New reports show racial and rural disparities for Floridians seeking maternal healthcare – State of Reform

New reports document the challenges Floridians face while seeking maternal healthcare, and provide opportunities to improve maternal outcomes.

The March of Dimes released the Where You Live Matters: Maternity Care in Florida report on Aug. 1st. The report presents data on several maternal factors, including levels of maternity care access and maternity care deserts by county, distance to birthing hospitals, availability of family planning services, community level factors associated with prenatal care usage, and the burden and consequences of chronic health conditions across the state. Key findings included:

• 10.8 percent of Florida women had no birthing hospital within 30 minutes, compared to 9.7 percent across the US  
• Overall, women in Florida have a very high vulnerability to adverse outcomes due to the availability of reproductive healthcare services 
• 20.8 percent of birthing people received no or inadequate prenatal care, greater than the US rate of 14.8 percent
• Women with chronic health conditions have a 48 percent increased likelihood of preterm birth compared to women with no chronic health conditions 
• 19.4 percent of Florida’s counties are defined as maternity care deserts, compared to 32.6 percent across the US

Traveling a long distance to receive maternity care increases the risk of maternal morbidity and adverse infant outcomes, according to the report. 

Women in Florida travel 10 miles and 16.5 minutes, on average, to their nearest birthing hospital. Women living in counties with the highest travel times could travel up to 49.4 miles and 57 minutes, on average, to reach their nearest birthing hospital in the state. And in rural areas across Florida, all women live over 30 minutes from a birthing hospital, compared to 10.7 percent of women living in urban areas.

Title X clinics are federally funded healthcare sites that provide low-cost reproductive healthcare services including contraceptives, wellness exams, and breast and cervical cancer screenings. The report displays Title X locations, and areas where women are vulnerable to poor outcomes due to lack of access to reproductive health services. There are 3.3 Title X clinics per 100,000 women in Florida, compared to 5.3 per 100,000 throughout the US.

The March of Dimes recommended the increased use of telehealth services to help address maternal challenges in Florida.

“To address the limited access to maternity care in the US, states must adopt and support telehealth and other innovative practices to expand access and provide more options for healthcare delivery. By highlighting innovative solutions implemented across states, policymakers and healthcare professionals can identify policies and programs that can improve health for pregnant people in Florida, and ensure they receive the support and care needed before, during, and after pregnancy.”

— March of Dimes report

Health Foundation of South Florida President and CEO Loreen Chant said the foundation is working to address health disparities related to Black maternal health at the Florida State of Reform Health Policy Conference in May. The foundation funded the Black Maternal Health Equity Collaborative in Broward County, Jackson Health System, the Southern Justice Network, a Black birthing center at a YWCA, a collaborative in the Florida Keys for initiatives to address disparities, and other Black maternal health projects.

“Those have been funded to the tune of about $3 million,” Chant said. “We needed to provide the technical assistance, the funding, and the time to put the projects together.”

Miami Law’s Human Rights Clinic and the Florida Health Justice Project released The Florida Maternal and Infant Health Crisis report on Aug. 7th, which also notes discrepancies in Black maternal health.

The report states that the maternal and infant health crisis disproportionately impacts marginalized populations in the US, such as Black, Native American, other communities of color, rural communities, and low-income individuals. Black women are about four times more likely to die from pregnancy-related issues than white women in the US, it states. 

The trends are similar in Florida. In 2016, 41 percent of Floridians who died of pregnancy-related complications were Black, despite making up just 16 percent of the state’s population. And Florida mothers were three times more likely to die from pregnancy-related complications, and twice as likely to experience infant mortality compared to their white counterparts, according to the report.

The report provides human rights-based recommendations to improve maternal and infant health. It focuses on three critical solutions: Medicaid expansion, Florida’s Family Planning Waiver Program, and increased use of midwives and doulas.

“Medicaid plays a key role in maternal and infant health, financing more than two out of every five births in the US, and half of all births in Florida. However, Florida has opted out of Medicaid expansion, denying coverage to many women. This lack of coverage has had dire consequences for both maternal and infant health, all too often resulting in mortality.”

— Florida Maternal and Infant Health Crisis Report