In the United States, publicly-funded healthcare is provided through Medicaid and the Children’s Health Insurance Program (CHIP). These programs are collaborative efforts between state and federal governments, offering health insurance to low-income individuals, children, people with disabilities, and pregnant individuals. Due to these eligibility criteria, some individuals qualify for coverage during pregnancy and the postpartum period but not at other times. Medicaid covers 41% of births in the United States. Federal law mandates that states provide coverage for up to 60 days postpartum. A 2021 bill allowed states to extend coverage up to one year postpartum.

In May 2024, the Centers for Medicaid and Medicare Services (CMS) published an infographic summarizing maternal health data for beneficiaries. CMS collects demographic data on age, race and ethnicity, and geography, as well as outcome data on maternal mortality, severe maternal morbidity (SMM), underlying causes of maternal mortality, access to dental care, postpartum contraceptive use, pregnancy spacing, chronic conditions, timeliness of prenatal and postpartum care, smoking, behavioral health and substance use, neonatal abstinence syndrome, postpartum depression (PPD), preterm birth, and low-risk cesarean delivery. Additionally, CMS gathers health system data on healthcare service provider distribution, state quality improvement activities, and state participation in the optional extended postpartum coverage program.

Key Takeaways:

The data reveal significant disparities among Medicaid beneficiaries and provide crucial insights for healthcare policymakers and system designers on areas needing improvement. For instance, the data show that Black birthing individuals experience mortality at a rate 2.6 times higher than their white counterparts. This supports other research and underscores the importance of publicly funded doula care to help reduce Black maternal mortality rates. Additionally, the data indicate that individuals under 19 have higher rates of PPD (22% compared to the average of 17%). This suggests the need for universal PPD screening and additional support for this age group during the postpartum period.

This 9-page resource offers valuable information to support US birthworker advocacy for expanded access to birth and postpartum doula care, provider choice, birth location options, and mental healthcare. For birthworkers in Canada and other regions, it serves as a model of comprehensive demographic and outcome data collection.

Keira Grant (she/her)

Diversity, Equity and Inclusion Lead

Keira brings a wealth of experience to the Online Community Moderator role. She is a Queer, Black woman with a twenty-year track record in Equity, Diversity, and Inclusion (EDI) education, projects, and community building initiatives.