Neera Tanden Remarks at the National Association of Counties Event on Black Maternal and Infant Mortality
As Prepared For Delivery:
Good afternoon, and thank you, Matt [Chase], for the kind introduction. We are so grateful to you for helping ensure that leaders across federal, state, and local governments have robust communication and coordination on a full range of important policymaking and resources.
Thank you so much to the National Association of Counties for inviting me to speak at today’s important event on Black maternal and infant mortality.
I know you all have heard from many of my colleagues from across the Biden-Harris Administration and other leaders in the maternal and infant health space. I am so grateful to be among so many incredible advocates.
We all know how important this issue is.
The reality is that the United States is facing a maternal health crisis.
I’m sure you have heard this today, but it bears repeating: Our country’s maternal mortality rate is the highest of any developed nation in the world. It is more than double the rate of peer countries.
What’s more, every year, thousands of women experience serious complications from labor: heart issues, needed blood transfusions, eclampsia, blood infections, injuries, and more.
These issues are even more acute among Black women, American Indian/Alaska Native women, and rural women.
Black women are three times more likely to die from a pregnancy-related cause than white women.
And that is regardless of income or education.
Furthermore, Black babies have 2.4 times the infant mortality rate as white babies.
Multiple factors contribute to these disparities.
Variation in healthcare. Underlying chronic conditions. Structural racism. Implicit bias.
Women report having their pain ignored, requests for help denied, and decisions on medical interventions—like labor induction, for example—being made for them.
This is unacceptable.
And frankly, it is unnecessary.
Because here’s the thing: Most pregnancy-related deaths are preventable.
That is why the Biden-Harris Administration is so committed to addressing Black maternal and infant health.
That is why we’re working to give Black mothers and their children the care we deserve.
This is a priority for this Administration.
It is a priority for me, as a mother of two.
In 2021, President Biden issued the first-ever Presidential Proclamation for Black Maternal Health Week. He’s issued one every year since.
We’re putting our efforts behind his powerful words.
That means laying out our strategy.
Last year we released the released the Blueprint for Addressing the Maternal Health Crisis.
This Blueprint lays out specific actions that the Federal Government will take to improve maternal health.
The Blueprint is focused on five core goals and has dozens of actions we have or will take to improve maternal health. And the President has secured funding from Congress to implement this plan.
First, we’re making it easier to get care, including behavioral health care—and to get care covered.
We have expanded postpartum Medicaid coverage from 60 days to 12 months in more than 30 states and D.C., and made this a permanent option for states.
This Administration also has worked to implement the No Surprises Act. This legislation helps ensure that women are protected from certain unexpected out-of-network medical bills that can come up during pregnancy, postpartum care, and delivery.
And because we know that mental health issues are the most common complications of childbirth, we are working to increase screening for postpartum depression and other conditions.
That’s also why we launched the Maternal Mental Health Hotline (1-833-TLC-MAMA).
This is a confidential, 24-hour, toll-free number that new and expecting moms and families can call or text to connect with professional counselors.
Secondly, we’re ensuring those giving birth are heard. That they are actually decisionmakers in their care. That systems of care are accountable for how they treat women and families.
That’s why we created a new “Birthing Friendly” hospital designation.
This is a public-facing recognition of the quality and safety of maternity care in hospitals, which will be publicly reported beginning this fall.
It’s like a good housekeeping seal for hospitals. It will ensure that patients can quickly determine if a hospital provides adequate care to birthing parents.
Third, we’re improving data collection and transparency in the system.
That includes expanding Maternal Mortality Review Committees from 39 to all 50 states.
When there is a pregnancy-related death, these multidisciplinary committees look at both clinical and non-clinical information—including county data—to understand why. And they develop recommendations to prevent similar deaths in the future.
In addition, we’re expanding and diversifying the perinatal workforce, including increasing the number of physicians, licensed midwives, doulas, and community health workers in underserved communities
Next, we’re looking beyond the doctor’s office and treating the whole person. I know that addressing the social determinants of health is a key focus of today’s conversation around the Harris County ACCESS program.
To that end, we are:
Bolstering the Maternal, Infant, and Early Childhood Home Visiting Program, which was reauthorized this past year; and Working to modernize the Special Supplemental Nutrition Program for Women, Infants, and Children, better known as WIC. We also expanded participation in WIC with $390 million from the American Rescue Plan.
President Biden also signed legislation to ensure employers make reasonable accommodations for pregnant workers and job applicants. This legislation also expands the use of break time and access to private spaces for millions of nursing parents.
Relatedly, if we want workers to participate and be productive in the labor force, they need affordable, high-quality child care.
In April, the President signed a historic Executive Order on care. It represents the most comprehensive set of actions any President has ever taken to advance care. And it builds on President Biden’s efforts to secure a critical 30 percent bump in funding for child care this last fiscal year.
Finally, we recognize we can’t do this work alone.
If we’re going to improve maternal health in this country, it will take a whole-of-society approach — including federal, state and local governments; the health care system; and the private sector.
That’s why Vice President Harris, a long-time champion of this issue, issued a call to action to reduce maternal mortality and morbidity.
The Vice President has galvanized actions from the public and private sectors.
For example, Pampers supported implicit bias training for maternal and infant health workers in high-need states. This ensures that over 20,000 birthing parents every year receive care from health workers who are trained to identity and address their own implicit bias.
And CVS supported a new film series to help expecting parents through their maternity care journey. It also launched an initiative to improve obstetric care for Black pregnant women in 12 safety-net hospitals.
So, we’ve made some progress. But we have a lot more work to do.
I thank you all for your continued efforts to support this work.
County governments play such a crucial role in improving maternal health, especially by addressing those social determinants of health—from economic development, to good nutrition, to transportation.
I encourage you all to continue to innovate and test new models of care and service delivery. Those innovations fuel efforts at the national level, so I thank you for this important work.
Additionally, we are eager for your help to ensure people stay covered by Medicaid.
Legislation enacted at the beginning of the pandemic allowed people to keep their Medicaid coverage, without having to re-establish their eligibility.
Now, three years of eligibility redeterminations are happening all at once.
This puts people at risk of being disenrolled from Medicaid if they don’t take appropriate actions.
It’s extremely important that we help people who are still eligible for Medicaid keep their coverage, and help others transition to employer or ACA plans.
I know many of you are already engaged in this effort, and we are so grateful. Ensuring families stay connected to coverage is an all-hands-on deck effort.
Similarly, if your state has not yet expanded postpartum Medicaid coverage, we encourage you to double down on efforts on that front.
It’s incumbent on all of us to correct course regarding maternal health, and in particular, Black maternal health.
We have the ability to go from one of the worst developed countries in terms of maternal health, to one of the best.
Our vision is that the United States will be considered the best country in the world to have a baby.
Americans deserve nothing less.
Thank you.
