Many of us have experienced childbirth and postpartum recovery. After delivering babies in recent years, we both had issues arise in the subsequent year, including back pain and clogged ducts, which required help from our obstetrician, physical therapists, lactation consultants and other providers. Fortunately, we both had private insurance and were able to access a wide variety of resources to help us through the first year and beyond.
The same is not true for women accessing Medicaid due to their pregnancy. Any pregnant woman below 198% of the federal poverty level qualifies for this coverage. Unfortunately, the benefit ends at 60 days postpartum, creating a dangerous gap in care. Some women may be eligible for regular Apple Health coverage, but approximately 10,000 women in Washington state lose coverage a mere 60 days after their pregnancy ends.
One Seattle mom, Angela, shared that she experienced a painful pelvic-organ prolapse but was only able to get one physical therapy visit before her Apple Health for Pregnant Women coverage ended. The high deductible with her new insurance put physical therapy out of reach. Angela has not been able to get the care she needs and is still suffering at nearly one year postpartum.
Washington state can lift up new mamas and their babies by passing SB 6128 to extend Apple Health for Pregnant Women to one year postpartum. This concept has bipartisan support at the state and national levels. A federal waiver could secure matching funds.
We want all babies to grow up to be healthy, smart and well-adjusted adults. But focusing on them isn’t enough. We also need to focus on the people who delivered them into this world. Untreated postpartum depression may impact new moms and their families. Breastfeeding moms may develop painful mastitis, requiring antibiotics to resolve. New moms suffer through diastasis recti, pelvic-floor issues, severe postpartum depression or anxiety without appropriate care. Having access to health care is important to resolve these issues, and keep moms and babies healthy.
Our nation is experiencing a maternal-mortality crisis. Too many women are dying within a year of childbirth. Some die in childbirth or immediately after from hypertensive disorders or obstetric hemorrhage. The Centers for Disease Control and Prevention reported that approximately 700 women die annually in the United States from pregnancy-related complications. Approximately three in five pregnancy-related deaths were preventable.
Some women die later in the postpartum period due to suicide or accidental overdose caused by behavioral health conditions. But maternal deaths aren’t the only thing to worry about. For every woman who dies, 60 other moms will suffer severe maternal morbidity — serious complications that can have both short and long-term consequences. Maternal mortality and morbidity can touch all walks of life, representing the extreme cases but indicating where inequities persist.
Nonwhite birthing populations and Medicaid enrollees are being left behind in our state and across the nation. In Washington state, American Indian and Alaska Native mothers are six to seven times as likely to die from a pregnancy-related cause as white women. Due to these disparities and others, Washington’s Maternal Mortality Review Panel recommends extending health-care coverage for a full year postpartum.
Many new parents have a hard time getting in to see their doctors within 60 days of delivery. Transportation to and from the clinic can be a struggle. Child care may be inaccessible. And this is before needing to select a new health plan, pay the monthly premium, find a new in-network provider with scheduling availability, or cost-sharing. If new parents do make it to their doctor for a six-week postpartum check, little time remains for them to access any other needed services. Sixty days is simply not enough time.
More needs to be done to truly solve the maternal mortality crisis. Extending postpartum coverage would be a first step in the right direction. We can show we value the lives of those who have given birth by providing them health-care coverage for a full year postpartum.