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As Pregnancy-Related Deaths Rise In The U.S., Experts Say Expanding Medicaid Is Key


The number of American women dying from pregnancy-related complications continues to rise. Many maternal health experts say one key to curbing that is making sure new mothers don't lose their health insurance. Christine Herman of member station WILL looks at Illinois' efforts to ensure new moms keep their coverage after giving birth.

CHRISTINE HERMAN, BYLINE: This story is about women dying from childbirth. In the U.S., 700 women die each year from pregnancy-related causes. In fact, this country is the only industrialized nation where the maternal death rate is rising. And here, Black and Indigenous women are at two to three times greater risk than white women. U.S. Representative Robin Kelly of Illinois says these racial disparities are unacceptable.

ROBIN KELLY: When you look at educated Black women with money, they still die more than less educated, less wealthy white women.

HERMAN: She's been spearheading policies to try to address the issue, including a change to Illinois's Medicaid program that aims to ensure new moms don't lose their health coverage soon after their baby is born. In the U.S., many moms enrolled in Medicaid during pregnancy lose that coverage 60 days after giving birth if they surpass income eligibility limits in their state. This happens to hundreds of thousands of women each year. This month, Illinois became the first state to get federal approval to extend Medicaid for a full year after pregnancy for moms with incomes up to about double the federal poverty level.

KAREN TABB DINA: This is tremendous - extending Medicaid.

HERMAN: Karen Tabb Dina is a maternal health researcher at the University of Illinois. Of the 70 pregnancy-related deaths in Illinois each year, the data shows most are preventable. Tabb Dina grew especially concerned when she saw that a growing number of mothers lacking health insurance were turning up in emergency rooms.

TABB DINA: Well, the emergency department is not the best place to set up a treatment plan and to ensure that person is followed up with. So by losing people through the cracks, we are losing real lives.

HERMAN: Several other states, including New Jersey, Georgia and Virginia, are taking similar steps to extend Medicaid coverage. And President Biden's COVID relief package contains a provision to help more states do so. Rachel Bervell is an obstetrician in Seattle and co-founder of The Black OB-GYN Project that's working to raise awareness about racial injustices in maternal health care.

RACHEL BERVELL: Many of the health issues and health problems extend beyond the 60-day period that Medicaid is currently covering.

HERMAN: Medicaid is the largest payer of maternity care in the country, and Black women are overrepresented in the Medicaid population. So they're also overrepresented among those who get kicked off their plan. But there are also structural barriers to getting care, things like transportation issues and inadequate housing. Tabb Dina says we have to do a better job listening to the tens of thousands of mothers each year who experience dangerous, even life-threatening complications.

TABB DINA: We need to understand the real, lived stories of our near-misses, people that almost die.

HERMAN: And then ask the question, what else needs to change so that no child has to grow up without a mother whose death could have been prevented?


HERMAN: For NPR News, I'm Christine Herman in Urbana, Ill.

(SOUNDBITE OF THE SHINS SONG, "THE FEAR") Transcript provided by NPR, Copyright NPR.

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