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Maternal Health

Improving Maternal Care Across All Demographics

Photo: Courtesy of Sharon McCutcheon

Maternal health is at the intersection of women’s rights, reproductive rights, health justice, and social justice. It is an issue with which we all must wrestle and, shockingly, the United States has the worst maternal health outcomes among high-income nations.


Carol Sakala

Director for Maternal Health, National Partnership for Women & Families

The healthcare system in the United States is not equitable. Access to care varies by income level, geographic location, type of insurance, race, ethnicity, and employer. Standard hospital care of birthing people does not meet the needs of many expecting and new families. Many people prefer midwifery care and doula support, but do not have access to these. Many do not have a choice of methods of pain relief or for other care preferences. Too many have cesareans that they don’t need or want. Discrimination during delivery and heartbreaking accounts of doctors and nurses not listening to people who know their bodies create unnecessary stress for new parents and their families, often with tragic outcomes .

Expanding care models

Improving maternal care includes ensuring that all parents have access to such family-friendly services as midwifery care, community birthing centers, and doula support. Each of these prioritizes safe, respectful, individualized care, and support. Employers, health plans, Medicaid agencies, Congress, and state legislatures all have a role and responsibility in expanding access to these exemplary forms of care. Parents and families can speak up and tell their employers, health plans, and elected officials that they need and want these high-value services.

Real-world examples of community-based care

The National Partnership for Women & Families investigated four community-based maternal health organizations in different states for their impacts, effectiveness, culturally-sensitive and relevant care, and reach. Commonsense Childbirth in Florida, Mamatoto Village in Washington, D.C., Breath of My Heart Birthplace in New Mexico, and Mana Sana Vibrant Woman in Texas all offer support and clinical services that are tailored to the needs of communities. Services include midwifery care, postpartum support, prenatal care, birth companions, and parental counseling. These programs positively impact their respective communities. Similar groups are arising across the country to meet the needs of childbearing families.

Moving forward for families

Equity is core to this conversation. To close unacceptable gaps in maternal and infant health outcomes between families of color and white families, we must improve the quality and experience of maternity care.

We must also recognize the important effects on maternal and infant health of social circumstances — such as the neighborhood we live in or whether we have access to paid family leave.

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