Women’s health is economic health. Research demonstrates a direct link between improved maternal health outcomes and global economic prosperity, indicating that improving women’s health can lead to a boost of $1 trillion to the global GDP. Women represent tremendous economic power, and ensuring the health and wellness of women and mothers in the heartland is critical to the region’s economic resilience and success.  

Where the Heartland Stands

In recent years, the United States has experienced worsening maternal health outcomes for many reasons including economic disparities, institutional biases and increasing maternal age. As discussed in Heartland Forward’s report, The Economic Case for Investing in Maternal Health, the United States continues to be an outlier among developed nations and is in the bottom two-thirds of all nations in the world for maternal deaths per 100,000 live births (i.e., maternal mortality rate). As Heartland Forward’s report further details, these statistics are often most acute in heartland states.

Moving Maternal Health Forward

Given the clear need for change, heartland leaders in state government and health care have taken action to improve prenatal and postnatal outcomes both for mothers and infants. 

Illinois

University of Illinois’ Health Two-Generation Clinic is providing innovative care to new mothers and their infant children—treating them both during the same visit. Launched in 2020, the UI Health Two-Generation Clinic describes itself as a “one-stop destination where women and children of all ages can receive comprehensive primary care and behavioral health support from a team of providers that includes physicians specializing in internal medicine and pediatrics.”

The Two-Generation Clinic’s approach of treating mothers and their infants during the same visit often results in improved outcomes for both mom and baby. The model developed out of the need for new mothers to receive primary care immediately following pregnancy and the fact that many new moms often don’t receive this critical care—which can result in decreased maternal health outcomes and occasionally even death. 

“Many of the challenges facing new moms are primary care issues; they aren’t gynecological issues. But most young women, especially after they’ve moved through obstetrical care, are not seeing primary care. Our clinic came out of the idea of, if moms are coming in for their babies, how can we meet their needs where they are?” Dr. Sam Wainwright, assistant professor of internal medicine and pediatrics, University of Illinois Chicago College of Medicine

The clinic has delivered a tremendous impact—a study from the University of Illinois Chicago reported that mothers were five times as likely to receive regular health care when using the family care model prioritized by the UI Health Two-Generation Clinic and significantly more likely to receive specialty care, emphasizing the lack of post-partum care mothers without access to similar models normally receive. 

Arkansas

In February of this year, Arkansas Governor Sarah Huckabee Sanders announced the Healthy Moms, Healthy Babies Act to promote positive maternal health outcomes. The legislation includes many reforms recommended by the Governor’s Strategic Committee on Maternal Health such as expanding Medicaid coverage, increasing provider reimbursements and enhancing access to telemedicine, along with other key provisions including: 

• Presumptive Medicaid eligibility for pregnant mothers, allowing them to receive prenatal care as their application is pending. 
• Pathways to reimbursement for community health workers and doulas. 
• Expanded Medicaid coverage for pregnancy-related remote monitoring care. 
• Unbundled Medicaid payments for pregnancy care, covering up to 14 prenatal and postnatal visits. 
• Increased coverage of traditional and cesarean section births up to 70%.

This act seeks to address Arkansas’ need for updated maternal health care policy and additional resourcing. 

Michigan

Michigan is among the many heartland states working to address poor maternal health outcomes, recently enacting a comprehensive maternal health legislative package that was signed by Governor Gretchen Whitmer in January of this year. The package includes provisions such as:

• Expanded access to blood pressure monitoring for new mothers, citing obstetrician-gynecologist for Corewell Health in West Michigan Dr. Kania McGhee’s estimate that 15-20% of pregnancies result in some form of high blood pressure. 
• Expanded access to postpartum mental health care for new mothers, citing a 2018 CDC survey indicating 13% of new mothers exhibited depressive symptoms.
• Requirements that hospitals provide information to patients on how to enroll their newborns in health insurance.

The package, including additional legislation, took inspiration from an American College of Obstetricians and Gynecologists study reporting that 60% of maternal deaths in the US are avoidable. 

What Else Can We Do?

Heartland Forward recently released the Maternal Health Action Plan, alongside last year’s maternal health report, which focuses on providing recommended steps that state legislatures and private partners can take to promote infant and maternal health. The action plan focuses on the following four solution areas:

1. Supporting and advocating for the use of community health workers in maternal care
2. Expanding access to telehealth
3. Addressing workforce shortages across the health care industry
4. Increasing transparency through data collection and evaluation

Investing in quality maternal and infant care is critical both for the lives and livelihoods of heartland residents, but it is vital to the heartland’s economic health. Heartland Forward research estimates that reducing the number of maternal and infant deaths by 50%, addressing low birth weights and lowering the frequency of preterm births could lead to savings of more than $75 billion.