What the U.S. is doing to address its deepening maternal mortality crisis

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• John Yang:

  Pregnancy in the early weeks of parenthood can be a difficult and stressful time and getting access to mental health care can be an additional challenge. Ali Rogin tells us what the federal government is doing to help.

• Ali Rogin:

  There are grim statistics surrounding American motherhood, the U.S. maternal mortality rate continues to steadily increase. 2021 was one of the worst years on record, and U.S. maternal deaths far exceed that of many other developed countries.

  According to the Centers for Disease Control, one of the leading causes of pregnancy related deaths is mental health conditions, including those that lead to death by suicide. Last year, the United States launched the National Maternal Mental Health hotline, a 24/7 resource where new and expectant parents can talk to counselors, it received almost 12,000 calls in its first year.

  To discuss these challenges I'm joined by Carole Johnson, head of the Health Resources and Services Administration, which is an agency of the Department of Health and Human Services. Carole, thank you so much for joining us.

  Carole Johnson, Administrator, Health Resources and Services Administration: Thank you so much for having me. And thank you for calling attention to this issue. It is a critical need across the country. And we in addition to hearing the volume of calls that we've received, we also get incredible feedback from stakeholders, meaning clinicians and community based organizations that work with pregnant moms about how important it is to have a resource like this have a safe space for pregnant moms and new moms to have a conversation with a counselor and be able to get their concerns heard.

• Ali Rogin:

  And Carole about a quarter of pregnancy related deaths are related to mental health, which is of course extremely important. And the national hotline seems like a very well applied solution to help address that problem.

  But if you look at the numbers, a plurality appear to be related to physical ailments, including hemorrhage, heart complications, infection, or those types of root causes those physical things harder to treat on a national level.

• Carole Johnson:

  The maternal mental health hotline is part of our larger strategy across the Biden-Harris administration to tackle this crisis. So we are investing not only in this critical resource, our maternal mental health Hotline at 833-TLC-MAMA, but also improving the way care is delivered, both in terms of improving access to prenatal care, improving access to postnatal care.

  Too often new moms were dropped off and Medicaid relatively quickly after delivery. We're making sure that states are expanding access to Medicaid. We're doing better data collection collaborating more with states, we're building the workforce more certified nurse midwives more community based doulas to make sure that the healthcare system is centered around hearings women's voices and concerns because we know that's going to make a real meaningful difference in this work.

• Ali Rogin:

  I know you recently announced a 65 million award package to health centers across the country to address the more maternal mortality crisis, is what you just mentioned part of the package of services you're intending to bolster with that money?

• Carole Johnson:

  It absolutely is we at the Health Resources and Services Administration fund 1,400 health centers around the country health centers see patients regardless of their ability to pay. And so health centers are in underserved communities in rural communities across the country.

  And our investment of $65 million is about helping health centers meet the needs of the pregnant women and post postpartum women in their communities, including, you know, expanding access to mental health services, integrating mental health services into OB services, really focused on getting those community health workers who can be that critical linkage and support to help connect pregnant women to community social services. That being part of the solution as well.

• Ali Rogin:

  Carole, as you well know, the rate of maternal mortality varies greatly on racial lines, black and indigenous women are two to three times more likely to die of pregnancy related causes than white women. Why this disparity? And what is the administration doing to address it?

• Carole Johnson:

  Your unacceptable disparities in maternal health outcomes and that is why the administration has launched our blueprint for maternal health. This is really led by the President's commitment, and in particular, the Vice President's commitment to addressing those disparities. She has been a leader on this issue since she was in the Senate. And she has really called us all together across the administration to tackle this issue.

  In fact, I got to participate in her convening the first Cabinet meeting around maternal mental health, which really put us in the Department of Health and Human Services around the table with our colleagues from the Department of Labor, and housing, and really recognizing that transportation. All of these issues are part of the solution here.

• Ali Rogin:

  When you disaggregate the CDC data on maternal health, mental health issues are the underlying cause of most of the deaths for white and Hispanic mothers. But in fact, Black and Asian mothers suffered much more from heart conditions and hemorrhaging. So, is it harder again, to address these, these challenges when the root causes seem to vary so much by race?

• Carole Johnson:

  Well, you know, that's why we have to invest in all of the above. And so here at HRSA, we're also investing in helping hospitals prepare for hemorrhage and helping them be ready and OB ready to respond to those crisis moments, and also moving further upstream and better managing hypertension, and gestational diabetes in women during the prenatal period, which is why it's so important that we get people connected to prenatal care earlier. And so we hope that these efforts will help us address some of these critical disparities.

• Ali Rogin:

  Carole Johnson, Head of the Health Resources and Services Administration, thank you so much for your time.

• Carole Johnson:

  Thank you. Really appreciate it.