May 9, 2015 —
By Jamie Dudensing, CEO, Texas Association of Health Plans
AUSTIN—New research has revealed startling facts about the state of maternal care in the United States – news that I hope inspires action at every level of government and across the health care field. According to Save the Children’s 16th annual “State of the World’s Mothers” report, the U.S. ranks 61st globally in maternal health, performing worse than any other developed country. The report found that women in the U.S. face the highest risk of maternal death of any developed country, and that a woman in the U.S. is more than 10 times as likely to die in pregnancy or childbirth than women in nations like Belarus, Poland or Austria. Women in the U.S. face twice the risk of childbirth-related death than those in China and three times the risk faced by those in the United Kingdom.
As a mother, a former labor & delivery nurse, and someone who has helped craft health care policy in state government, I know firsthand that more must be done to care for and educate expectant and new mothers in Texas and the nation. The U.S. is just one of eight countries to experience a rise in maternal death rates over the past 10 years, according to research by the Institute for Health Metrics and Evaluation at the University of Washington. Worse yet, this rate in the U.S. is nearing its highest point in the past 25 years.
While the numbers are grim, another important figure tells us this alarming trend can be reversed: 98 percent of maternal deaths are preventable. Years of research by the brightest minds at home and around the globe has taught us the major causes of maternal deaths and high-risk pregnancies. We know both what can lead to and what can prevent these tragic outcomes, yet every year, we continue to lose mothers whose deaths could have been prevented. As a nation we must do everything we can to improve maternal care and ensure every mother in the U.S. is getting the prenatal and post-partum care she needs.
In Texas, several important steps have been taken in recent years to enhance maternal care, including the establishment of the Healthy Texas Babies Initiative, which seeks to reduce infant mortality using evidence-based interventions. Texas Medicaid has adopted a policy to prohibit payments for inductions that are not medically necessary before the 39th week – a move that supports new guidelines issued by the American Congress of Obstetricians and Gynecologists, who recommend that doctors refrain from inducing labor unless “it’s an absolute medical necessity.”
Still, Texas has considerable room for improvement in the realm of maternal health care. Texas continues to rank among the lowest nationally in several birth outcome indicators—38th in the nation for the percentage of births that are pre-term and 32nd for the percentage that have low birth weight.
Texas commercial health plans and Medicaid health plans recently created a coalition with the Department of State Health Services to identify several strategies to improve maternal health. These include developing wellness programs for women of reproductive age to educate on the best behaviors to ensure a healthy pregnancy, providing peer support services to expectant and new mothers to encourage breastfeeding, and providing a better continuum of care as mothers transition from prenatal to post-partum care. This is especially important for expectant mothers on Medicaid. As it stands, pregnant women on Medicaid only have coverage until 60 days after the birth of their children. Several proposals currently under consideration in the Texas Legislature would extend their coverage for up to 12 months after birth.
We must also do more to incentivize and reward facilities, providers and consumers who follow the best practices to lead to healthy pregnancies. And we must build on efforts to reduce the number of medically unnecessary inductions and c-sections, which are currently overused here in Texas and across the country and can pose serious risks to a mother’s health.
These efforts will require the coordination and commitment of every involved party—providers, health plans, medical facilities, and government leaders. We each have a role to play in improving care, and we can and should do better by Texas women.
As we gather this Mother’s Day to celebrate those who have devoted their entire lives to the well-being of their children, I hope it is a wake-up call for Texas and the nation to do everything in our power to ensure that future mothers in this country have the best care and support in the world.
The Texas Association of Health Plans
The Texas Association of Health Plans (TAHP) is the statewide trade association representing private health insurers, health maintenance organizations, and other related health care entities operating in Texas. Our members provide health and supplemental benefits to Texans through employer-sponsored coverage, the individual insurance market, and public programs such as Medicare and Medicaid. TAHP advocates for public and private health care solutions that improve the affordability, access and accountability of health care for many Texans. As the voice for health plans in Texas, TAHP strives to increase public awareness about our members’ services, health care delivery benefits and contributions to communities throughout the state.