health and the economy.
If you’re thinking serious crisis, really? The answer is, yes, really! And in fact, things in the U.S. have gotten worse in the last few decades. As of today, we have the highest maternal mortality rate of any nation of similar wealth in the entire world. Put another way, this means that more people in the U.S. die of pregnancy-related causes (whether during the birth itself or after birth) than any other country of similar income. So yes, a true crisis.
“Mothers are the backbone of our economy, and their children are the future of our economy," Harris continued. Harris also acknowledged—very importantly—that this issue is not one size fits all. Disturbingly, pregnant people of color—specifically Black and Native pregnant people—are more likely to suffer from systemic inequities even in childbirth and maternal health care, potentially leading them to be mistreated or unsupported during childbirth. And as we know, racial bias in medicine can literally be deadly.
As Harris said, Black pregnant people are three times more likely to die from pregnancy-related complications, and Native pregnant people are twice as likely. Harris also pointed out that pregnant people in rural areas are about 60% more likely to die from pregnancy-related complications than pregnant people in urban areas.
“When it comes to pregnancy and childbirth, these systemic inequities can be a matter of life and death,” Harris said, adding that a “healthy economy” requires healthy pregnant people “and healthy babies.”
So, what can be done? Well, once passed, the idea is that Build Back Better (once passed by the Senate, that is) will offer some extremely important provisions for maternal health. For example, all states will have to offer continuous Medicaid coverage for a full year postpartum, which is important because gaps in health insurance or coverage can have potentially life-threatening ramifications for people who have given birth. This sort of health care could include, for example, vaccines, pelvic exams, and screening for postpartum depression. Right now, the standard is only two months of continued coverage, so the jump to a full year is a big and necessary step.
The biggest-picture change includes investing more than $3 billion to improve data collection, monitor maternal health risks, coordinate better care, more widely promote relevant health research, and (in my opinion) most importantly, invest in funds to address substance use disorders and challenges that impact maternal health.
The White House fact sheet also describes an “innovation” in allowing states to create “maternal health homes” to “better coordinate” care for birthing people before, during, and after birth. I can’t say there are a lot of details on what that would look like in practice, but I’m definitely intrigued and encouraged by the idea. There will also be new designations for “birth-friendly” hospitals, as well as offering new support to underappreciated health care workers like doulas.
As a note, while the action is called the Maternal Health Day of Action, I made an effort to use gender-inclusive language throughout this piece, which is why you’ll see references both to maternal health, for example, as well as pregnant people or birthing people. Nonbinary people and trans men absolutely can (and do!) become pregnant and give birth, and are absolutely at risk of the same issues as pregnant women, if not even more, due to systemic transphobia in medicine.
If you’re interested in learning more about a pregnant person’s experience with pregnancy, birth, and parenting who isn’t a woman, I really recommend checking out an interview I did with author Krys Malcolm Belc about their memoir, The Natural Mother of the Child.
Sign the petition: Demand lawmakers address Black maternal mortality by providing Black families accessible, quality health care.
You can watch the address Harris gave below.