Michelle Winokur, DrPH, and the AfPA Governmental Affairs Team, Alliance for Patient Access (AfPA) 

Pregnancy-related mortality is one of those issues. Native American moms are dying at more than twice the rate of their white counterparts. Black moms are three times more likely to die than white moms. (3) 

The Black Maternal Health Momnibus Act of 2021 

In February, the Black Maternal Health Caucus of the U.S. House of Representatives introduced the Black Maternal Health Momnibus Act of 2021. (4) The package includes 12 bills that collectively “address every dimension of the maternal health crisis in the United States.” Vaccines, social determinants of health, mental health care, and the perinatal workforce are among the topics of individual bills. 

More than 190 organizations have declared their support for the legislative Mominibus. Proponents include the Association of Women’s Health, Obstetric and Neonatal Nurses, among others. 

“These bills align with our agenda of reducing maternal morbidity and mortality, improving the health status of women, addressing racial health disparities and structural and social determinants of health, and resolving health inequities contributing to these issues,” declared Cyndy Krening, MS, the association’s president. 

The Rural Maternal and Obstetric Modernization of Services Act 

Also, in February, Representatives Dan Newhouse (R-WA) and Cindy Axne (D-IA) led another group of lawmakers in refiling the Rural Maternal and Obstetric Modernization of Services Act.(5) The legislation extends support to rural moms, who are experiencing inequitable maternal mortality rates, too. 

“Rural areas have a maternal mortality rate that is 38% higher than urban area,” according to a one-pager from the bill’s sponsors.(6) It also noted that maternal health care’s disappearance in rural America disproportionately affects people of color. (7) 

These outcomes are driven, in part, by the shortage of health care providers and the lack of access to labor and delivery hospital services in remote areas. (8) Financial strain has forced many rural hospitals to close their labor and delivery units or shutter their entire facility. This forces expectant and new moms to travel great distances to get quality maternal health care. Ten to 40% do not keep a postpartum appointment in part because of geographic isolation or limited transportation. (9) 

The Rural MOMS Act aims to address these access challenges by expanding existing federal telehealth grant programs to include birth and postpartum services. It will also establish a rural maternal and obstetric care training demonstration to provide maternal care services in rural community-based settings. 

The United States posts the highest maternal mortality rates in the developed world. (10) It is even more disturbing that the vast majority of these deaths are preventable. Now, an enthusiastic new Congress appears committed to addressing the drivers of this unfortunate and rising trend. As Representative Alma Adams (D-NC) declared, “Black mamas can’t afford to wait.” 

References 

1. https://www.pewresearch.org/fact-tank/2021/01/28/racial-ethnic-diversity-increases-yet-again-with-the-117th-congress/ 
2. https://www.pewresearch.org/fact-tank/2021/01/15/a-record-number-of-women-are-serving-in-the-117th-congress/ 
3. https://www.cdc.gov/reproductivehealth/maternal-mortality/ pregnancy-mortality-surveillance-system.htm?CDC_AA_ refVal=https%3A%2F%2Fwww.cdc.gov%2Freproductivehealth%2Fmaternalinfanthealth%2Fpregnancy-mortality-surveillance-system.htm 
4. https://blackmaternalhealthcaucus-underwood.house.gov/Momnibus 
5. https://newhouse.house.gov/media-center/press-releases/newhouse-axne-introduce-bill-improve-healthcare-access-outcomes-new-and 
6. https://newhouse.house.gov/sites/newhouse.house.gov/ files/Rural%20MOMS%20One%20Pager.pdf 
7. https://ccf.georgetown.edu/2020/06/12/rural-disparities-racial-disparities-and-maternal-health-crisis-call-out-for-solutions/ 
8. https://www.pewtrusts.org/en/research-and-analysis/articles/2020/02/25/child-and-maternal-health-in-rural-areas-lags-the-nation-highlighting-barriers-to-access 
9. https://www.pewtrusts.org/en/research-and-analysis/articles/2020/02/25/child-and-maternal-health-in-rural-areas-lags-the-nation-highlighting-barriers-to-access 
10. https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries#:~:text=Key%20Findings%3A%20 The%20U.S.%20has,and%20midwives)%20relative%20 to%20births.