Maternal health

Study finds fewer post-partum hospitalizations in Medicaid expansion states

States that expanded Medicaid under the Affordable Care Act (ACA) saw a 17% drop in hospitalizations among women during the first 60 days postpartum, new research shows (Source: “Medicaid expansion linked with fewer postpartum hospitalizations: research,” The Hill, Jan. 11).

According to a study published in the journal Health Affairs, states with expanded Medicaid coverage for residents with lower incomes saw a 17% drop in post-partum hospitalization within the first 60 days.

Expansion states included in the study were Iowa, Maryland, New Mexico and Washington. Rates were compared with non-expansion states Florida, Georgia, Mississippi and Utah.

Currently, 40 states (including Ohio) and Washington D.C., have expanded Medicaid under the ACA. Much of the Southeast region of the country continues to hold out on adoption, along with Texas, Kansas, Wyoming and Wisconsin.


DeWine announces plans to prioritize mental health services in second term

Gov. Mike DeWine, who just won his bid for re-election, said he’s going to focus on improving the physical and mental well-being of Ohioans in his second term in office (Source: “DeWine's plans for improving mental health services in Ohio includes paid internships,” Statehouse News Bureau, Nov. 30).

At an Ohio Chamber of Commerce event focusing on health care Wednesday morning, DeWine said his office is working with lawmakers in three key areas during his second term.

“One, growing our behavioral health force so it is the most robust in this country. Two, leading the nation in mental health research and innovation. And three, providing Ohioans with the best access to behavioral health care in this country," DeWine said.

DeWine wants the state to invest more in high school workforce programs and he wants to invest $85 million dollars in federal funds to pay students for internships and residencies for those who are studying to work in these areas at Ohio's universities.

DeWine said he wants the state to do a landmark study on mental health barriers. That information can then be used to come up with ways to break those barriers down. He also said he wants to build a statewide center of innovation for behavioral health along with increasing research capacity for Ohio’s universities. DeWine said these changes would make mental and behavioral health services more accessible for Ohioans.


Pregnancy complications worse among Black women in Ohio, data shows

Urban centers are seeing the highest rates of pregnancy complications for Ohio women, followed by Appalachia, with Black women being impacted the most, a report from HPIO found (Source: “Severe pregnancy complications are affecting Black women in Ohio the most,” Ohio Capital Journal, Nov. 28).

The brief, Racial and Geographic Disparities in Maternal Morbidity and Mortality, points to systemic racism, a lack of health care access and poor community conditions as reasons for the disparities.

Not only are there disparities in general maternal health, but also in maternal morbidity: severe complications that happen during or after labor and delivery that can lead to other major health problems, including hysterectomy or the need for a blood transfusion, according to the brief.


Graphic of the week

MaternalMorbidity_Fig3_Standalone

Analysis by HPIO earlier this year found that stark differences in maternal health outcomes signal that not everyone has what they need to live a healthy life before, during and after pregnancy.

The graphic above, from the HPIO fact sheet “Racial and Geographic Disparities in Maternal Morbidity and Mortality,” shows urban and Appalachian counties have the highest rates of maternal morbidity in Ohio. Additionally, across both urban and Appalachian counties, Black mothers have the highest rates of maternal morbidity

According to the fact sheet, “High maternal morbidity and mortality rates are preventable. State and local policymakers have many options to address racism and discrimination, inequitable community conditions, toxic stress and poor prenatal care access.”


Graphic of the week

MHTreatment_UnmetNeed_HPIOStandalone
Last week, the Health Policy Institute of Ohio released a new Data Snapshot detailing trends in mental health among Ohioans.

Among the data findings in the Snapshot are that while Ohioans receive mental health treatment at rates higher than the U.S., one in four Ohio adults report they did not receive mental health care (as displayed in the graphic above).

The Snapshot also includes data that shows the percent of Ohio adults reporting frequent poor mental days increased 20% from 2011 to 2020 (click for news coverage from Ohio Capital Journal).

 

The new HPIO Data Snapshot includes visualizations on mental health prevalence and trends in Ohio (frequent poor mental health days and depression), access to mental health care and quality and trends in suicide in Ohio. It also includes a list of resources to improve mental health in Ohio. 

If you would like to feature graphics from this publication in your own work, visit 


Four of five pregnancy-related deaths are preventable, CDC finds

Eighty percent of pregnancy-related deaths, including those caused by opioid overdose, excessive bleeding, heart problems and infections, are preventable, according to a new federal report (Source: “Majority of pregnancy-related deaths can be prevented, CDC says,” WKSU radio via WOSU, Sept. 27).

According to the report from the Centers for Disease Control and Prevention, the leading underlying cause of death varied by race and ethnicity. Cardiac and coronary conditions were the leading underlying cause of pregnancy-related deaths among non-Hispanic Black people, mental health conditions were the leading underlying cause for Hispanic and non-Hispanic White people, and hemorrhage was the leading underlying cause for non-Hispanic Asian people.

Earlier this year, the CDC released a report highlighting evidence-informed state strategies for preventing pregnancy-related deaths.


CMS approves Ohio Medicaid coverage extension for new moms

Federal officials have approved Ohio Medicaid’s plan to extend benefits for new mothers from 60 days to 12 months after the birth of their child (Source: “Ohio Medicaid extends postpartum coverage for new mothers,” Dayton Daily News, Aug. 17).

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services (CMS), on Tuesday approved the state’s request to extend the coverage.

“Maternal health is a strong predictor of a child’s health, so by extending health coverage for new moms, we are helping to provide the healthiest possible start in life for Ohio’s children,” said Gov. Mike DeWine.

The American Rescue Plan Act (ARPA) provided the option for states to expand this Medicaid coverage for new moms from 60 days to 12 months. The state of Ohio’s budget included this expanded coverage in its portion of Medicaid funding. DeWine said the state of Ohio began this extended coverage on April 1 and CMS’s final approval is the last step to continuing those services.


Graphic of the week

MaternalMorbidity_Fig3_Standalone
Click to enlarge

Recent analysis by HPIO has found that stark differences in maternal health outcomes signal that not everyone has what they need to live a healthy life before, during and after pregnancy.

The graphic above, from the HPIO fact sheet “Racial and Geographic Disparities in Maternal Morbidity and Mortality,” shows urban and Appalachian counties have the highest rates of maternal morbidity in Ohio. Additionally, across both urban and Appalachian counties, Black mothers have the highest rates of maternal morbidity

According the fact sheet, “High maternal morbidity and mortality rates are preventable. State and local policymakers have many options to address racism and discrimination, inequitable community conditions, toxic stress and poor prenatal care access.”


Walmart expands doula services for employees to address racial disparities in birth outcomes

Walmart is expanding health care coverage for employees who want to enlist the services of a doula, a person trained to assist women during pregnancies, to address racial inequities in maternal care (Source: “Walmart expands health services to address racial inequality,” Associated Press, June 22).

After first offering doulas to employees in Georgia last year, the nation’s largest retailer said Wednesday that it will expand the same benefit to its employees in Louisiana, Indiana and Illinois.

Black women are three times more likely to die from a pregnancy-related cause than white women, largely due to differences in the quality of health care, underlying chronic conditions and structural racism, according to the Centers for Disease Control and Prevention. Employing a doula as a part of a birthing team decreases C-sections by 50%, shortens the time of labor by 25% and decreases the need for other medical interventions by more than 50%, according to the National Black Doulas Association.

Earlier this month, the Ohio House passed a bill that would provide Medicaid coverage for licensed doula services. (Source: “Doula services could soon be covered by Medicaid after racial equity bill passes Ohio House,” Ohio Capital Journal, June 9).


Ohio House approves Medicaid coverage of doulas in attempt to address racial disparities

A bill that is aiming to combat racial disparities in infant and maternal mortality rates passed the Ohio House during a session Wednesday (Source: “Doula services could soon be covered by Medicaid after racial equity bill passes Ohio House,” Ohio Capital Journal, June 9).

House Bill 142 would provide Medicaid coverage for licensed doula services.

Between 2008 and 2017, Black women died during birth about two and a half times more than white women, according to the Ohio Department of Health. Black women also have twice the amount of birth complications, which ODH data show cannot be attributed to factors such as the pregnant person’s income, education, marital status, tobacco/ alcohol use and insurance coverage.

Doulas “can save lives,” said Dorian Wingard, partner and COO of Restoring Our Own Through Transformation (ROOTT), an organization dedicated to addressing the needs of women of color. “They can prevent the death of mothers, they can prevent the death of children.”

Doula services can also result in lower rates of preterm births, as well as help save money for families, according to Wingard.

Republican state Rep. Tom Brinkman, one of the bill’s sponsors, said he convinced his fellow Republicans to vote for the bill by explaining that it could allow Ohio to save money, since doula services lead to fewer preterm births, which are expensive for the state.

“The hardest thing was to talk to my colleagues and say, ‘look, we are going to expand Medicaid, which we don’t necessarily want to do because we’re trying to restrain costs, but what it’s going to do is result in overall savings because we won’t be paying for [as many complications],” Brinkman said.