The Moment is Now: Congress Must Take Steps to Address the Black Maternal Health Crisis

Early this summer, Representative Underwood, Kelly, Adams, and Senator Booker led a letter with over 160 members of Congress, urging leadership to prioritize maternal health in any upcoming package. More than 200 cross-movement organizations, including In Our Own Voice, National Birth Equity Collaborative, Black Mamas Matter Alliance, Center for American Progress, Community Catalyst, and Center for Reproductive Rights, are supporting the health and wellness of birthing people and babies and are reinforcing that call to action across the country. Black and Indigenous women are more than three and two times, respectively, more likely to die from pregnancy-related complications than white women, due to systemic racism and barriers to care. Further, at least one-third of maternal deaths happen after the end of pregnancy, during the vulnerable postpartum year. Nearly one-quarter of maternal deaths happen more than six weeks postpartum, a period when new mothers can face a range of medical challenges, such as pregnancy-related complications, chronic conditions, or postpartum depression, all while caring for a newborn. The American Rescue Plan Act took a critical first step towards birth equity by creating an option for states to extend Medicaid coverage to 12 months postpartum but did not go far enough. Black and Indigenous women and all birthing people deserve access to coverage of holistic, high-quality care that addresses gaps in care and ensures continuity of care, regardless of where they live. Further, pregnant people deserve support from trusted providers in their communities – resourcing communities and listening to people most affected are at the center of a birthing justice agenda. 

The letter focuses on three areas:

ONE: Ensure Coverage for Birthing People

The extension of Medicaid coverage to one year must be required across states and be accompanied by a Federal Medical Assistance Percentage of 100% to ensure that states have the resources and support needed to implement this critical change. Further, Congress must close the coverage gap in states that have not expanded their Medicaid programs, guaranteeing people in all states have access to affordable coverage and the full range of health care benefits, including necessary and preventive health care services. Closing the coverage gap is critical for better maternal health and achieving broader health equity.

TWO: Build out Maternal Health Services, Centering Racial Equity

To date, President Biden’s proposal shows a clear commitment to invest federal resources in maternal health, paving the way for key policies included in the Black Maternal Health Momnibus Act of 2021 (H.R.959/S. 346). We applaud this effort to improve maternal health, specifically for Black and Indigenous people, and urge Congress to include the president’s request and pass additional legislation, guided by the voices of advocates whose work centers on the needs of moms and birthing people. Congress should advance the policies included in the Momnibus, making needed investments in maternal care. 

THREE: Invest in Community-Based Partners

Finally, the Momnibus would ensure needed funding for the community-based organizations working to provide birthing people with a safe, healthy birthing experience free from the stress of racism and bias. Community-based partners are also best positioned to address social determinants of health that can lead to poor health outcomes including access to housing, healthy food and water, transportation, child care services, and improving access to health care. Congress should prioritize investments that direct much-needed resources to community-based partners that are working on the front lines to address the racial inequities of maternal health through culturally congruent, place-based caregiving.

The moment to move the conversation forward is now. Racial inequities in maternal health have reached crisis proportions. According to the CDC, an estimated 60 percent of maternal deaths are preventable. Across the country, advocates have demanded action on maternal health. National advocates such as Black Mamas Matter Alliance, the National Birth Equity Collaborative, In Our Own Voice: National Black Women’s Reproductive Justice Agenda, Center for American Progress, Community Catalyst, Center for Reproductive Rights, Families USA, March of Dimes, and the National Partnership for Women and Families and others are actively working to improve maternity care for women of color and have long called on legislators to take this up as a priority. The letter released today exemplifies the shared demand for action from a diverse set of national and state organizations ranging from the American College of Obstetricians and Gynecologists and Association of Maternal & Child Health Programs to state and community-level organizations across the country including Ancient Song Doula Services, Black Women for Wellness, Mothering Justice, or Mamatoto Village and more. Together, with one voice, we call on Congress to deliver and keep equity and birth justice-centered as they begin their reconciliation work in the coming month.

For more policy recommendations on Black maternal health, visit the Black Reproductive Justice Policy Agenda.