Many have lamented the breakdown of civic dialogue in our society, and some even predict an eventual national breakup. Not only do I believe this is an overly pessimistic take, but this view overlooks the real good that we could be doing in areas where there is, in fact, existing bipartisan agreement. And these areas of agreement, I would argue, include some of the most important issues our country could be addressing.
One of these issues is maternal mortality. The United States has the worst maternal mortality of the developed countries; our rate of 23.8 deaths per 100,000 live births dwarfs that of the OECD average of 9.8 deaths. The U.S. maternal mortality rate has been steadily rising since the turn of the century, and even before the Dobbs decision, had reached levels as bad as 50 years ago. In addition, maternal mortality for Black mothers in the United States is worse than the corresponding rate for a less developed country such as Peru. This is scandalous, and worse, it is utterly tragic for the families who lose a beloved woman in this way.
Getting Congress to pay attention has been a battle — there are always sexier issues than maternal mortality — but we have recently seen real bipartisan effort to do something about this national tragedy. There are many bills worth mentioning (13 alone in the so-called “Momnibus” legislative package), but a few introduced in 2023 stand out.
Sens. Tim Kaine, D-Va., and Lisa Murkowski, R-Alaska, have co-sponsored the “Mothers and Newborns Success Act,” which provides funding for the establishment of state or regional maternal health task forces that will develop and implement strategic plans to reduce maternal and infant mortality.
The legislation also asks the Centers for Disease Control and Prevention to oversee an overhaul of death certificate information for pregnant and postpartum women, since the current system has often not allowed these deaths to be recognized as maternal deaths, especially those occurring later than six weeks after birth.
The legislation would also establish a Maternal Health Research Network within the National Institutes of Health and offer substantial funding for network research.
Sens. Chuck Grassley, R-Iowa, and Margaret Wood Hassan, D-N.H., are co-sponsoring the “Healthy Moms and Babies Act,” which would mandate state Medicaid reporting of maternal and perinatal health, require states to conduct an investigation of racial disparities in cesarean section rates and require hospitals to publish their C-section rates.
The legislation would also establish coordinated postpartum care for women for up to a year after birth, establish a “National Expert Group” to reconsider training of birth professionals to include an examination of practices that may lead to worse outcomes for certain groups, such as Black women, and expand Medicaid coverage to include birth doulas and telehealth.
I’m heartened by these bipartisan efforts. And there are many other proposals that surely will receive bipartisan support, such as better data collection on maternal outcomes, greater provision for home visits by health professionals after birth and better care for incarcerated pregnant women. There is also legislation that has been filed to provide pregnant women and mothers with far better visibility and consideration in pandemic response than we saw during the COVID-19 lockdown.
There are other dimensions to maternal mortality that could also be addressed through bipartisanship. While we have seen a bipartisan effort to increase mental health support for pregnant women and mothers as a result of finally acknowledging that many maternal deaths are the result of suicide, we have not yet seen any initiatives crafted to address the fact that the leading cause of maternal death in the United States is actually homicide. This, too, is a scandal that places the United States beyond the pale amongst the nations of the world.
In addition, it is clear that we need strong bipartisan work at the state level to ensure that in the wake of the Dobbs decision, maternal mortality does not increase due to doctors’ reluctance to treat women in medical emergency situations that might result in abortion.
Widening our view even further, we could certainly ask about the potential of paid maternity leave to improve maternal outcomes and reduce infant mortality. Paid parental leave has been shown to significantly improve mothers’ mental health, and to significantly reduce infant mortality. Mothers and babies need time together, and women need time to recover from birth. Only 56% of mothers in the U.S. have the right to unpaid leave, and many who do not have to return to work within a few days of giving birth in order to keep their jobs. That’s unconscionable. We need a universal right to unpaid maternity leave without exception, and we need to move in the direction of a universal right to paid maternity leave.
Federal employees and military service personnel already have the right to paid maternity leave in the United States, as do the citizens of 11 states and the District of Columbia. How hard can it be if all of the nations of the world except the United States and a handful of island nations, such as Nauru, are capable of providing paid maternity leave? Recent polling figures show that 89% of Democrats, 76% of independents, and 70% of Republicans support paid parental leave, so there is ample bipartisan support for such legislation.
Bipartisanship may be scarce in today’s culture, but not where it concerns the health of mothers and their babies. The maternal mortality rate of the United States is truly shocking, and it’s time for robust movement on the bills described here, as well as others that would safeguard maternal health.
In addition, there is plenty of political will among the American people for a move to paid maternity leave. Pundits have lamented the subreplacement birth rate of the United States: It’s time to walk the walk and prioritize the well-being of the women who are the only ones capable of mitigating that trend.
Valerie M. Hudson is a university distinguished professor at the Bush School of Government and Public Service at Texas A&M University and a Deseret News contributor. Her views are her own.