Extending Postpartum Coverage

Supporting Black Maternal and Child Health.

Expanding postpartum coverage under Medicaid from 60 days to 12 months will improve Black maternal health

Black women die from pregnancy-related causes more than three times the rate of white women, and experience Severe Maternal Morbidity at a rate 73% higher than white women.  One contributing factor is the lack of a health care safety net for postpartum women who receive health insurance from Medicaid.

To achieve optimal Black maternal health outcomes in the state of Nebraska, it is essential to further expand meaningful access to affordable and consistent health care for Black birthing folks, wherever they live, throughout their lives.

OUR CALL TO ACTION

Nebraska can support women and people with the capacity for pregnancy by filing a State Plan Amendment to extend postpartum coverage under Medicaid from 60 days to 12 months.

What is Severe Maternal Morbidity and Mortality?

According to the U.S. Centers for Disease Control and Prevention, Severe Maternal Morbidity is defined as “unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to the health of a birthing person.”

The CDC categorizes Severe Maternal Morbidity by 21 different adverse events or indicators. These include, but are not limited to, heart failure, hemorrhaging, and renal failure. Although Severe Maternal Morbidity impacts all birthing folks, it disproportionately exacerbates Black women and folks with reproductive systems, which already have the worst maternal health outcomes in Nebraska.

The Severe Maternal Morbidity rate is 63% higher for women in Black communities than in white communities. This is due to the already existing health disparities, such as increased likelihood of chronic illness, access to healthcare, and inadequate care, that are exacerbated during pregnancy. In fact, Black birthing folks are 27% more likely to experience severe pregnancy complications than white birthing folks.

Severe Maternal Mortality

Maternal Mortality is defined as “the death of a woman during pregnancy or within one year of the end of pregnancy.”

Similar to Severe Maternal Morbidity, Maternal Mortality disproportionately affects Black women despite continued progress in medical care and technology. Maternal Mortality rates among Black women continue to increase.

There are many factors resulting in this disparity, including but not limited to, structural racism, implicit bias, access to healthcare, and pre-existing chronic conditions.

Nebraska reports of maternal deaths in the state, 3 out of 4 deaths were preventable. Nationally, 1 out of 3 maternal deaths happen from one week to one week to 1 year, and being able to access health is crucial to preventing these deaths. 

The share of births covered by Medicaid is much higher for Black birthing people, at 65%

In 2021, Nebraska’s Office of Maternal and Child Health Epidemiology reports of factors contributing to maternal mortality, almost 30% are due to lack of access/financial resources or continuity of care.

In Nebraska, maternal death occurred, on average, 128 days after pregnancy.

Medicaid beneficiaries had a severe maternal morbidity rate of 52.3 per 10,000 births.