Lawmakers push to end maternal health crisis

Lawmakers are pushing for increased protections for pregnant people of color in the hopes of passing legislation before the end of the session. 

The Black Maternal Health Caucus has been leading legislation talks. The caucus was established in 2019 to fight the drastic racial disparities that exist for pregnant Black people. Despite proposing a 12-package act of protections for pregnant people, most of the caucus’s legislation hasn’t passed. 

The Black Maternal Health Momnibus Act of 2021 called for recognizing and fighting against the social determinants of health, funding for community-based organizations, diversifying the perinatal workforce and other key provisions. But so far, only one part of the package has been signed into law by President Joe Biden — the Protecting Moms Who Served Act.

That particular act commissions the first-ever comprehensive study on America’s maternal health crisis among women veterans while also supporting maternal care programs at Department of Veterans Affairs facilities.

Still, Rep. Lauren Underwood (D-Ill.), a lead sponsor of the Momnibus and founder and co-chair of the Black Maternal Health Caucus, said the caucus is happy with the progress they’ve made so far. 

“We have incredible momentum,” Underwood told The Hill. “Eighty percent of the rest of the Momnibus was included in Build Back Better and we’ve been working with our Senate colleagues to find an avenue for a vehicle for the Momnibus to get enacted. And I feel very optimistic at this point in time.”

Provisions in the Momnibus came from Underwood’s own experience as a nurse as well and from a stakeholder summit in early 2019 where experts, health care providers and community leaders helped identify the most pressing issues of the maternal health crisis. Recently, the Maternal Vaccination Act, which would provide funding for programs to increase maternal vaccination rates, was passed with bipartisan support in the House.

But with midterms just days away, legislative talks have been put on hold, though the caucus has been working with Sen. Cory Booker (D-N.J.), the Senate lead on the bill, to attach the rest of the package to another vehicle in the hopes of passing. 

Meanwhile, Sen. Chuck Grassley (R-Iowa) recently introduced his own bill, the Healthy Moms and Babies Act. 

Key provisions of the act include coordinating and providing “whole-person” care, modernizing maternal health care through telehealth to support women of color and women living in rural America, and improving the understanding of social determinants of health in pregnant and postpartum women.

As Finance Committee chairman, Grassley joined Sen. Ron Wyden (D-Ore.) to gather committee member and stakeholder feedback on factors contributing to poor maternal health outcomes in the U.S. That work helped inform the challenges and solutions addressed in the Healthy Moms and Babies Act.

“We must do a better job at supporting pregnant moms and their babies,” Grassley said in a statement to The Hill. “The Healthy Moms and Babies Act will enable high-quality coordinated care to our most vulnerable moms. Through 21st century technology and community-based efforts, we can prevent maternal mortality and high-risk pregnancies – regardless of a mom’s zip code or economic background. As a strong supporter of the Maternal, Infant and Early Childhood Home Visiting Program and stillbirth prevention efforts, I’ll continue working with my colleagues to help expectant families.” 

While unclear if the Act will be attached to the Momnibus in any manner, Grassley’s office added the senator does plan to work in a bipartisan and bicameral manner with his colleagues to pass the Healthy Moms and Babies Act. 

But Underwood added the Black Maternal Health Caucus has also been bipartisan since its launch in 2019. 

Efforts toward advancing the Momnibus, the Protecting Moms Who Served Act, the Mom’s Matter Act and the Tech to Save Moms Act are all bipartisan. 

“I would say politics around all of this really demonstrate that there is bipartisan agreement … ending our nation’s maternal health crisis is a priority,” said Underwood. 

“I think that this is something that is deeply personal for a lot of members and people are often sharing stories from their communities or sharing stories from their states and why they’re so committed to this work,” she continued.  “It really resonates with audiences and voters broadly because in 2022, we should be able to keep moms alive. And that should be something where it’s consistent throughout the United States. We shouldn’t have these disparities based on race or ethnicity, we shouldn’t have these disparities based on geographic location, urban or suburban or rural.”

Among developed nations, the United States has the highest rate of people dying of pregnancy-related complications during or within 12 months of the end of their pregnancy, according to the Center on Budget and Policy Priorities.

These racial disparities persist in Native American communities as well, where Native American mothers are two times more likely to die from pregnancy-related causes. Asian Americans and Pacific Islanders (AAPI) have higher rates of maternal mortality during hospitalization for delivery.

But 84 percent of these deaths are preventable, according to the Centers for Disease Control and Prevention Maternal Mortality Review Committees September report. 

Mental health conditions were the leading underlying cause of maternal deaths between 2017 and 2019. White and Hispanic women were most likely to die from suicide or drug overdose.

Cardiac problems were the leading cause of death for Black women. Black women are more likely to suffer from preeclampsia and eclampsia than white women, with mortality rates five times those of white women, according to the Population Reference Bureau.  

“By passing the Momnibus and making these critical investments — $3 billion in our nation’s maternal health crisis — it improves the quality of care for everybody,” said Underwood. “This is something that helps us all, and also ends the severity that for decades has been just cruelly taking the lives of Black moms in America.”

Underwood said the caucus will work until the last day of the session to get the Momnibus enacted with a bipartisan 60-vote passage.