American Academy of Nursing Statement Reducing Maternal Mortality and Morbidity and Advancing Maternal Health Equity
Posted 5 months ago
Washington, DC (June 20, 2024) — High rates of maternal mortality and morbidity as well as poor perinatal health outcomes and inequities are crises for women in the United States (U.S.). The American Academy of Nursing (Academy) has long championed policies to address these critical public health issues.1 The Academy supports evidence-based policies that ensure all pregnant people have access to critical resources, high-quality health care, and social supports throughout the perinatal period.2 While recent state and federal legislative efforts have attempted to address the maternal mortality and morbidity health crises, health inequities exacerbated by systemic and structural racism, bias, and a shortage of perinatal care providers are still evident. Increasing access to services supporting mothers and families throughout the perinatal period and promoting the growth and diversity of the perinatal workforce are essential to addressing these crises.
The terms “maternal,” “women,” and “mothers” are used throughout this statement. However, the Academy recognizes and affirms that some individuals who are pregnant and give birth may be transgender men or nonbinary people. Perinatal is defined as the period of pregnancy through 12 months post-birth.3,4Policy Recommendations:The Academy supports evidence-based policies that ensure all pregnant people have access to critical resources, high-quality health care, and social supports throughout the perinatal period. There is a need for increased action at the state and federal levels directed toward improving access to services, coverage, and care, addressing the social determinants of health, and strengthening the perinatal workforce to promote maternal health equity.
- Extend Medicaid eligibility expansion and coverage of pregnancy-related care to 12 months postpartum in all states.
- Enact the Black Maternal Health Momnibus Act, which would address the root causes of maternal mortality, morbidity, and disparities through multi-agency efforts.
- Advance legislation at the state and federal level that would provide paid family leave.
- Enact the Midwives for MOMs Act and explore opportunities to partner with postsecondary institutions, including Historically Black Colleges and Universities (HBCUs) and other minority-serving institutions, to grow the number of nurses and APRNs, in particular, nurse-midwives from accredited nurse-midwifery programs, who are from historically marginalized populations.
- Implement the recommendations from HHS’s National Strategy to Improve Maternal Mental Health Care to improve perinatal mental health and substance use disorders.
- Utilize data made available through the Data Mapping to Save Moms’ Lives Act to identify areas for needed maternal telehealth service expansion, particularly in medically underserved rural areas.
- Invest in perinatal research with a multifactorial approach that prioritizes mitigating disparities.
- Incentivize the development of interdisciplinary models of care to improve maternal and perinatal health outcomes.
- Incentivize reimbursement for APRN care through Medicaid and other insurance and enact the IMPACT to Save Moms Act to test innovative payment models for maternity care.
This position statement originated from the Academy’s Expert Panels on Maternal & Infant Health; Health Equity; Women’s Health; Breastfeeding; and Environmental & Public Health. The Academy’s Expert Panels are the organization’s thought leadership bodies. Through the Expert Panels, Academy Fellows, with subject matter expertise, review the current trends, research, and issues within their field to make informed and evidenced-based recommendations. The Academy's Board of Directors approved this statement on June 5, 2024.______________[1] American Academy of Nursing. (2021, February). Momnibus Support Letter. https://bit.ly/3z7PEs9[2] American Academy of Nursing. (2021, September). Build Back Better Maternal Health Stakeholders Letter. https://bit.ly/4cvJPTG[3] The American College of Obstetricians and Gynecologists. Perinatal Mental Health Toolkit. (2019). https://www.acog.org/programs/perinatal-mental-health.[4] Garcia, E.R., Yim, I.S. A systematic review of concepts related to women’s empowerment in the perinatal period and their associations with perinatal depressive symptoms and premature birth. BMC Pregnancy Childbirth 17 (Suppl 2), 347 (2017). https://doi.org/10.1186/s12884-017-1495-1###About the American Academy of Nursing
The American Academy of Nursing serves the public by advancing health policy through the generation, synthesis, and dissemination of nursing knowledge. Academy Fellows are inducted into the organization for their extraordinary contributions to improve health locally and globally. With more than 3,000 Fellows, the Academy represents nursing’s most accomplished leaders in policy, research, administration, practice, and academia.