Paper Urges National Maternal Health Care Investment

Maternal health care is in crisis across the US and investment, including in the form of baby bonds, investing in a diverse workforce and additional services, must scale up.

According to a white paper from The Federal Reserve Bank of New York and NYU Rory Meyers College of Nursing, despite advances in medicine, the US maternal mortality ratio has worsened since 1987, and that most deaths of this nature are preventable.

“Healthy families are a source of strength for communities, but serious maternal complications and deaths can reverberate through families for generations,” said Audrey Lyndon, Professor of Health Equity at NYU Rory Meyers College of Nursing and the paper’s co-author.

“For true change to happen, we have to look beyond hospital-based care to address the broader systemic issues affecting maternal health, like housing, food insecurity, and the social safety net,” she added.

The paper, titled The Fourth Trimester and Beyond: The Case for Transformative Investments and Solutions in Maternal and Child Health, also found racial disparities in the maternal mortality rate, which is worse for Black mothers than for any other group.

The rate for 2019, the most recent year for which statistics are available in the US, was 44 deaths for every 100,000 live births among Black mothers, 17.9 deaths among white mothers, and 12.6 deaths for Hispanic mothers.

“These deaths touch hundreds of families, children, and communities—and the economy as a whole,” said Marisa Casellas-Barnes of the New York Fed's Community Development team and co-author of the paper.

“Investment in services such as community-led place-based programs that provide comprehensive perinatal support pay dividends in the form of healthier mothers and children,” she added.

The paper recommended applying a full-system financing structure so investors may partner with Mediaid to support full coverage for midwifery-led birth centers, for example.

Other investment options included baby bonds and investing in a diverse maternal care workforce, home nurse visitation, and other interventions.

Financial institutions are increasingly pledging to help bridge the healthcare gap in the US, with many issuing inaugural social bonds whose proceeds are set to be allocated to promoting access to both education and health care across the country.