Lack of healthcare can mean life or death when giving birth in America — it’s up to states to help

Americans hoping to build a family face a stark reality: Childbirth in the United States is dangerous. 

That’s right, our nation has the highest maternal mortality rate of any other developed country. Between 2000 and 2017, the global maternal mortality rate dropped by 38 percent. But here in the U.S., that rate is actually rising. Women of color are particularly at risk — Black women are over three times more likely to die from pregnancy-related causes than white women. 

Policymakers could seriously curb these risks by ensuring mothers can access better health coverage through Medicaid. But despite broad bipartisan support, our leaders refuse to take simple steps to do so. And as Roe v. Wade hangs in the balance, improving maternal care is more important than ever. 

I know this all too well. I lead the Mississippi Center for Justice, which has been pushing for affordable, accessible health care in Mississippi for decades — including ensuring proper care for people giving birth — well after a child has actually been born. 

First, it’s important to understand the many health implications of childbirth. Pregnancy itself is incredibly physically and emotionally taxing. Childbirth comes with a host of potential risks. And in the weeks and months after bearing a child, women can experience serious physical and mental health issues — including depression, heart problems, and blood clots. All of these issues can seriously hurt the entire family — and in the worst cases, lead to a mother’s death. 

The good news: The vast majority of pregnancy-related deaths are entirely preventable. We just need to act.  

Medicaid is a crucial piece of this puzzle. Medicaid pays for four in 10 births in the nation. It’s an instrumental service for low-income women and their newborn babies. It provides an important stopgap for families who don’t have access to health insurance through employment. 

But a dozen states, including Mississippi, have yet to exercise their option to expand Medicaid coverage to even more people who can’t afford insurance, leaving hundreds of thousands of Americans without a source of health care. That leaves many women with an impossible choice: Rack up huge sums of medical debt that could bury a family for the long haul, or decline adequate health care. 

It doesn’t have to be this way. Research shows that expanding Medicaid reduces maternal mortality, particularly among Black women. It’s appalling that we wouldn’t take such a simple, research-backed step to save lives. 

What’s more, the federal government only requires Medicaid to provide postpartum care for two months following childbirth, even though pregnancy-related health problems can persist long beyond that time. That leaves many women — disproportionately women of color — without health insurance during an incredibly vulnerable time.

A provision in the American Rescue Plan attempted to address this by allowing states to extend Medicaid postpartum coverage to one year after giving birth. That has made approximately 720,000 pregnant and postpartum people eligible for benefits. 

But states have to opt in to access this. More than 35 states have already done so or are in the process of doing so. But many, including — unsurprisingly — Mississippi, have declined to take action. 

The situation in Mississippi was particularly disheartening. While the Senate voted to expand postpartum coverage by a huge margin – a rare feat in our state — the House allowed the bill to die. And all because of partisan politics. 

This refusal is particularly ironic given the Mississippi legislature’s “trigger law” that will make abortion illegal if Roe v. Wade is overturned by the U.S. Supreme Court’s upcoming decision in Dobbs v. Jackson Women’s Health Organization, for which my organization is serving as co-counsel. It’s a prospect that is even more ominous after the leak of the draft majority opinion that would do overturn Roe. What’s absurd is Mississippi’s hypocritical claim of protecting the “sanctity” of life by “protecting” the unborn embryo when its lawmakers fail to devote reasonable attention to ensuring that women and their families have the resources to live healthy, fruitful lives — like basic shelter, food, and health care  

Every person who wants to have a child deserves to have affordable, high-quality health care. This issue cannot continue to be a political bargaining chip. Lives are on the line.

Vangela M. Wade is president and CEO of the Mississippi Center for Justice, a nonprofit, public interest law firm committed to advancing racial and economic justice.