California’s Ambitious Plan to Halve Maternal Mortality by 2026
In a groundbreaking move, California’s Surgeon General, Dr. Diana E. Ramos, alongside Governor Gavin Newsom and First Partner Jennifer Siebel Newsom, has launched an ambitious initiative aimed at reducing the state’s maternal mortality rate by 50% by December 2026. This initiative, named ‘Strong Start & Beyond’, comes at a critical time as maternal mortality rates have seen an alarming increase in recent years, partly due to the COVID-19 pandemic. Despite California having one of the lowest maternal mortality rates in the United States, the recent surge has highlighted the need for immediate and effective action. Dr. Ramos emphasized that while California has made strides in maternal health, there is still significant room for improvement.
Statistics reveal that 80% of maternal deaths in the United States are preventable, a staggering figure that underscores the importance of this initiative. The leading causes of maternal deaths in California include heart disease, hemorrhage, mental illness, substance use, and infections. These complications often arise in the days, weeks, and months following delivery, making postpartum care crucial. On average, about 70 pregnant and birthing individuals die annually in California from pregnancy or childbirth-related complications. This data points to a systemic issue that requires comprehensive strategies to address effectively.
One of the most concerning aspects of maternal mortality in California is the racial disparity. Black women in California experience a maternal mortality rate three times higher than that of white women. This stark difference has been a source of public outrage, particularly in Los Angeles County, where the deaths of black mothers like April Valentine and Bridgette Burks have sparked widespread concern. Factors contributing to these higher rates among black women include systemic racism, higher incidences of chronic diseases, and inequities in healthcare access and quality. Addressing these disparities is a key focus of the ‘Strong Start & Beyond’ initiative.
The initiative also aims to tackle rising maternal mortality rates among Latino and Asian/Pacific Islander communities in California. These communities have also seen an increase in maternal deaths, highlighting the need for targeted interventions. The ‘Strong Start & Beyond’ initiative plans to educate patients on potential risks before pregnancy and provide robust support during and after birth. This patient-centered approach marks a shift from previous efforts that primarily focused on healthcare professionals. By involving patients directly, the initiative hopes to empower them to take an active role in their health and well-being.
One innovative aspect of the initiative is the introduction of a self-assessment questionnaire that patients can complete at home. This tool will help expecting parents assess their risk of complications and receive tailored recommendations for next steps. Additionally, all medical facilities in California will be required to use a standardized screening tool to evaluate the risk levels of pregnant patients. Those identified as having a higher risk of complications may be referred to hospitals better equipped to handle complex cases. This proactive approach aims to ensure that high-risk patients receive the specialized care they need to prevent adverse outcomes.
The timing of this initiative is particularly critical as many hospitals in California are closing their labor and delivery units due to financial constraints. Over the past decade, there has been a wave of such closures, especially in black, Latino, and low-income communities. One of the latest hospitals to announce the closure of its labor and delivery unit is USC Verdugo Hills Hospital in Glendale. These closures exacerbate the challenges faced by pregnant individuals in accessing timely and adequate care. The ‘Strong Start & Beyond’ initiative seeks to mitigate these challenges by ensuring that high-risk patients are directed to facilities capable of providing the necessary care.
The educational component of the initiative is extensive, aiming to spread awareness about health risks related to pregnancy among both patients and healthcare providers. The initiative includes an educational campaign called ‘Strong Start & Beyond’, which was launched in San Francisco with the involvement of the U.S. Secretary of Health and Human Services. This campaign does not introduce new funding or programs but focuses on raising awareness and highlighting existing resources. By increasing knowledge and understanding of the factors contributing to maternal deaths, the initiative hopes to foster a more informed and proactive approach to maternal health.
A significant emphasis of the initiative is on addressing disparities in maternal health outcomes, particularly the high maternal death rate among Black women. Collaboration with community organizations and advocacy groups is seen as essential to the success of the initiative. Engaging with these groups helps build trust and ensures that the strategies implemented are culturally sensitive and effective. The initiative also highlights the importance of managing chronic conditions before and after pregnancy, such as high blood pressure and obesity, which are significant risk factors for maternal complications.
The postpartum visit is another critical focus area of the initiative. This visit provides an opportunity to identify and address any complications that may have arisen during pregnancy and potentially save a mother’s life. Ensuring that all new mothers attend their postpartum visits and receive comprehensive care during this period is vital. The initiative aims to improve follow-up care and support for new mothers, recognizing that the postpartum period is a vulnerable time for many women. By enhancing postpartum care, the initiative seeks to reduce the number of preventable maternal deaths.
Governor Gavin Newsom has proclaimed September 17, 2024, as ‘Strong Start & Beyond Day’ to raise awareness and promote the goals of the initiative. This proclamation underscores the state’s commitment to improving reproductive and maternal health. The California Maternal Health Blueprint, which guides the initiative, outlines outreach, education, and strategies aimed at reducing maternal mortality. This comprehensive plan reflects the collaborative effort of various stakeholders, including healthcare providers, advocacy organizations, and community groups, all working towards a common goal.
Despite California’s progress in maternal health, the state still faces significant challenges. On average, a new mother dies every five days in California due to pregnancy-related complications. This statistic is even more dire for black women, who are three times more likely to die from pregnancy-related causes compared to white women. The increasing maternal mortality rates among Hispanic and Asian American and Pacific Islander communities further highlight the urgency of the situation. The fact that more than 80% of maternal deaths are preventable makes these statistics even more alarming and underscores the need for immediate action.
California has already taken several steps to address the maternal health crisis, including the implementation of the Momnibus Act, which adds Medi-Cal coverage for doulas, extends eligibility for postpartum individuals, eases access to CalWORKs for pregnant people, and requires implicit bias training for perinatal healthcare providers. However, Governor Newsom believes that more must be done. The ‘Strong Start & Beyond’ initiative represents a renewed commitment to tackling this issue head-on. By focusing on education, awareness, and collaboration, the initiative aims to create a safer and healthier environment for all pregnant individuals in California.
The success of the ‘Strong Start & Beyond’ initiative is crucial to saving the lives of mothers across all communities in California. All eyes will be on the state to see if it can achieve its ambitious goal of halving maternal mortality by 2026. The initiative’s focus on collaboration, education, and patient empowerment offers a promising approach to addressing this complex issue. By improving maternal health, California hopes to give families and newborns a strong start and a healthy future, ultimately strengthening communities and the state as a whole. The journey ahead is challenging, but the commitment and determination of all involved provide hope for a brighter future in maternal health.