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Maternal health inequities during the COVID-19 pandemic: challenges, promising advances, and opportunities to promote equitable care
Maternal health inequities during the COVID-19 pandemic: challenges, promising advances, and opportunities to promote equitable care
- Collection:
- Health Policy and Services Research
- Author(s):
- Borroughs, Emily, author
Hill, Ian, author
Taylor, Kimá Joy, author
Benatar, Sarah, author
Haley, Jennifer M., author
Allen, Eva H., author
Coquillat, Sarah, author - Contributor(s):
- Robert Wood Johnson Foundation, issuing body.
Urban Institute, issuing body. - Publication:
- Washington, DC : Urban Institute, May 2021
- Language(s):
- English
- Format:
- Text
- Subject(s):
- COVID-19
Health Status Disparities
Maternal-Child Health Services -- supply & distribution
Maternal Health -- statistics & numerical data
Racism -- statistics & numerical data
United States - Genre(s):
- Technical Report
- Abstract:
- The COVID-19 pandemic has prompted dramatic changes to the delivery of maternal health care; consumers’ fears of contracting the virus and the imperative of social distancing exacerbated discontinuities in care, limited in-person visits with providers, and increased reliance on telehealth (Gonzalez et al. 2021; Hill and Burroughs 2020). The public health crisis has also highlighted preexisting deficiencies in our health care system. Most notably, long-standing racial inequities in health care access and health outcomes have been amplified by the disproportionate toll the pandemic has taken on communities of color (Artiga, Corallo, and Pham 2020). The pandemic has also raised new challenges, increasing both medical and social needs while isolating people from community and family supports. On the other hand, the crisis has generated creative thinking and innovative strategies for safely reaching and serving patients. These developments are occurring during an ongoing maternal mortality and morbidity crisis in the United States, which has been further compounded by the public health emergency. In this brief, we identify challenges and promising strategies for addressing maternal health inequities during the COVID-19 crisis and opportunities for sustained improvements to maternal health after the pandemic. Part of a larger series on the pandemic and maternal health equity, this paper primarily reflects insights into how the public health emergency affected maternity care and what provider and system responses emerged from March through October 2020. We also place these findings in the context of early 2021 and the recent passage of the American Rescue Plan Act. With support from the Robert Wood Johnson Foundation, our team conducted literature reviews and in-depth interviews with maternal health stakeholders and facilitated a discussion with panelists representing varied community provider perspectives at a virtual convening in October 2020. Key findings from this work include the following: (1) Though the pandemic has disrupted care delivery, stakeholders are optimistic that access to care could be strengthened by federal and state policies that ease restrictions on telehealth and expand health insurance coverage. However, some worry that these changes may not be sustained after the pandemic and that not all populations are equitably benefiting from them. (2) The public health emergency necessitated some shifts away from traditional interventionist maternity care, such as Caesarean sections and labor inductions, and simultaneously increased patients’ and policymakers’ interests in alternative care models, like birth centers and doula services. The pandemic-induced economic downturn also highlighted that addressing families’ basic needs is critical to overall maternal health. (3) Expanding and diversifying the maternal health workforce is critical for promoting more culturally and linguistically effective care and addressing inequities. Pandemic-related staffing shortages have underscored this need and prompted legislators and payers to reimburse a broader range of providers. (4) Payers, providers, health systems, and communities lack data on maternal outcomes disaggregated by race and ethnicity, creating uncertainty as to how pandemic-related changes to maternity care may be affecting preexisting inequities. Addressing these gaps will require transparent, community-driven data collection, data analysis, and data sharing that protects people’s privacy.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-DC license. (More information)
- Extent:
- 1 online resource (1 PDF file (18 pages))
- NLM Unique ID:
- 9918315982906676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918315982906676