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Inspired By A Modest North Carolina Program, New Bills Aim To Lower Maternal Mortality Rates In The U.S. | HuffPost https://www.huffingtonpost.com/entry/maternal-mortality-rate-social-causes_us_5b87276ae4b0511db3d47c1c?4is[8/30/2018 1:42:41 PM] maternal care. California, for example, has managed to cut maternal deaths by more than half since 2006, while the rest of the country’s maternal mortality rate continues to rise. Experts attribute this to the state’s maternal quality care collaborative, a network of hospitals and public health agencies that share real-time data in the hopes of improving performance on preterm births, cesarean sections and other factors that can complicate a woman’s care. But focusing solely on the medical care delivered at a hospital doesn’t address the nine months of prenatal care a woman typically receives during her pregnancy, as well as the postpartum period in which she is at a high risk of medical complications related to birth. A different bill, proposed by Sen. Kamala Harris (D-Calif.) last week, takes an unusual approach by focusing on the community and social stressors that might make pregnancy more dangerous for women, especially women of color. It suggests that investing more money to improve the quality of these mothers’ lives may also help avoid birth-related complications and deaths. Given their late introduction in the legislative session and the lack of support from Republican senators, both bills have a slim chance of passing the Senate. But they could be poised to move quickly if the Democrats win a majority in Congress. If that happens, would Harris’ plan to focus on the social factors affecting pregnancy and childbirth work? One modest state program could give us a preview. A portion of Harris’ bill relies heavily on the architecture of an innovative social program in North Carolina called a pregnancy medical home. It incentivizes doctors to screen every woman on Medicaid at their first prenatal appointment and assign them a pregnancy care manager if they’re deemed to be at high risk for a dangerous birth, whether for medical issues like a history of stillbirths, or for social issues like intimate partner violence or homelessness. “Things like loving relationships, safe homesand being part of a fair and equitablecommunity also play an important role inwhether a woman has a positive experiencewith pregnancy and giving birth.