Across the U.S., programs at all levels of government — federal, state and local — are striving to reduce maternal mortality and erase the racial gap.
Many are making headway in their communities and paving the way for other places.
The Associated Press examined efforts that are focused on individual patient needs and efforts seeking to improve medical care generally. Here are key takeaways.
Healthy Start is a federal program that has worked with vulnerable populations for decades. This year, the federal government gave out $105 million in grants to fund local projects. Officials say it's essential part of the Biden administration’s plan for addressing maternal health.
It “manages women through their pregnancy,” said Corrina Jackson, who heads up a local Healthy Start project in Tulsa, Oklahoma. “You try to get them in their first trimester and then work with them to delivery day, and then we also work with the babies to make sure that they reach their milestones.”
Healthy Start programs coordinate prenatal and postpartum care, as well as educate moms on health and parenting; provide referrals to services for things like depression or domestic violence; and help with transportation.
In Jackson’s more than 25-year tenure in Tulsa, she said there have been no maternal deaths among clients. The maternal death rate for Oklahoma as a whole, meanwhile, is currently higher than the national average.
California, by contrast, has the lowest maternal mortality in the nation at 10.5 per 100,000 live births. That wasn’t the case before it created a “maternal quality care collaborative” in 2006.
The partnership founded at Stanford University’s medical school brings together people from every hospital with a maternity unit to share best practices on problems that could lead to maternal injury or death, such as high blood pressure, cardiovascular disease and sepsis.
“When you look at the rate of maternal death in the United States compared to California, they basically ran neck-and-neck until it was established,” said Dr. Amanda Williams, clinical innovation adviser for the collaborative. “At that time they totally separated and California started going down. The rest of the country started going up.”
The hospitals get toolkits that describe what to do, how to set up medical teams and what supplies to keep on the unit. The collaborative also looks to improve obstetric care by integrating midwives and doulas — whose services are covered by the state’s Medicaid program.
New York City has a goal of reducing maternal mortality overall and achieving a 10% drop in Black maternal mortality by 2030. The city is targeting low-income residents, those living in public housing and others with its New Family Home Visits Initiative, which supports pregnant and new parents by offering visits from nurses, midwives, doulas and lactation consultants.
Jackson’s Healthy Start project in Tulsa is also grounded in her community. She and her staff understand the lingering effects of the city’s 1921 race massacre, which is estimated to have killed 100-300 people and destroyed homes, churches, schools and businesses. Jackson said all sorts of health disparities persist, and added that many Black women also distrust the health care system, so being relatable is valuable.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.