Years of Inaction and Thousands of Deaths Later, Congress Finally Addresses Maternal Mortality

By Amanda Michelle Gomez, ThinkProgress

26 April 18

Congressional committee to vote on bill that asks states to better collect maternal data, but advocates say it shouldn't be lawmakers' only response to a public crisis.

ach year about 700 to 900 mothers die, and thousands more nearly die, due to pregnancy or childbirth complications, many of which are preventable — and this year, there’s finally appetite among lawmakers to do something about it.  

The Senate Health committee will vote on a bill next month that addresses the country’s soaring maternal mortality rate, Sen. Patty Murray (D-WA) announced on Tuesday. Congress has never passed legislation directly focused on this public health crisis before. The bill that’s being marked up in May was introduced by Sen. Heidi Heitkamp (D-ND) nearly a year ago, and never pass through hearing or markup, despite bipartisan support. 

“We are wildly excited,” said Dr. Ginger Breedlove, founding president of March for Moms, a multi-stakeholder coalition lobbying for action on the issue. “It’s long overdue that we respond to the crisis and try to implement best practices.” The vote is expected to coincide with a March for Moms rally in Washington D.C. and congressional briefing on maternal health, she said, as to further encourage lawmakers to act.

Historically, bills like Heitkamp’s Maternal Health Accountability Act have been sidelined. Bill, after bill, after bill has been introduced, but gets stuck. One such bill aims to officially recognize “Black Maternal Health Week” to bring public awareness to the toll of racism on maternal health, as Black mothers are three to four times more likely to die from pregnancy-related causes than white mothers. “Why are politicians ignoring this Maternal Health Act?” asked maternal health advocate Timoria McQueen in 2014. Perhaps, they won’t anymore.

Instead of moving on policy to curb the country’s maternal mortality rate — the worst in the developed world — national lawmakers have moved in the other direction. The Trump administration has yet to fulfill a campaign promise to provide six weeks of maternity leave to any mom who needs it, but has made it easier for insurers to sell health plans that provide no maternity care. And Republican lawmakers on Capitol Hill spent nearly all of last year trying to pass legislation that drastically cuts Medicaid, insurance that finances nearly half of all U.S. births.

Breedlove — who has worked on maternal health issues for 40 years — believes this time is different, and that what’s driving action is increased education and ProPublica/NPR’s Lost Mothers initiative. Now that lawmakers are finally understanding the severity of the maternal death rate, stakeholders are hoping national lawmakers do three things.

The first — which Heitkamp’s bill addresses — is to fix the dearth state of maternal data. It’s pretty egregious: the National Center for Health Statistics hasn’t officially published a maternal mortality rate since 2007. The Maternal Health Accountability Act aims to create a grant program for states to establish maternal mortality review committees or sustain and improve existing ones.

These committees are a group of hospital administrators, doctors, nurses, and midwives who volunteer their time to identify and detail root causes. And when states actually take the recommendations of these committees, as was the case in California, they’ll see positive results. Roughly half of states nationwide created a committee, but not every state that implemented one has found success — at least not yet.

“[The bill] pushes states like Georgia that implemented committees but basically have done nothing,” said Breedlove. “It puts a little pressure to not just have them, but be accountable and transparent.” 

Advocates are also hoping the Senate moves on a House-passed bill introduced in January 2017. The Improving Access to Maternity Care Act requires the federal government to identify areas where there’s maternity care professional shortages — something already done for other health services, like hospitals or long-term care.

An admittedly more ambitious goal is to get lawmakers to act on national paid parental leave. For decades, the United Nations called on countries to have at least 14 weeks paid maternity leave, and out of 193 UN countries, only a small handful failed to establish national paid parental leave law, including the United States.

Evidence on how paid time off for new parents improves health is still emerging, but the goal is to reduce parental stress that could adversely affect moms and kids. “For mothers who worked prior to childbirth and who return to work in the first year, having less than 12 weeks of maternal leave and having less than 8 weeks of paid maternal leave are both associated with increases in depressive symptoms, and having less than 8 weeks of paid leave is associated with a reduction in overall health status,” according to a recent study.