Build Back Better: Improving Maternal & Infant Health DisparitiesLeave a Comment
President Joe Biden announced his Build Back Better Framework, a plan that introduces the most transformative investments in children and caregiving in generations. The Build Back Better Framework addresses climate change, expands affordable health care, and strengthens family economic security. December 7, 2021 marked the first-ever White House Maternal Day of Action.
The United States of America has the highest maternal mortality rates in the developed world. Black women are more than three times as likely to die from pregnancy related complications than White women and Indigenous women are more than twice as likely, regardless of their income or education to die from pregnancy related complications. Pregnant women who reside in rural communities are approximately 60 percent more likely to die before, during, or following birth than women in urban communities.
According to data from the Virginia Office of Health Statistics, the rate of fetal death in Virginia in 2019 was 7.6 fetal deaths per every 1,000 live births, which is the lowest it has been since 2015. From 2016-2020, there were a total of 2,723 infant deaths in Virginia. The Center for Disease Control (CDC) estimates that the infant mortality rate in Virginia is 5.8 infant deaths per 1,000 live births. Despite lower numbers of fetal deaths, Virginia continues to struggle to decrease disparities for non-White women and infants.
March of Dimes reported that from 2016-2018, the infant mortality rate for Black infants in Virginia was 9.5 per 1,000 live births as compared to White infants at 4.8 per 1,000 births. According to our Voices’ Racial Truth & Reconciliation Virginia equity impact statement, in 2018, Black women died two and a half times more often than White women. Additionally, non-White and non-Black women experience higher natural fetal death rates 1.5 times higher than their counterparts according to the Virginia Division of Health Statistics.
Build Back Better (BBB) includes a historic investment of $3 billion dollars in maternal health. $175 million in funding is included in BBB to address social determinants of maternal health ranging from housing and nutrition to environmental conditions. Additionally, the Black Maternal Health Momnibus Act includes innovative payment models for non-clinical perinatal support, data collection and quality measure processes, and the investment in digital tools to improve outcomes.
Once passed, the BBB Act’s policy investments could include:
Expanding Postpartum Medicaid Coverage: Currently, states are only required to provide 60 days postpartum coverage through their Medicaid programs, despite research that shows many deaths occur past the 60 days postpartum period. Build Back Better encourages states to pursue a path presented through the American Rescue Plan to provide 12 months of continuous postpartum coverage. If every state adopted the postpartum extension in BBB, the number of Americans gaining access to a full year postpartum coverage would double, extending coverage to approximately 720,000 people.
Create a new designation of Birthing Friendly Hospital: The Center for Medicaid and Medicare Services plans to propose the “Birthing-Friendly” hospital designation, which would be awarded to hospitals that participate in collaborative programs to improve maternal outcomes and patient safety practices. This designation would be reflected on the “Care Compare” website so that consumers are able to choose the hospital with the most implemented best practices.
Diversifying Perinatal Workforce: $295 million of funding in BBB is targeted to investing in a diverse perinatal workforce and better coordinated care. The funding proposed in Build Back Better would:
- Provide over 92,000 perinatal nursing students with loans, scholarships, and programmatic support over a ten-year period.
- Additionally, it would provide approximately 30,000 doulas in training with loans, scholarships, and programmatic support over a ten-year period.
- Provide over 42,000+ individuals training in maternal mental health or substance use treatment with loans, scholarships, and programmatic support over a ten-year-period.
Resources for Community-Based Organizations: Allows states to establish maternal health home to better coordinate health care for individuals before, during, and after birth. This also includes training to decrease biases. Build Back Better provides $75 million for community-based organizations working to promote maternal health equity.
Each year, thousands of women are susceptible to the maternal health crises, which has worsened across two decades, even as rates improve among peer nations. The bill would make investments in improving racial disparities in maternal health outcomes through the investments in the Black Maternal Health Momnibus. Children need healthy parents and caregivers to thrive.
We urge the Congress to swiftly act on BBB. Take action here to contact your representative and encourage them to support BBB.