MotherBaby Network

advocacy and commentary with a focus on Lane County, Oregon

Maternity Act – doing right by pregnant women and babies, everyone benefits

Despite mounting evidence to the contrary, bipartisan efforts aren’t dead in Washington, D.C. Just before Thanksgiving, Congressman Elliot Engel (D-NY) and Congresswoman Sue Myrick (R-NC) filed the Partnering to Improve Maternity Care Quality Act of 2010 (MCQA). This act begins the necessary work to remove the multiple, interlocking barriers separating women and babies from effective care.

MCQA is a prudent and overdue response to several years’ worth of reports and media coverage of the appalling disparities in access and outcomes for mothers and babies across and within communities in this country. Amnesty International’s Deadly Delivery: The Maternal Health Care Crisis in the USA is the latest report. Inside these reports are the details of our embarrassingly high national maternal mortality and infant maternal mortality rates. The most tragic of outcomes, these mortalities are a “canary in the mind shaft.”

62 Lane County babies lost before first birthday

Lagging behind 40 to 50 nations, including all other industrialized nations, the country’s infant mortality rates are evidence of far too many tragic and suboptimal outcomes for a country of our resources and standing. This is especially true given that US per-capita spending far exceeds that of any other country on the planet. Locally, Lane County’s fetal-infant mortality rate leads the state – 62 babies were lost before their first birthday from July 1, 2007 to June 30, 2009.

We’re talking serious money and not enough to show for it

The federal government has a big interest in seeing better outcomes for mothers and babies. Annually, 4.2 million babies are born in the US. Medicaid pays for more than 40% of all maternal hospital stays. Put another way, over half of hospital discharge bills going to Medicaid are for childbearing women and newborns. This adds up to a $39 billion dollar business. It’s reasonable to expect a better than below 40 ranking for this kind of investment.

MCQA does three things:

1. Develop a maternity care quality measurement program

Specifically, a complete set of national, evidence-based, quality consensus measures to assess processes, outcomes, and the value of maternity care provided to Medicaid and CHIP (Child Health Plus) beneficiaries will be developed.

2. Identify payment mechanism improvements

A national demonstration project to identify and evaluate emerging payment reform mechanisms that actually support high-quality, high-value care will be created. An example would be bundled payment for a complete care provided to women and newborns.

3. Identify essential evidence-based maternity care services

The Institute of Medicine will be authorized to identify a package of essential evidence-based maternity care services for childbearing women and newborns.

Creating and bringing each of these components to bear on our under-performing maternity care system would go a long way toward providing early prenatal care, effective breastfeeding support, stemming the tide of induction-driven preterm births and the cesarean epidemic and so much more.

More than a chit for motherbaby advocates

MCQA is much more than a boon or chit for motherbaby advocates. Rather, it fits part and parcel with all other efforts to move national and local economies beyond recession. Healthier women and babies mean stronger families, workforces and communities. Women now make up a majority of the paid workforce. Never have employers and government had a more obvious reason to support maternity care reform.

Don’t you think DeFazio should co-sponsor?

Let’s encourage Congressman DeFazio to co-sponsor MCQA. Send him a message using his email form. Be sure to refer to MCQA by its bill number: H.R. 6437. Feel free to copy and paste a link to this blog in your message.

Some media coverage please…..

As a final thought and in addition to legislative action, serious and ongoing local Lane County coverage of these bedrock issues affecting the well being of women and babies would be helpful. Despite high fetal-infant mortality rates in Lane County, community-level coverage has been scant at best.

The Sacramento Bee’s recent coverage of its local fetal-infant mortality rate is a positive and productive example of the kind of coverage needed in Lane County. The Bee article gets beyond the numbers to put a human face on the complicated but addressable issues contributing to the unnecessary suffering and loss of life.  Here’s hoping we see better (any?) coverage from, among others, The Register Guard, The Eugene Weekly and KLCC in 2011.

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2 responses to “Maternity Act – doing right by pregnant women and babies, everyone benefits

  1. Jill Herendeen December 23, 2010 at 2:05 pm

    Great, just what we need, more bureaucracy. Want to fix the problem? Push for universal, single-payer healthcare. When profit is removed as the motive for health care, and limited dollars are available, and actual GOOD RESULTS are the goal, then the problem will be solved: independent midwives will take over as primary maternity care clinicians, the c-section rate will drop by half, at least; maternal mortality will drop; and we’ll all be paying half of what we are now. How do I know this? This is what all the other industrialized countries of the world, which HAVE universal health care, have. Read anything by Dr. Marsden Wagner, for starters.

  2. motherbabynetwork December 23, 2010 at 3:57 pm

    Thanks Jill Herendeen for reading and commenting on my blog. I agree that anyone with an interest in reforming care for women and babies would do well to start with Marsden Wagner. I also agree that removing profit motives and replacing results as the goal are key to improving care. I see this proposed legislation as step toward this precisely because other industrialized countries with the kind of outcomes we should have do these things.

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