Reproductive Health

Pieces of a U.S. Maternal Health Plan Take Shape

Tuesday, June 7, 2011

A bill in Congress would help states research why so many U.S. women die in pregnancy and childbirth. And that data could make health reform more responsive to a worsening problem, a leading health activist says.



Health and Science, Reproductive Health (WOMENSENEWS)--Eleanor Hinton Hoytt knows all about negative U.S. maternal mortality statistics and she hopes that health reform--with help from a bill in Congress--can do something about it.

"Until recently we haven't had a national plan for addressing maternal health," says Hinton Hoytt, CEO of the Washington-based Black Women's Health Imperative. "We deal only with morbidity and mortality rather than putting in place a way to make sure that people have what they need."

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Hinton Hoytt spoke with Women's eNews by phone following her participation at a May congressional briefing on a bill--separate from health reform--that would prod states to study the rising problem of U.S. women dying from causes related to pregnancy and childbirth.

That bill, she says, will provide the means to collect data to make health reform programs for women--such as home visits during pregnancy and community health centers--more responsive to women's needs. Called the Maternal Health Accountability Act, the bill would give states funding to research their own maternal mortality statistics.

Hinton Hoytt said the bill would also help reveal underlying causes of maternal mortality for which she gives many examples: domestic violence, unemployment, discrimination in the workplace and "environmental toxins in which black women and poor women live."

"Those social determinants of health are real," says Hinton Hoytt. "This bill deals with that indirectly because once you have a way of collecting data then you can identify some of those social factors that impact what is going on and, therefore, begin to understand and address some of the assumptions that we have about these kinds of health disparities."

Hinton Hoytt added that even among women who have health insurance and good pre-natal care, some die or experience severe complications.

$10 Million in Funding

The Maternal Health Accountability Act (HR 894) authorizes $10 million in new funding annually between 2012 and 2018 to help states pay closer attention to the reasons why women die from causes related to childbirth and pregnancy.

States would have the option to participate. Only about half the states currently collect some of the data the act would require.

The funding would pay for state review committees composed of health professionals, social workers and members of affected communities to recommend prevention strategies and disseminate findings and recommendations. The bill would also create a program aimed at eliminating disparities in maternal deaths and negative health impacts.

The Maternal Health Accountability Act draws on a report, "Deadly Delivery: The Maternal Health Care Crisis in the USA," that Amnesty International released in 2010 and updated this year. It found that women living in low-income areas are twice as likely to suffer maternal deaths as women living in high-income areas.

Black women are three to four times more likely to die from pregnancy-related causes than white women, a statistic that Nan Strauss, lead researcher of the Amnesty report, says hasn't changed in the past 60 years.

The report also notes that problems are tied to well-known barriers to care, such as financial constraints, lack of medical professionals where the women live, lack of transportation to doctors' appointments and lack of child care. But it also targets issues such as jobs that don't offer women the flexibility to make health care appointments.

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