Author(s): Urban Institute
- Emily Burroughs
- Ian Hill
- Kima Joy Taylor
- Sarah Benatar
- Jennifer M. Haley
- Eva H. Allen
- Sarah Coquillat
Published: June 2, 2021
Report Intro/Brief:
“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. 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.
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.
Key findings from this work include the following:
- 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.
- 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.
- 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.
- 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.”
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