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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] Harris’ bill would replicate this by awarding $25 million to up to 10 states to create their own version of the pregnancy medical home. When North Carolina’s Medicaid agency launched this initiative in 2011, it wasn’t even thinking about maternal mortality, said Dr. M. Kathryn Menard, one of the co-founders of the North Carolina program and the director of Maternal-Fetal Medicine at the University of North Carolina School of Medicine. Instead, the goal was to keep Medicaid costs down by preventing preterm births and cesarean sections. But one fascinating side effect of the effort may be that it helped to narrow the gap between black and white women in terms of maternal mortality. Harris’ bill notes that in 2004, pregnancy-related deaths of black women in North Carolina were five times higher than those of white women. But by 2013, the latest year for which statistics are available, the gap disappeared. Black women’s maternal mortality rate declined to a rate of 24.3 deaths per 100,000 live births, while the maternal mortality rate for white women saw a slight uptick, to 24.2 deaths per 100,000. Meanwhile, in the rest of the U.S., black women die from pregnancy-related causes at a rate that’s three times higher than that of white women. These results caught the attention of Harris’ office, which confirmed to HuffPost that it mentioned North Carolina’s program because it’s the only statewide approach connecting the social issues affecting the health of mothers and babies to the prenatal care the mother receives. How The Program Works Every woman who is on North Carolina’s Medicaid plan, a safety net health insurance program, is supposed to answer a short two-page questionnaire during her first prenatal visit about factors in her life that have been linked to riskier births. These could be medical, like a history of stillbirth, hypertension or substance abuse, or social, like questions about homelessness, domestic violence or recent sexual trauma. These social issues connect directly to maternal and infant survival. Going hungry could lead to intrauterine growth restriction, which is when the fetus doesn’t grow and thrive in the womb. Domestic violence endangers the lives of both mother and child. High levels of the stress