Natalie Davis is CEO and Cofounder of United States of Care, an organization dedicated to making our health care system more equitable.
For every new mother, the months after birth are full of worries. As a mother of four, I know just how scary the postpartum period can be. You’ve spent the last nine months carrying your child, and now that baby is in the world. Although you try your hardest, you can’t prepare for everything that happens in the weeks and months to come. And in the stress of ensuring everything is okay for your baby, you can lose sight of taking care of yourself. And the health care system doesn’t feel like it’s set up to help you, but that it’s focused on the 40 weeks of pregnancy and later, the newborn baby. Society almost never asks: How is mom doing after birth?
The State Of Postpartum Care
I hear all the time in the United States of Care’s conversations with moms across the country that the postpartum period is fraught with challenges—especially for women of color and especially in the South. While they struggle with little sleep amid a complete change in their bodies, or even experience feelings of postpartum depression or anxiety, they might feel like they need to go it alone because access to postpartum care is scarce where they live, it isn’t covered by their insurance, or they just don’t even know that help exists.
The data—or lack thereof—reflects this. In many states, I haven’t seen data on postpartum depression rates, screenings for postpartum mental health, and postpartum care coverage for privately-insured women collected. And I think there is still much room for improvement in data on women covered by Medicaid. Women often don’t believe they are a priority at this point in their lives, and by not adequately collecting data on how they’re doing, we’re reinforcing that.
The data we have access to paints a bleak picture for postpartum women. Affordable, quality maternal health care that includes postpartum care isn’t just difficult to come by in a few corners of this country—in many places, it’s almost completely absent. In fact, March of Dimes reports that there are over 1,000 counties in the United States where there are no hospitals offering obstetric care, no birth centers and no obstetric providers. That’s more than 2 million women with absolutely no easy access to these services. At the same time, access to information about postpartum care is lacking.
For the women who do know about and have access to these services, there’s another roadblock—lack of coverage. While nearly all states have extended or plan to extend Medicaid coverage to 12 months postpartum for new mothers, that does nothing for the tens of millions of privately-insured women in the postpartum period. And even for those with insurance coverage, services like postpartum doulas, lactation consultants and home visits aren’t always adequately covered.
These barriers show up in the numbers—most maternal deaths happen in the postpartum period.
Achieving A Vision For Better Postpartum Care
The months after birth shouldn’t be like this—and there’s a lot of work to be done to improve postpartum care. Far too often in my conversations with people across the country, I hear from women who were given too little time off before being expected to come back to work and who were not given enough support to navigate the early months of motherhood.
This is where employers can step in to help us bridge these gaps. In an ideal world, women would have the time they need to heal, easy access to screenings for conditions like postpartum depression and anxiety, and care that meets them where they are through virtual care or home visits. Just like Amazon recently announced, employers should make sure they cover things like doulas (which Amazon recently announced coverage for), midwife resources, mental health services and postpartum provider visits. And they should provide work accommodations like comprehensive parental leave, lactation support, child care support and family planning resources.
Access to these services isn’t just beneficial to new mothers navigating the difficult postpartum period; I expect that it would help employers, too. Comprehensive postpartum care and work accommodations could enhance the well-being of our workforces, improve workplace culture, facilitate a healthy transition from pregnancy to motherhood and improve productivity and employee retention. It could also reduce employer health care costs from childbirth-related adverse events. To say the least, I believe strong postpartum care is good for moms and good for business.
New moms deserve to feel supported as they bring a new life into the world. And they deserve to have access to the help they need for themselves as they embark on this new and exciting journey into motherhood. Employers can help us achieve that reality. It’s what I wanted for myself, and it’s what every woman and mother deserves.
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