Darby O’Donnell, JD

Before Congress adjourned for the end of the year and the close of their 115th session, significant legislation to address maternal health care gaps was passed and signed into law by President Donald Trump.

The Improving Access to Maternity Care Act (H.R. 315/ S. 783) was authored by U.S. House Energy and Commerce Health Subcommittee Chairman Michael Burgess (R-Texas), an OB/GYN for nearly three decades in North Texas.

Safety and quality of healthcare for expectant women were the policy focus of this legislation. In addition, delivering adequate health care to women regardless of zip code was a key consideration in the bill’s development.

According to talking points in support of the legislation released from Senator Tammy Baldwin’s (D-WI) office:

• Every year, 1 million babies are born to mothers who did not receive adequate prenatal care.
• Babies born to mothers who received no prenatal care are three times more likely to be low birth weight and five times more likely to die than babies whose mothers received prenatal care.

The Improving Access to Maternity Care Act directs the Health Resources and Services Administration (HRSA) to identify areas where there are maternity care shortage areas, so that maternity health care professionals may be assigned to those target areas. HRSA is also required by the act to collect and publish data on the need for maternity health care within the designated shortage areas.

For purposes of the bill “maternity care health services” includes those during labor care, birthing, prenatal care, and postpartum care.

The bipartisan legislation was endorsed by the American Congress of Obstetricians and Gynecologists (ACOG), the American College of Nurse-Midwives (ACNM), the March of Dimes, and the National Rural Health Association (NRHA).

The National Rural Health Association described the need for this legislation within the context of a growing rate of rural hospitals without any obstetrics care or lack of an obstetrics unit. The association posted, “Today, more than half of rural counties have no hospital-based obstetrics services, and the most vulnerable communities – those who are low-income, minority, remote – experience the most damaging impact. When the distance to maternity care is directly correlated with outcomes, this care shortage has a devastating effect on the health of both the mother and the infant.” One Senate cosponsor of the bill, Senator Sherrod Brown (D-OH) described his reasons for support as such: ”Healthy pregnancies lead to healthy babies, and no mother-to-be should go without the care she needs.”

With the passage of this legislation, proponents are hopeful the federal government may address workforce shortages in rural America and improve health outcomes for both mothers and children through better geographic distribution of maternity care resources.