The United States faces a maternal health crisis that puts Black mothers and birthing people at disproportionate risk. Investments in the Build Back Better Act could help hundreds of thousands of women each year.
The social spending package that Congress is working to pass through reconciliation is an unprecedented opportunity to address our nation’s maternal health crisis. The United States has the worst maternal mortality rate among industrialized countries, and Black women die of pregnancy-related causes at approximately three times the rate of their white counterparts.
The causes may be complex—including historical and ongoing structural racism and discrimination—but these deaths are largely preventable, and we already know many of the key solutions.
Here’s what you need to know about how four investments included in Build Back Better—just a few of the maternal health investments in the package—would have an impact.
1. Build Back Better could save mothers’ lives by providing funding for postpartum Medicaid to a total of 1,170,000 uninsured new mothers over ten years.
One third of pregnancy-related deaths occur in the postpartum period, with about 12 percent occurring between six weeks and a year after pregnancy. Even worse, we know that Black mothers face higher mortality rates across the board, including after giving birth.
What is one key way to address the preventable deaths of mothers, and particularly Black moms? Invest in new mothers by funding the extension of Medicaid coverage to one year postpartum. Despite the high rates of death in the weeks and months following birth, many women and birthing people covered by Medicaid become uninsured just sixty days after giving birth. Investing in yearlong postpartum coverage is key to reducing racial disparities, saving lives, and ensuring health equity.
Funding Medicaid to provide continuous coverage for the full year postpartum will ensure an estimated 117,000 new mothers each year, for a total of 1,170,000 over ten years or proposed investments.
2. 92,000 nurses and perinatal nursing students would receive funding for loans, scholarships, and programmatic support over ten years.
In order to eliminate disparities in maternal health, we must grow the perinatal workforce and ensure diversity so that health care workers reflect the communities they serve. Doing so will not only better support women and birthing people of color: it has also been shown to improve communication between women and birthing people and their health care providers, which is particularly crucial in the context of giving birth and postpartum care.
Nurses, including registered nurses, nurse practitioners, and certified nurse midwives, make up a key part of the perinatal health workforce. The funding proposed in Build Back Better would provide over 92,000 perinatal nursing students and nurses with loans, scholarships, and programmatic support over a ten-year period.
3. 30,000 doulas would receive funding for loans, scholarships, and programmatic support over ten years.
Ensuring diversity in the health care workforce means investing in more than just nurses. Doulas in particular provide comprehensive non-clinical care to pregnant and postpartum individuals, including emotional, physical, and informational support. Doula care is associated with improved outcomes for both mothers and infants, better quality of care, and potential cost savings—yet this care is often out of reach for the Black women and birthing people.
The funding in Build Back Better would provide over 30,000 doulas in training with loans, scholarships, and programmatic support over a ten-year period.
4. 46,000 maternal mental health and substance abuse professionals would receive loans, scholarships, and programmatic support, over ten years.
Mental health and treatment for substance use disorders are critical to maternal health equity. One in eight mothers experience postpartum depression, and nearly 50 percent of pregnant women with depression go without treatment. Black women in particular experience higher rates of perinatal depression and mood disorders and are half as likely as white women to receive mental health treatment.
To address this critical issue, Build Back Better funding would provide over 46,000 individuals training in maternal mental health or substance use treatment with loans, scholarships, and programmatic support over a ten year period.
It is vital that Congress acts swiftly to get the Build Back Better Act over the finish line, with its maternal health funding intact. This is an unprecedented opportunity to invest in maternal health equity and the stakes have never been higher—particularly for Black women and birthing people.