Maternal Health Disparities,
oFederal and State Efforts to Close the Gap
Maternal health disparities remain one of the most persistent and troubling issues in healthcare, particularly in rural communities where access to maternity services and specialized care can be limited. Defined as a person’s death during pregnancy, labor, childbirth, or the postpartum period, maternal mortality continues to challenge clinicians and public health professionals alike despite growing awareness and funding aimed at improving maternal health outcomes.
Notably, research indicates that education level and economic status are not primary drivers of this disparity. Black women experience similar mortality rates regardless of whether they hold a high school diploma or a postgraduate degree. Similarly, Hispanic/Latina women with private insurance remain significantly more likely to experience severe pregnancy complications than their white counterparts — evidence that the root causes run deeper than access alone.
Nearly all of these deaths are considered preventable and are recognized as such by maternal mortality review surveillance systems.
The Ongoing
Maternal Health Crisis
National statistics continue to underscore stark inequality: roughly 24 maternal deaths per 100,000 births, one in five mothers experiencing mental health concerns, and marginalized women continuing to face significant challenges due to a lack of proactive intervention.
- Black women face a two to three times higher risk of dying from pregnancy-related causes compared to white women
- Black women are more likely to experience an unwanted, prematurely decided cesarean delivery
- Black infants are two to three times more likely to be born preterm, and twice as likely to die within their first year of life compared to white infants
- Hispanic/Latina women have seen significant spikes in maternal mortality, and those covered by Medicaid face a notably higher risk of complications
- Women facing social and economic inequities are more likely to experience worse maternal health outcomes, largely due to systemic racism
Federal Initiatives Addressing Maternal Health
| Initiative | Focus |
|---|---|
| CDC Safe Motherhood Initiative | Expanding maternal mortality review committees nationwide |
| CDC Immunization Program Expansion | Improving immunization access for underserved pregnant women and infants |
| CDC Maternity Practices in Infant Nutrition and Care Survey | Collecting data to improve hospital and healthcare center care practices |
| HHS Postpartum Maternal Health Collaborative | Addressing disparities in postpartum care |
| National Governors Association Rural Maternal & Child Health Policy | Improving maternal and child health access in rural America |
| CMS Transforming Maternal Health (TMaH) Model | Improving maternal health for perinatal individuals enrolled in Medicaid and CHIP |
The TMaH model centers on three core goals: infrastructure, quality improvement, and holistic care. Infrastructure improvements can be both physical and operational from offering free or affordable parking at maternity wards to building proficient materials management teams that ensure adequate, cost-effective supplies for every patient during childbirth. Seemingly small barriers, like paid hospital parking, can create real obstacles for families trying to be present during a loved one’s delivery.
As a firm committed to whole-person care, DHJ Services has consistently emphasized the importance of the entire care team including the effectiveness of doula services and midwifery care in supporting holistic maternal health outcomes.
State-Level Initiatives New York
New York’s maternal mortality rate remains among the worst in the nation. Within New York City, two areas show the highest concentrations of severe maternal morbidity: Central Brooklyn, where the affected population is largely Black women from the Caribbean, and the South Bronx, where the affected population is largely African American or Hispanic/Latino.
These hotspots have prompted targeted intervention proposals, including:
- Removing co-pays for pregnancy services
- Extending access to doulas statewide
- Educating clinicians on maternal mental health
- Providing free cribs to low-income parents
- Implementing a system to monitor physicians who perform medically unnecessary cesarean sections
State-Level Initiatives California
California has taken the position that maternal health disparities cannot be attributed to income alone, and must have roots in systemic racism and implicit bias leading to the introduction of implicit bias training requirements for providers statewide.
California’s Department of Health Care Services has named birth equity a population health focus, working in conjunction with CalAIM’s Population Health Management Program. The demographic groups facing the greatest disparities in maternal morbidity and mortality include Black, American Indian, Alaska Native, and Pacific Islander individuals during pregnancy and the postpartum period. State-level data analysis (rather than county-level) is also being used to help reform Enhanced Care Management (ECM) eligibility criteria at both the plan and member level.
Why There's Reason for Optimism
Despite the troubling disparities that persist, federal and state initiatives continue to demonstrate meaningful commitment to addressing the systemic issues underlying maternal health outcomes. Increased funding, enhanced access to care, and targeted efforts addressing root causes like systemic racism and implicit bias all point toward genuine progress.
DHJ Services is in full support of these efforts. As we continue to navigate this landscape, we remain committed to raising awareness, keeping our community and clients informed, and creating opportunities to engage with best practices in maternal health equity.
we’re here to all your questions
Straight answers to the questions we hear most about maternal health disparities.
Q: Why do Black women face higher maternal mortality rates regardless of income or education?
Research shows that education level and economic status are not primary drivers of the disparity Black women experience similar mortality rates across income and education levels, pointing to systemic racism and implicit bias as root causes rather than access alone.
Q: What is the Transforming Maternal Health (TMaH) model?
It’s a federal model focused on improving maternal health outcomes for Medicaid and CHIP-enrolled individuals through three goals: infrastructure improvement, quality improvement, and holistic, whole-person care.
Q: How does birth equity factor into state-level policy?
States like California have named birth equity a specific population health focus, using state-level data to identify disparities among Black, American Indian, Alaska Native, and Pacific Islander individuals and reform care management eligibility accordingly.
Q: What role does holistic care play in improving maternal health outcomes?
Holistic, whole-person care including doula and midwifery support is increasingly recognized as essential to closing maternal health gaps, not just for improving outcomes but supporting the full needs of the birthing parent.
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Connect
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For further information on DHJ Services’ dedication to advancing maternal health equity, reach out to us we’re here to help.