Maternal health

Graphic of the week

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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.


Graphic of the week

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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 fact sheet HPIO released last month titled “Racial and Geographic Disparities in Maternal Morbidity and Mortality,” shows that the severe maternal morbidity rate for Black, non-Hispanic mothers in Ohio was 1.85 times higher than the rate for white women in 2019. Asian, non-Hispanic mothers also have a higher maternal morbidity rate than Ohio mothers overall.

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.”


Federal legislation proposed to reduce maternal deaths

The push to reduce poor maternal health outcomes has seen new momentum as federal lawmakers and Biden administration officials previewed their priorities — including reversing a rise in maternal disparities among Black women (Source; “Lawmakers, advocates hopeful for more bills to curb maternal deaths,” Roll Call, April 20).
 
The United States leads among developed nations in its poor maternal mortality rates, referring to deaths during or up to one year after childbirth. These deaths — alongside maternal morbidity, or long-term health problems arising from pregnancy or childbirth — are growing problems nationally.
 
Last week, HPIO released a fact sheet titled “Racial and geographic disparities in maternal morbidity and mortality.” The fact sheet includes an analysis of the drivers of maternal morbidity and mortality in Ohio and descriptions of what works to reduce disparities.


HPIO fact sheet explores drivers of maternal health disparities, spotlights what works to address them

The Health Policy Institute of Ohio has released a new fact sheet titled “Racial and geographic disparities in maternal morbidity and mortality.”

The fact sheet includes an analysis of the drivers of maternal morbidity and mortality in Ohio and descriptions of what works to reduce disparities.

“With collaboration from both public and private partners, it is possible to reduce severe maternal morbidity and mortality and improve health outcomes for Ohio mothers,” according to the fact sheet. “Policymakers and other stakeholders can implement evidence-based strategies to ensure that parents and babies in Ohio are healthy and thriving.”


Black women in Ohio 2.2 times more likely to die from pregnancy-related causes, data shows

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According to the most-recent data, Black women in Ohio are 2.2 times more likely to die from a cause related to pregnancy and have a 1.85 times higher rate of maternal morbidity (i.e., health problems related to pregnancy and childbirth) than white women.
 
Differences in healthcare access and conditions such as housing, transportation and income, as well as the cumulative impacts of toxic stress and discrimination, all contribute to stark disparities in maternal outcomes across the state.
 
Improving maternal health and eliminating disparities are priorities of the Ohio Department of Health’s 2020-2022 State Health Improvement Plan.
 
Next week is the fifth annual Black Maternal Health Week, an event that coincides with National Minority Health Month. As part of its annual recognition of Minority Health Month, the Ohio Commission on Minority Health has released an extensive calendar of events. Throughout the month, HPIO is releasing new data graphics exploring health disparities in the state. More information and resources about health equity in Ohio are available on HPIO’s website.
 
HPIO plans to release a fact sheet on maternal mortality and morbidity in Ohio later this month.


DeWine announces funding for housing assistance program aimed at improving birth outcomes

Gov. Mike DeWine announced this week that $2.5 million is going to the Coalition of Homelessness and Housing in Ohio “to help improve birth outcomes and reduce infant mortality by providing stable housing for low-income families” (Source: “Ohio Gov. Mike DeWine announces $2.5 million for program to help pregnant women, improve birth outcomes,” WKYC-TV (Cleveland), April 6).
 
Gov. DeWine’s office said the Housing Assistance to Improve Birth and Child Outcomes Program will assess the impact of rental assistance on factors that contribute to infant mortality. The project aims to increase housing stability of low-income households with children while improving maternal and infant health outcomes.
 
The program is an expansion of Healthy Beginnings at Home (HBAH), a housing stabilization pilot project designed to improve maternal and infant health outcomes for low-income families that launched in 2017 with funding from the Ohio Housing Finance Agency. That program, which provided 49 pregnant women in Columbus with rental assistance and other services, was implemented by CelebrateOne, a Columbus-based infant mortality prevention collaborative.
 
CelebrateOne contracted with HPIO to complete a final report summarizing the outcome and process evaluation results of HBAH. 


Maternal deaths spiked during first year of pandemic, especially for women of color

Deaths during pregnancy and the first six weeks after childbirth increased during the first year of the coronavirus pandemic, especially for Black and Hispanic women, according to a new report (Source: “Maternal Deaths Rose During the First Year of the Pandemic,” New York Times, Feb. 23).

The new National Center for Health Statistics report found that the number of maternal deaths rose 14%, to 861 in 2020 from 754 in 2019. Health officials attribute the sharp increase partly to Covid and pandemic-related disruptions.

The United States already has a much higher maternal mortality rate than other developed countries, and the increase in deaths pushes the nation’s maternal mortality rate to 23.8 deaths per 100,000 live births in 2020 from 20.1 deaths in 2019. Maternal mortality rates in developed countries have in recent years ranged from fewer than two deaths per 100,000 live births in Norway and New Zealand to just below nine deaths per 100,000 live births in France and Canada.

Black women in America experienced the most deaths: One-third of the pregnant women and new mothers who died in 2020 were Black, though Black Americans make up just over 13%nof the population. Their mortality rate was nearly three times that of white women. The mortality rate for Hispanic women, which has historically been lower than for white women, also increased significantly in 2020 and is now almost on par with the rate for white women.