ABSTRACT
Most early maternal deaths are preventable, with many occurring within the first year postpartum (we use the terms "maternal" and "mother" broadly to include all individuals who experience pregnancy or postpartum and frame our recognition of need and policy recommendations in gender-neutral terms. To acknowledge limitations inherent in existing policy and the composition of samples in prior research, we use the term "women" when applicable). Black, Hispanic, and Native American individuals are at the most significant risk of pregnancy-related death. They are more commonly covered by Medicaid, highlighting likely contributions of structural racism and consequent social inequities. State-level length and eligibility requirements for postpartum Medicaid vary considerably. Federal policy requires 60 days of Medicaid continuation postpartum, risking healthcare coverage loss during a critical period of heightened morbidity and mortality risk. This policy position paper aims to outline urgent risks to maternal health, detail existing federal and state-level efforts, summarize proposed legislation addressing the issue, and offer policy recommendations for legislative consideration and future study. A team of maternal health researchers and clinicians reviewed and summarized recent research and current policy pertaining to postpartum Medicaid continuation coverage, proposing policy solutions to address this critical issue. Multiple legislative avenues currently exist to support and advance relevant policy to improve and sustain maternal health for those receiving Medicaid during pregnancy, including legislation aligned with the Biden-Harris Maternal Health Blueprint, state-focused options via the American Rescue Plan of 2021 (Public Law 117-2), and recently proposed acts (HR3407, S1542) which were last reintroduced in 2021. Recommendations include (i) reintroducing previously considered legislation requiring states to provide 12 months of continuous postpartum coverage, regardless of pregnancy outcome, and (ii) enacting a revised, permanent federal mandate equalizing Medicaid eligibility across states to ensure consistent access to postpartum healthcare offerings nationwide.
Many maternal deaths happen within the first year postpartum and can be prevented. Black, Hispanic, and Native American mothers are at more risk for many reasons, including unfair systems and insufficient healthcare coverage from government insurance (Medicaid). Rules for getting Medicaid can be very different across states and in postpartum compared to pregnancy. The US government only requires states to continue providing Medicaid for 60 days postpartum, after which it is up to each state. If mothers are required to re-qualify for Medicaid shortly after giving birth, they could lose healthcare when they are at more risk of dying or getting sick. In this policy position paper, a team of maternal health researchers and clinicians reviewed and summarized recent research and current laws related to postpartum Medicaid to propose future laws that could address these issues. Some proposed laws would expand Medicaid coverage during postpartum, but lawmakers have not recently discussed them. This position paper recommends that lawmakers (i) consider laws that require states to provide 12 months of postpartum healthcare coverage and (ii) have the US government make the same rules to qualify for postpartum Medicaid across all states.
Subject(s)
Child Health , Medicaid , Postpartum Period , Humans , Medicaid/legislation & jurisprudence , United States , Female , Pregnancy , Child Health/legislation & jurisprudence , Maternal Health/legislation & jurisprudence , Health Policy/legislation & jurisprudenceABSTRACT
Fundamentada en la Ley para la Maternidad Saludable, considerada como prioridad nacional y amparada en el Acuerdo gubernativo: No. 102-105, esta Política Nacional quiere reconocer la labor de las comadronas, quienes por siglos han aportado a la salud de la comunidad a través de la atención materna neonatal y dado que la función de las comadronas está estrechamente vinculada a la promoción de la Maternidad Saludable. Según el INE, en el 2013 las 23,320 comadronas registradas por el MSPAS, atendieron 124,688 partos, que constituyen el 32,2 % de todos los partos atendidos en el país. Por todo ello, el MSPAS, implementará acciones para respetar, reconocer y revitalizar la labor de las comadronas en la población de Guatemala. La Política fue elaborada con base a los resultados de los 33 diálogos en los que participaron las comadronas representativas de las 29 áreas de salud de los 22 departamentos de Guatemala, en coordinación con instituciones gubernamentales, sociedad civil y agencias de cooperación internacional que trabajan en salud, lo que le da un respaldo social e institucional a la misma. Especialmente relevante es superar la incomprensión de algunos personeros de salud, debido a la desvalorización de dichas prácticas tradicionales. Por medio de esta Política no solo se quiere lograr el reconocimiento, sino establecer los ejes institucionales para el trabajo conjunto en pro del bienestar materno-infantil.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant , Adult , Maternal and Child Health , Culturally Competent Care/legislation & jurisprudence , Maternal Health/legislation & jurisprudence , Midwifery/legislation & jurisprudence , Health of Indigenous Peoples , Reproductive Health/legislation & jurisprudence , Cultural Rights , Guatemala , Health Services, Indigenous/organization & administrationABSTRACT
Esta Ley tiene como objetivo, la creación de un marco jurídico que permita implementar los mecanismos necesarios para mejorar la salud y calidad de vida de las mujeres y del recién nacido, y promover el desarrollo humano a través de asegurar la maternidad de las mujeres, mediante el acceso universal, oportuno y gratuito a información oportuna, veraz y completa y servicios de calidad antes y durante el embarazo, parto o posparto, para la prevención y erradicación progresiva de la mortalidad materna-neonatal, entre otros. Contiene 32 Artículos. Contiene además: "Reglamento de ley para la maternidad saludable: acuerdo gubernativo No. 65-2012" (Págs. 24-46), que tiene por objeto establecer los procedimientos que permitan desarrollar las disposiciones de la Ley para la Maternidad Saludable
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant Mortality , Maternal and Child Health , Women's Health/legislation & jurisprudence , Reproductive Health/legislation & jurisprudence , Maternal Health/legislation & jurisprudence , Parturition , Guatemala , Midwifery/legislation & jurisprudenceABSTRACT
Esta Ley tiene como objetivo, la creación de un marco jurídico que permita implementar los mecanismos necesarios para mejorar la salud y calidad de vida de las mujeres y del recién nacido, y promover el desarrollo humano a través de asegurar la maternidad de las mujeres, mediante el acceso universal, oportuno y gratuito a información oportuna, veraz y completa y servicios de calidad antes y durante el embarazo, parto o posparto, para la prevención y erradicación progresiva de la mortalidad materna-neonatal, entre otros. Contiene 32 Artículos.