Uncertainty. Fear. Worry.
These are just a few of the thoughts and emotions that run through the minds of almost every expecting parent. And for many expecting Black parents, those feelings can be more acute.
That’s because for far too many, having a child is a life and death struggle.
Last week was Black Maternal Health Week and April is Minority Health Month, making right now an opportune time for all of us to recognize this crisis and frame the national conversation around dismantling the systemic barriers to care for Black and other pregnant people of color .
Today, women are 50% more likely to die in childbirth than their mothers were. The risk of death is three to four times higher for Black mothers than for their white counterparts. Black mothers in the U.S. are also twice as likely to lose an infant to premature death. With lived experiences like these, it is no wonder the United States has the highest maternal mortality rate of any high-income country in the world.
Maternal mortality and poor maternal health outcomes are the result of myriad, interconnected factors. Systemic racism is undoubtedly one of the most complex factors at play. To solve this crisis, we must address them all.
Most maternal deaths are preventable. One study found that 60% of pregnancy-related deaths were preventable. That same report found, not surprisingly, that access to quality care is a key step to reversing this trend. Which means we can save lives if we ensure access to health care before, during and after pregnancy. This is especially important for historically marginalized people.
Fortunately, our nation’s policymakers signed into law a mechanism to expand maternal health coverage next year. Embedded in the American Rescue Plan is a key provision that allows states to extend postpartum Medicaid benefits to a full year — 10 months beyond what is currently available. This extended benefit is critical for improving maternal health and birth outcomes.
But the new federal law only incentivizes states to extend this coverage, it doesn’t mandate it. We need Connecticut leaders to take the next step toward addressing health equity among pregnant people and their babies and act to include this coverage in all Medicaid programs.
U.S. health policies have too frequently failed to recognize maternal health needs overall and historically demonstrated hostility toward women of color. State Medicaid programs across the country now have an opportunity to show that our values are evolving with regard to health inequities and how we must view health care as a human right.
Importantly, the American Rescue Plan’s postpartum provision recognizes that oral health plays an essential, but underappreciated, role in protecting the health of babies and their mothers. The new law allows states to extend oral health coverage for one year postpartum, as well. This expanded view of postpartum coverage gives me hope, as a physician, mother, and advocate, for a more accessible and equitable future where oral health is integral to overall health care.
For states, this should be a no-brainer. Four in 10 of all pregnant women have tooth decay or gum disease from changing hormones, and those that do are at higher risk for poor birth outcomes such as low birth weight, preterm delivery and risk of preeclampsia. Poor oral health raises a pregnant person’s risk of high blood pressure, a precursor to preeclampsia, which can lead to major complications and even death. And children are three times more likely to have dental disease if their mother was not able to receive dental care during pregnancy. These kinds of preventable complications and poor health outcomes place additional financial stress on individuals, the health care system, and state budgets.
It’s no coincidence that Black women who face the highest mortality rates also face some of the highest rates of oral disease. Expanding access to oral and overall health care before, during and after pregnancy will literally be life changing and bring us closer to real health equity.
The act of having a child should be one of the most joyous blessings of any parent’s life. Let’s work together to address the nation’s maternal health crisis and alleviate at least some of the fear and anxiety that parents feel across this country.
The only question left is do we have the will to act while we have the chance?
Myechia Minter-Jordan, MD, MBA, is the President and CEO of the CareQuest Institute for Oral Health.