Secretary Becerra and HHS Leaders Celebrate Black Maternal Health Week 2022

Biden-Harris Administration continues to advance its goals of improving maternal health and equity.

Today, Secretary Xavier Becerra and leaders across the U.S. Department of Health and Human Services (HHS) released the following statements in recognition of Black Maternal Health Week, which takes place this year from April 11 –17. In recognition of Black Maternal Health Week, President Biden also issued a proclamation underscoring the Administration’s commitment to addressing the crisis of Black maternal mortality and morbidity across our country. The Biden-Harris Administration has championed policies to improve maternal health and equity since the President and Vice President first took office. Last year, President Biden issued the first-ever Presidential Proclamation marking Black Maternal Health Week, coupled with a set of initial actions to address the Black maternal health crisis; and Vice President Harris hosted the first-ever White House Day of Action on maternal health.

Secretary Xavier Becerra: “As we mark the beginning of Black Maternal Health Week, we recognize all the efforts of everyone who has spoken out and taken action to address the heart-wrenching maternal health crisis in our country. Currently, Black mothers suffer pregnancy-related deaths at a rate that is three times higher compared to White mothers. This is unacceptable. These disparities persist regardless of education and income level. And we know that many of these deaths are preventable.

“At HHS, we are taking unprecedented action to close such disparities and strengthen Black maternal health by expanding coverage, implementing new policies, and providing funding to ensure safer pregnancies and postpartum services for new parents and their babies. The President’s 2023 Budget provides HHS with even more resources to improve the health of our nation’s moms. It invests $470 million across HHS agencies to reduce maternal mortality and morbidity. And it also invests $86 million for the Office of Minority Health to focus on areas with high rates of adverse maternal health outcomes and areas with significant racial or ethnic disparities.

“Becoming a parent is among life’s greatest milestones, and pregnancy and childbirth should be a dignified and safe experience for all. We will continue to advance the Biden-Harris Administration’s commitment to ensuring equitable access to health care before, during, and after pregnancy for all mothers in our country.”

Assistant Secretary for Health Rachel L. Levine, MD: “As the Assistant Secretary for Health, child and maternal health is a primary focus. As a pediatrician with a specialty in adolescent medicine, I recognize we need a healthy foundation to build from. A healthy future begins with a healthy childhood and better care for our moms. The United States has the highest maternal mortality among high-income countries. We must and will do better. As we have seen during COVID-19, we are all interconnected and need to ensure that a healthier future includes eliminating health disparities and promoting health equity for all.”

Assistant Secretary of the Administration for Children & Families January Contreras: “Recognizing and addressing the need to alleviate the health crises surrounding Black mothers, both during and after pregnancy, is vital,” said January Contreras, assistant secretary for the Administration for Families and Children. “ACF’s commitment to take a preventative and proactive approach to ensuring child, youth, family and individual well-being includes meeting the human services needs of expectant mothers. Black mothers, and all expectant mothers, deserve equitable access to resources that can help them keep themselves and their babies healthy and safe.”

Centers for Disease Control and Prevention Director Rochelle Walensky, MD, MPH: “Unacceptable racial disparities exist in rates of maternal mortality. Black mothers are three times more likely to die from pregnancy-related causes than white mothers. At CDC, we are committed to taking actionable steps to prevent pregnancy-related deaths and to achieve equity in care and outcomes for all pregnant people. During Black Maternal Health Week, we reaffirm our commitment to addressing these disparities. In FY2022, CDC will expand our direct support to states and tribal nations, to support maternal mortality review committees, which are a cornerstone of public health infrastructure that provide detailed, robust data on maternal mortality and develop recommendations and interventions for prevention. Additionally, CDC’s Hear Her campaign provides resources and tools to help guide the delivery of quality, patient-centered care. We will continue our critical efforts to build the maternal mortality prevention infrastructure needed to eliminate preventable pregnancy-related deaths.”

Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure: “Addressing the maternity care crisis in the United States is one of my top priorities as CMS Administrator.  We are using every lever we can to address the underlying disparities in our health care system, provide whole-person care to pregnant people and their families, and advance health equity across the country. For too long, ingrained racism in our health care system has created devastating disparities in the care people receive and the health outcomes they can achieve. These disparities can be a matter of life and death — so we’re utilizing all our resources to improve maternal health in the United States, including engagement with states and using our oversight and requirements for hospitals that care for pregnant people. This Black Maternal Health Week, I want to thank the advocates, researchers, and people with lived experiences that have be raising the alarm on this issue, often without a spotlight or applause.  At CMS, we are committed and energized around the work that we’ll do together to advance maternal health.”

Health Resources and Services Administration Administrator Carole Johnson: “Every maternal death is a tragedy. The fact that maternal deaths disproportionately happen to Black women is a national crisis. We are committed to improving Black maternal health and overcoming the social and structural inequities that tragically have led to far too many Black mothers and their babies dying during and shortly after pregnancy. At HRSA, we are investing in growing the community-based doula workforce; expanding the Maternal, Infant, and Early Childhood Home Visiting Program; and supporting locally led efforts to improve outcomes before, during, and after pregnancy in order to address this crisis head on.”

Indian Health Service Acting Director Elizabeth Fowler: “This week, we pause to reflect on the sobering fact that too many women die each year in the United States as a result of pregnancy or delivery complications. We recognize this risk is two-three times higher for American Indian and Alaska Native and Black women. We also recognize so many of these deaths are preventable and may be attributed to social determinants of health including factors such as access to care, quality of care, prevalence of chronic diseases, structural racism and implicit biases. IHS works collaboratively with other federal agencies and tribal and urban Indian organizations to reduce severe maternal morbidity and mortality and improve overall maternal health outcomes for mothers, infants, families and communities.”

National Institutes of Health Director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Diana W. Bianchi, MD: “Black women are three times more likely to die from a pregnancy-related cause than white women. Reducing pregnancy-related deaths and complications is the highest priority for the National Institutes of Health, not just during Black Maternal Health Week, but year-round. The National Institutes of Health has provided $224 million for more than 550 research projects to improve maternal health and care. Because one maternal death is one too many, we will remain steadfast in our commitment to safeguard the health of all pregnant women and to eliminate the pregnancy-related health disparities that are all too common.”

National Institutes of Health Associate Director for Research on Women’s Health Janine Austin Clayton, MD, FARVO: “The Maternal Morbidity and Mortality (MMM) Web Portal is a centralized resource that features information about funding opportunities both within the National Institutes of Health (NIH) and across U.S. Department of Health and Human Services (HHS). It also highlights helpful guidance for pregnant people and those that administer them care, including doulas and midwives. The MMM Web Portal  provides innovative information and educational resources for clinicians and scientists seeking to better understand the causes and solutions for poor maternal outcomes. Additionally, the MMM Web Portal provides recommendations to deliver evidence based care to Black women prior to pregnancy, during pregnancy, and for the full year and thereafter. The Office of Research on Women’s Health (ORWH) views pregnancy in the context of the lived experiences of Black women and recognizes the importance of taking a life course perspective where everything that came before affects current health and everything that happens today affects the future health of women, their children, and our society.”

Office for Civil Rights Director Lisa J. Pino: “OCR recognizes that a key pathway to improving maternal health outcomes for Black women is guaranteeing that health care is free of bias and discrimination. As we honor Black Maternal Health Week, OCR is committed to holding providers accountable to nondiscriminatory obstetrics and postpartum care to close the gap on health equity.”

In addition to the Administration’s request for funds to improve maternal health in the 2023 federal budget, Vice President Kamala Harris recently announced a call to action to both the public and private sectors to help improve health outcomes for parents and infants in the United States. HHS is committed to advancing the Biden-Harris Administration’s ongoing efforts to support safe pregnancies and childbirth and reduce complications and mortality in the year following birth.

Recent HHS investments to strengthen maternal health:

• Restored access to Title X services nationwide to fill service gaps caused by more than a quarter of Title X providers withdrawing from the program over the past two and a half years in response to the previous administration’s Title X rule; Awarded $256.6 million in grant funding to support 76 grantees to deliver equitable, affordable, client-centered, and high-quality family planning services.
• Announced the availability of $4.5 million for hiring, training, certifying, and compensating community-based doulas in areas with high rates of adverse maternal and infant health outcomes, double the number of Healthy Start doula programs nationwide.
• Offered state Medicaid and CHIP agencies a new state plan opportunity under the American Rescue Plan to provide 12 months of continuous postpartum coverage, which could extend coverage for more than 130,000 Black Americans. So far, HHS has approved state proposals to expand postpartum Medicaid coverage to 12 months in Illinois, Virginia, New Jersey, and most recently in Louisiana. (A number of other states have announced that they are working to extend Medicaid coverage to 12 months after pregnancy.)
• Provided $10 million for the Services Grant Program for Residential Treatment for Pregnant and Postpartum Women — a program that provides pregnant and postpartum women and their children with comprehensive substance use treatment and recovery support services across residential and outpatient settings.
• Made $12 million available for the Rural Maternity and Obstetrics Management Strategies program to test models to address the unmet needs of rural moms.
• Invested nearly $350 million in total to expand the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program for vulnerable families, and strengthen the Healthy Start initiative to increase access to doulas, address health disparities in infant deaths, and improve data reporting on maternal mortality.
• Adopted a measure in the Hospital IQR Program in the FY 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) Final Rule that will encourage hospitals to standardize protocols addressing obstetric emergencies and complications arising during pregnancy.
• Launched a postpartum care challenge competition to identify innovative ways to improve postpartum care for Black and American Indian/Alaska Native (AI/AN) persons enrolled in Medicaid and CHIP coverage, with an emphasis on follow-up care for conditions associated with morbidity and mortality in the later postpartum period.  Phase II of this challenge opens in September 2022; Phase 1 closed in February 2022.
• Led the development of a new, standard clinical definition for opioid withdrawal in infants, which will help improve both the diagnosis and care of infants experiencing withdrawal from prenatal substance exposure. [HHS]
• Developed the HHS Overdose Prevention Strategy, that emphasizes the importance of integrated care and combating stigma associated with substance use, which may discourage people from seeking care during pregnancy and the postpartum period. [HHS]

Other actions HHS has taken to promote maternal and postpartum care:

• Published a report that estimated approximately 720,000 people would benefit if all states were to adopt the American Rescue Plan’s new option to extend post-partum Medicaid coverage for a full 12 months. [ASPE]
• Implemented a new quality measure for the Hospital Inpatient Quality Reporting Program to improve maternity care. Initially based on data reported by hospitals on this measure, and in combination with data reported by hospitals on other measures in the future, a hospital could receive a maternity care hospital designation on the CMS Care Compare website. [CMS]
• The National Institutes of Health (NIH) Maternal Mortality Task Force developed the IMPROVE Initiative, which focuses on promoting the study of the leading causes of maternal mortality in the U.S., including cardiovascular disease, infection, and immunity, as well as other health conditions and social factors such as mental health disorders, diabetes, obesity, and substance use disorders. [NIH]
• Launched the HHS Perinatal Improvement Collaborative to deploy clinical, evidence-based best practices in maternity care through a network of over 200 hospitals. [Office of the Assistant Secretary for Health (OASH)/OWH]
• Started the Breastfeeding Program for African American mothers and families to increase breastfeeding rates in that population, one in which 75.5 percent of infants are not breastfed. [OASH/OWH]
• Funded 14 organizations across twelve states to develop and implement interventions to reduce maternal deaths due to violence, and to sustain other interventions that significantly improve maternal health outcomes. [OASH/OWH]
• Increased funding for the Enhancing Reviews and Surveillance to Eliminate Maternal Mortality Program to reach six additional states, for a total of 30 awards supporting 31 states. This funding directly supports agencies and organizations that coordinate and manage Maternal Mortality Review Committees (MMRCs) to identify, review, and characterize pregnancy-related deaths; and identify prevention opportunities. [CDC]
• Released a report that describes the characteristics of pregnancy-related deaths due to mental health conditions from fourteen state Maternal Mortality Review Committees. Nearly 1 in 9 pregnancy-related deaths were due to mental health conditions. Among pregnancy-related mental health deaths with a preventability determination by the MMRC, 100% were determined to be preventable. Nearly three-quarters of people with a pregnancy-related mental health cause of death had a history of depression, and more than two-thirds had past or current substance use. [CDC ]
• Hosted the second National Convening on Substance Exposure in the Mother-Infant Dyad to discuss findings from HHS’ evidence-based methodology on improving identification and care for mothers and infants with substance exposure; and published the first recommendations for standardized identification. [OASH]