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Ensuring a woman’s physical, mental, and societal needs are met at the onset of pregnancy through the postpartum can significantly – and positively – impact health disparities, healthcare costs, maternal and infant mortality, as well as pregnancy-related complications.
The Centers for Disease Control and Prevention (CDC) estimates half of counties across the United States have no obstetrical providers. Furthermore, rural and low-income communities are disproportionately affected by access issues due to the need to travel further for both obstetrical providers and neonatal care. The inability to access these services amplifies the risk of unidentified and untreated physical and mental health conditions that can harm the health and life of the mother and baby. Maternal mortality has steadily increased in the United States, with an estimated 80% of pregnancy-related deaths deemed preventable. Clearly, Effective Maternal Care Is A Public Health Issue That Must Be Addressed. Maternal health is a strong predictor of child health outcomes at delivery and continues to have a significant impact during adulthood. Research shows that early engagement and intervention in pregnancy care decreases adverse health outcomes for both the mother and newborn. However, for those with limited access to preventative or obstetrical provider care, many routine needs go unaddressed and educational opportunities do not occur. While solutions for barriers to care across all social and economic levels are essential, pregnancy and infant health disparities continue to disproportionately impact Black, Indigenous and People of Color (BIPOC), highlighting the underlying difference these populations experience when it comes to care – systematic racism and discrimination within the healthcare system. The CDC states that compared to white pregnancies, these groups experience higher rates of pregnancy-related deaths, preterm births, low birthweight births, and delayed or no prenatal care. Fragmented postnatal care for both infant and parent can result in increased physical and mental health complications risks, leading to higher rates of illness, hospital stays, longer-term recovery, and increased costs. Many states have adopted policies extending Medicaid coverage of the mother for 12 months postdelivery providing an opportunity for uninterrupted care. This is an important step in addressing maternal health disparities enabling continuous care for physical health concerns and mental health conditions such as depression. This additional time helps foster engagement with interventions to support healthy lifestyle choices inspiring better long-term health outcomes for parents and their children. While access to care, addressing social barriers, and health education support improved rates of outcomes for historically marginalized groups, ultimately closing these gaps will require a conscious effort on the part of healthcare organizations, providers, and community leaders to combat structural racism and discrimination affecting healthcare. Using a data-driven, clinically informed framework to implement solutions that measurably improve the communities’ health enables greater equity, allowing individuals to achieve their highestlevel health. By identifying communities where birthing parent and infant health disparities are more prominent, the use of local community-based services, including doulas, can provide individuals additional access to care and increase the opportunity to address cultural barriers. Using pregnancy assessments that take a whole-health approach during each trimester can add to understanding an individual’s barriers to achieving a healthy pregnancy and delivery and influence an individualized care plan. Solving barriers such as access to prenatal vitamins, transportation to appointments, and preexisting or emerging mental health concerns also contribute to positive outcomes. Payers and the healthcare system have a unique opportunity to harness the power of data to drive critical decisions and support comprehensive care. Analytical findings should be leveraged to create an engaging person-centered experience that meets individuals’ needs. By constructing an inclusive, personcentered, integrated, whole-health 1555 experience, the healthcare industry can improve birth outcomes, combat racial inequity in care, reduce neonatal admissions, and coordinate care for pregnant individuals and their newborns – leading to improved health outcomes.