The White House Blueprint for Addressing the Maternal Health Crisis: Two Years of Progress

For far too many American mothers, complications related to pregnancy, childbirth, and postpartum can lead to devastating health outcomes—including hundreds of deaths each year. Unfortunately, our nation has one of the highest maternal mortality rates of any wealthy country in the world. This maternal health crisis is particularly devastating for Black women, Native women, and women in rural communities who all experience maternal mortality and morbidity at significantly higher rates than their white and urban counterparts. That is why President Biden and Vice President Harris have worked to address this crisis with the urgency it demands.  

In June 2022, Vice President Harris announced the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis, a whole-of-government effort to combat maternal mortality and morbidity. Its focus has been on reducing disparities in maternal health outcomes and improving the overall experience of pregnancy, birth, and postpartum for all women in the United States. Since the Blueprint was released, the Biden-Harris Administration has made significant strides in improving maternal health for women across the country. 

Today, Vice President Harris announced some of the Blueprint’s key accomplishments while speaking to more than 20,000 women in Dallas, TX at the 71^st National Boulé for the Alpha Kappa Alpha Sorority, Inc.—the world’s oldest college-based sorority founded by African-American women. As part of the Blueprint, the Biden-Harris Administration has:

• Created the first-ever baseline federal health and safety requirements for maternal emergency and obstetric services in hospitals. Vice President Harris announced the first-ever baseline federal health and safety requirements that hospitals would have to meet for obstetrical services. These new standards focus on ensuring emergency departments have sufficient protocols and supplies (e.g., “crash carts”) for obstetrical emergencies, that hospitals have procedures in place for transferring maternity patients to other facilities if they do not have the capabilities to provide sufficient care, and when a maternal death happens, that a hospital understands why and works to improve care so it does not happen again. These new standards include annual staff training on evidence-based maternal health practices, among other topics.
   
• Extended postpartum Medicaid coverage from 2 to 12 months, providing lifesaving coverage to hundreds of thousands of new moms, and encouraged states to cover doula services. Historically, states have only been required to offer mothers Medicaid coverage for 2 months postpartum. The American Rescue Plan allowed states to provide women coverage for a full year after having a baby—when postpartum mortality remains a risk—and the FY 2023 Consolidated Appropriations Act made this option permanent. In December 2021, Vice President Harris called on states to extend their postpartum coverage to a full year. To date, the Biden-Harris Administration has approved postpartum extensions in 46 states plus D.C. and the U.S. Virgin Islands.
   
• Created a new “Birthing Friendly” hospital designation so that women can more easily find high-quality maternity care.  The Blueprint called for establishing a new “Birthing Friendly” designation for hospitals with a demonstrated commitment to improving maternity care quality.  Now, over 2,000 facilities are considered “Birthing Friendly” and women can easily search for the “Birthing Friendly” logo on the CMS Care Compare website and in many private health plan directories to see which hospitals and plans participate.
   
• Launched the National Maternal Mental Health Hotline, which has connected nearly 38,000 individuals to free, confidential, 24/7 support.  Behavioral health issues, such as maternal depression, are the most common complication of pregnancy and childbirth. New moms and their families can receive immediate support, resources, and referrals through the National Maternal Mental Health Hotline (1-833-TLC-MAMA/1-833-852-6262).  Professional counselors offer free, 24/7, confidential support by phone or text, in English and Spanish. Interpreter services are available in 60 languages. In its first two years, the Hotline has helped more than 37,700 individuals.
   
• Continued to close the Medicaid coverage gap.  Since the start of the Biden-Harris Administration, four states have expanded Medicaid coverage, with an additional 1.1 million Americans gaining Medicaid coverage.  To date, 40 states, Washington, D.C., and the U.S. Virgin Islands have all expanded Medicaid.
   
• Launched the Transforming Maternal Health Model to improve maternal health care for people enrolled in Medicaid and Children’s Health Insurance Program.  The model will support participating state Medicaid agencies in the development of a whole-person approach to pregnancy, childbirth, and postpartum care that addresses the physical, mental health, and social needs experienced during pregnancy. Up to 15 states will be selected in the fall, with awards of up to $17 million per state.
   
• Distributed 3,000 newborn supply kits and announced the delivery of 10,000 more in 2024. In 2023, Vice President Harris launched the Newborn Supply Kit Pilot Project, distributing kits with essential supplies (such as diapers and information on federal resources like the Maternal Mental Health Hotline) to families in Arkansas, Louisiana, and New Mexico. An additional 10,000 kits will be distributed across these and seven other states (AL, CA, GA, MS, NY, TN, TX) in 2024.
   
• Trained maternity care providers on maternal mental health and substance use disorders. The Biden-Harris Administration has invested in training nearly 2,000 providers on how to screen, assess, treat, and refer for maternal mental health and substance use disorders so that pregnant and postpartum women can get the care they need when they need it.
   
• Invested in growing and diversifying the perinatal workforce, including non-traditional providers like doulas and lactation counselors. The Biden-Harris Administration has increased the number of obstetrician-gynecologists (OB/GYNs), nurses, midwives, doulas, and community health workers, especially in places without them, through grants, scholarships, and loan repayment support. For example, a $27.5 million program provided specialized maternity care training to over 2,200 OB/GYNs, nurses, and other providers; and a $10 million program provided 95 loan repayment and scholarship awards to nurses with expertise in maternity care. In addition, doulas, lactation consultants, and lactation counselors are now covered under a demonstration project for certain members of the military, retired members, and their family members who receive care under TRICARE.
   
• Expanded the Department of Veterans Affairs’ maternity care coordination program to support pregnant and postpartum Veterans through 12 months postpartum. In 2023, the VA extended its maternity care coordination program from 2 months postpartum to 12 to ensure that women have access to the care they need including primary care, mental health care, treatment for substance use disorder, intimate partner violence assistance, housing assistance, and resources to address food insecurity. The program impacts 8,000 Veteran families per year, and that number is expected to grow.
   
• Established new maternity care target areas to address workforce shortages through loan repayment and scholarship programs. The Biden-Harris Administration established a specific new designation for areas with shortages of maternity health care professionals and will award $8 million in loan repayment assistance and scholarships to those committed to providing OB/GYN care in these high need areas.
   
• Launched the HHS Secretary’s Postpartum Maternal Health Collaborative in six states to improve health outcomes. The Collaborative works to synergize efforts at the local, state, tribal, and federal levels to improve postpartum outcomes. Iowa, Massachusetts, Maryland, Michigan, Minnesota, and New Mexico are participating and focused on addressing behavioral health and substance use disorders or hypertension and other cardiac issues in postpartum women.
   
• Made resources available for all states to better understand and prevent pregnancy-related deaths. The Biden-Harris Administration expanded the resources available for Maternal Mortality Review Committees (MMRCs) so that all states and territories have access, up from the 39 that previously had access. MMRCs are state-level groups that review deaths that occur during or within 1 year of a pregnancy and make recommendations on how to prevent future deaths.
   
• Expanded the reach of the “Hear Her” campaign, which raises awareness about urgent maternal warning signs, to critical new populations. The Biden-Harris Administration designed materials with and for American Indian and Alaska Native women so that those who are pregnant or postpartum, their providers, and their loved ones can spot warning signs of postpartum complications—like chronic headache, dizziness, and trouble breathing—and receive medical care.
   
• Hosted events around the country that connect people with maternal health resources. In 2023, the Department of Health and Human Services launched the M.O.M.S. Tour (Maternal Outcomes Matter Showers) in 11 cities, serving over 5,000 prenatal and postpartum women and 300 men and children; and connecting over 1,700 people to mental health services, 500 to health care coverage, and 800 to midwifery and doula services. In addition, more than 100 Black women were certified as doulas. An additional 25 stops are anticipated in 2024.
   
• Invested tens of millions to bolster research initiatives on maternal health. For example, the Biden-Harris Administration launched a $3 million challenge competition for community-based organizations to conduct maternal health research and final prizes will be awarded this summer. An $8 million challenge was also launched to accelerate development of technology that can improve access to postpartum health care, with final prizes slated for this winter.  In addition, 12 Maternal Health Research Centers of Excellence were established with approximately $28 million in first-year funding to develop innovative approaches, in collaboration with community organizations, to improving maternal health. The Biden-Harris Administration also launched a new Maternal Health Research Collaborative for Minority Serving Institutions that provides funding for research to 16 institutions of higher education that serve a large percentage of underrepresented or disadvantaged students across the country. Lastly, three community implementation projects were also funded with $3.6 million to pilot approaches to reducing maternal health disparities.
   
• Worked to protect pregnant workers and nursing women while on the job. In 2022, President Biden signed into law the Pregnant Workers Fairness Act (PWFA) and the Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act, which are now in effect. PWFA helps millions of pregnant women by ensuring that employers make reasonable accommodations for them in the workplace, such as additional breaks to drink water, eat, or use the restroom; a stool to sit on while working; and/or time off for health care appointments. The PUMP Act extends protections for reasonable break time and private space to express breast milk to nine million additional nursing workers.
   
• Ensured that the federal government serves as a model employer for maternal health care coverage to its more than 8 million enrollees. Currently, 100% of plans offered to federal employees and their families cover mental health treatment for postpartum depression; 99% cover certified nurse midwives; 67% cover delivery at birth centers; 67% cover nurse home visits; and 45% cover doulas. Plans also support the Biden-Harris Administration’s “Birthing Friendly” hospital designation by contracting with designated facilities and adopting the “Hear Her” campaign in their provider education work.
   
• Worked to replace the nation’s lead pipes to decrease risk of miscarriage. Drinking water from lead service lines can increase a woman’s risk of miscarriage. The Biden-Harris Administration invested $15 billion from the Bipartisan Infrastructure Law and launched the “Get the Lead Out Initiative” in 200 underserved communities to accelerate removal of lead service lines nationwide.
   
• Modernized the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and increased program participation to combat food insecurity. With $390 million from the American Rescue Plan, USDA made it easier to apply for WIC and provided new ways for people to participate in the program, including virtual options. USDA also updated the WIC food packages to align with the latest nutrition science to promote healthy maternal and child outcomes, increase access to fruits and vegetables, allow more flexibility to meet special dietary needs, and provide more support for individual breastfeeding goals. These changes, taken together, have resulted in 400,000 more people with WIC benefits.
   
• Invested in new community health center efforts to address maternal health disparities. Invested more than $65 million in 35 HRSA-funded health centers across the country to implement innovative approaches to improve maternal health outcomes and reduce disparities for patients at highest risk. 
   
• Secured public and private sector commitments from over 30 entities, all of which have been completed or are ongoing for multi-year investments. Several examples include Merck, which committed to invest $15 million of new funding to address racial disparities in maternal health by building and scaling evidence-based community-led approaches; CVS, which invested nearly $1.8 million in new maternal health initiatives focused on providing expecting parents, health care providers, and hospitals with critical educational resources; the Blue Cross Blue Shield Association, which partnered with the March of Dimes to offer additional training to providers, students, perinatal quality collaboratives, community organizations and their employees in more than 20 states nationwide; and Kaiser Permanente which extended and will evaluate the impact of its hypertension remote care monitoring program on health outcomes by race and ethnicity. The full list of commitments is available here.
   

Today’s announcement builds on President Biden and Vice President Harris’s long record of fighting for the health, safety, and wellbeing of women. Vice President Kamala Harris came into office as a key leader on maternal health. As Attorney General of California, she was a fierce advocate for domestic violence victims, who are all too frequently mothers or pregnant. As Senator, she introduced a number of bills addressing racial disparities in maternal morbidity and mortality that later passed into law, including the Maternal CARE Act, which included $125 million for states to establish care coordination programs for pregnant women to identify high-risk pregnancies and provide women with essential care and resources. She also introduced the Black Maternal Health Momnibus Act, which sought to make investments in social determinants of health, community-based organizations, and the growth and diversification of the perinatal workforce among other actions to improve Black maternal health.

Leading up to the White House Blueprint for Addressing the Maternal Health Crisis, the Vice President hosted a roundtable on Black Maternal Health and was joined by women who shared their experiences with complications from pregnancy, childbirth, and postpartum as well as their work in advocacy and research, highlighting the disparities that Black women face in maternal health. In April 2022, she convened a historic meeting with Cabinet Secretaries and agency leaders to discuss the Biden-Harris Administration’s whole-of-government approach to addressing maternal mortality and morbidity. And the Vice President will continue to use her platform to raise public awareness about the maternal health crisis in our nation, as she has done while calling on states to extend Medicaid postpartum coverage, highlighting the Maternal Mental Health Hotline, and more.

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