Black Mamas Matter: Advancing the Human Right to Safe and Respectful Maternal Health Care. Black Mamas Matter Alliance, Center for Reproductive Rights
This toolkit includes information to advance maternal health as a human rights issue and includes an overview of research on maternal mortality and morbidity in the US, along with policy framework to improve access to and quality of maternal and reproductive healthcare.Kozhimannil, K. B., Henning-Smith, C., Hung, P., Casey, M. M., & Prasad, S. (2016). Ensuring Access to High-Quality Maternity Care in Rural America. Women's health issues: official publication of the Jacobs Institute of Women's Health, 26(3), 247.
This article outlines the lack of access to childbirth providers in rural America and provides suggestions for federal and state policies to improve access and quality of prenatal healthcare in these regions.Homer, C. S., Friberg, I. K., Dias, M. A. B., ten Hoope-Bender, P., Sandall, J., Speciale, A.M., & Bartlett, L. A. (2014). The projected effect of scaling up midwifery. The Lancet, 384(9948), 1146-1157.
This article provides data on how expanding access to midwifery care can improve health outcomes, specifically by reducing maternal deaths, stillbirths, and neonatal deaths. It was projected that 61% of these deathsState Maternal Mortality Review Committees, PQCs, and AIM. American College of Obstetricians and Gynecologists. April 1, 2019
This document is a list of the existing Maternal Mortality Review Committees, Perinatal Quality Collaboratives, and current status as an AIM (Alliance for Innovation on Maternal Health) state for all 50 US States and the District of Columbia. It specifies if there is pending legislation or development of committees to establish a MMRC, PQC or become an AIM state.Jolles, D. R., Stapleton, S. R., & Alliman, J. (2019). Strong start for mothers and newborns: Moving birth centers to scale in the United States. Birth, 46(2), 207-210.
This 5-year evaluation report discusses the Strong Start for Mothers and Newborns Initiative report, published by the Centers for Medicare and Medicaid Innovation. It reports that the strong start model (which is midwifery-led birth center care) has improved health outcomes than usual care or medical model of maternity care, is safe for the majority of pregnant people, and should be expanded in order to improve maternal health outcomes in the US.MARCH OF DIMES POSITION STATEMENT MIDWIFERY CARE AND BIRTH OUTCOMES IN THE UNITED STATES
The March of Dimes supports increased access to midwifery care for low- and moderate-risk women and encourages states to examine laws and regulations that unnecessarily restrict access to midwifery care, as well as laws that limit full practice authority for midwives.Attanasio, L. B., Alarid-Escudero, F., & Kozhimannil, K. B. (2020). Midwife-led care and obstetrician-led care for low-risk pregnancies: A cost comparison. Birth, 47(1), 57-66.
This study examined the costs of childbirth for low-risk women with midwife-led care as compared to physician care. It evaluated model of costs, use of medical procedures during childbirth, and outcomes of care in midwife-led vs. obstetrician-led care. The study found that a shift from obstetrician-led care to midwife-led care for low-risk pregnancy may be cost saving.Luthi, S. (2019). Midwives seek rebirth in maternity care. Modern Healthcare
This article supports increasing access to midwifery care and discusses national and state legislative efforts to remove physician-supervision laws.Carter, M. C., Corry, M., Delbanco, S., Foster, T. C. S., Friedland, R., Gabel, R., Gipson, T., Jolivet, R. R., Main, E., Sakala, C., Simpkin, P. & Simpson, K. R. (2010). 2020 vision for a high-quality, high-value maternity care system. Women's health issues, 20(1), S7-S17.
This article outlines an action plan developed by interdisciplinary health experts for improving maternity care in the US by 2020. The foundation for the transforming maternity care project included six aims: woman-centered, safe, effective, timely, efficient, and equitable care. Other values identified included promoting, protecting, and supporting physiologic birth, acknowledging pregnancy and birth as a life-changing experience, providing evidence based care, measuring quality of care, supporting informed decision making, and providing coordinated care.
The article provides a summary of goals for improving pregnancy, birth, and postpartum care.North Carolina Institute of Medicine, in partnership with the Division of Public Health and the North Carolina Department of Health and Human Services. (2020). A report from the NCIOM: Perinatal System of Care Task Force. NCMJ 81(1), 70-74.
This report lists specific recommendations for improving maternal and infant health in several settings including inpatient labor and delivery care, preconception, prenatal, and postpartum care, and addressing the impact of social determinants of health on perinatal health.The American College of Obstetrics and Gynecologists, Society for Maternal Fetal Medicine. (2019). Obstetric Care Consensus: Levels of Maternal Care. Obstetrics and Gynecology 134 (2)
This 2019 report replaces the previous obstetric care consensus from 2012. It reaffirms the need for levels of maternal care including a standardized description of maternity facility capabilities and personnel, and a framework for integrated systems to address maternal health needs, with the goal of reducing maternal morbidity and mortality and encouraging the growth and maturation of health systems in order to provide appropriate care to promote safe birth settings and better outcomes.National Academies of Sciences, Engineering, and Medicine 2020. Birth Settings in America: Outcomes, Quality, Access, and Choice. Washington, DC: The National Academies Press. https://doi.org/10.17226/25636.
This book discusses maternal and newborn care in the US including epidemiology of clinical risks in pregnancy and childbirth, systemic influences on outcomes in pregnancy and childbirth, issues in measuring outcomes by birth settings, maternal and newborn outcomes by birth setting, and a framework for improving birth outcomes in the US.North Carolina Institute of Medicine (2020). Health moms, healthy babies: Building a risk-appropriate perinatal system of care for North Carolina.
Written by the North Carolina Institute of Medicine’s Task Force on Developing a Perinatal System of Care, this report outlines methods to improve maternal healthcare in the following areas: developing a risk-appropriate regional perinatal system of care, improving preconception and prenatal care, identifying quality improvement needed to achieve a risk-appropriate perinatal system of care, improving access to postpartum services and supports, and increasing support for pregnant women and their families.Kozhimannil, K. B., Attanasio, L., Alarid-Escudero, F. (2019). More midwife-led care could generate cost savings and health improvements.
This policy brief describes the potential cost savings that may result from increased use of midwifery-led care in the United States.American College of Nurse-Midwives (2021). Essential facts about midwives.
This fact sheet provides information about midwifery attended births, midwifery education, and midwifery practice in the United States.Avery, M. D., Bell, A. D., Bingham, D., Corry, M. P., Delbanco, S. F., Gullo, S. L., Ivory, C.H., Jennings, J. C., Kennedy, H. P., Kozhimannil, K. B., Leeman, L., Lothian, J. A., Miller, H. D., Ogburn, T., Romano, A., Sakala, C., & Shah, N. T. (2018). Blueprint for advancing high-value maternity care through physiologic childbearing. The Journal of Perinatal Education, 27(3), 130-134.
This document highlights six strategies for advancing high-value maternity care through physiologic birth. The strategies include improving maternity care through innovative delivery and payment systems and quality improvement initiatives, advancing performance measurements for high-value maternity care, meaningfully engaging all childbearing women and families, transitioning to interprofessional education that supports team-based care for maternity care professionals, fostering an optimal maternity care workforce composition and distribution, and conducting priority research to advance the science of physiologic childbearing and its impact on maternal and child health outcomes.DeJoy, S. A., Bohl, M. G., Mahoney, K., & Blake, C. (2020). Estimating the financial impact of reducing primary cesareans. Journal of Midwifery & Women's Health, 65(1), 56-63.
This article discusses a replicable cost comparison model between vaginal and cesarean birth for nulliparous, term singleton vertex (NTSV) pregnancies, finding significant financial savings for vaginal births vs. cesarean births. American College of Nurse-Midwives. (2020). Core competencies for basic midwifery practice.
This document discusses the competencies for basic midwifery practice, including scope of practice, midwives roles in primary care, hallmarks of midwifery, components of midwifery care, professional responsibilities of midwives, the midwifery management process, and care of the newborn.Centers for Medicare and Medicaid Services-Center for Medicare and Medicaid Innovation. (2018). Strong start for mothers and newborns.
This document summarizes an evaluation report of the Strong Start Model, which funded enhanced prenatal care to Medicaid and CHIP beneficiaries with the goals of reducing rates of PTB and LBW infants, and reducing costs to Medicaid during pregnancy, birth and first year of life.Centers for Medicare and Medicaid Services. (2019). Improving access to maternal health care in rural communities.
This issue brief discusses barriers to obstetric services in rural communities across the US and outlines opportunities and strategies to improve access. It provides information on distribution of hospitals, birth centers, access to midwifery care, and other factors that influence maternal health.Medicaid and CHIP Payment and Access Commission. (2020). Report to Congress on Medicaid and CHIP
This report, addressed to the Vice President and Speaker of the House, identifies current challenges facing Medicaid, the integration of Medicare and Medicaid, Medicare Savings Programs, and Medicaid’s role in maternal health. Chapters 5 and 6 explicitly discuss mortality and morbidity among pregnant women and the effects of substance use disorder on pregnant women covered by Medicaid and their newborns.Kozhimannil, K. B., Henning-Smith, C., Hung, P., Casey, M. M., & Prasad, S. (2016). Ensuring Access to High-Quality Maternity Care in Rural America. Women's health issues: official publication of the Jacobs Institute of Women's Health, 26(3), 247.
This article discusses strategies for increasing access to high-quality maternity care in rural settings, specifically supporting federal and state policies that improve quality of maternity health care.