Advancing Maternal Health Equity in Southern States

Many states, nationally and in the South, are adopting Medicaid policy changes to improve maternal healthcare and advance equity.

The Issue

The United States is facing a severe maternal morbidity and mortality crisis, and Black women and women of color are particularly at risk. Maternal mortality rates are also higher in the southern United States than in other regions.  

Key Findings

• In 2020, Medicaid covered more than 47 percent of all births in southern states, and in some, Medicaid covered well over half of the births.
• Like many states across the nation, some southern states are adopting policies that could expand access to care and improve maternal outcomes, such as extending postpartum coverage and adding perinatal services covered by Medicaid.
• Postpartum Medicaid/Children’s Health Insurance Program (CHIP) extensions could provide greater access to care during a medically fragile time.
  • More than one-quarter of new mothers who are unisured—including more than one-third of non-Hispanic Black mothers—could benefit from the nationwide adoption of a 12-month postpartum coverage extension.
• Only a few states have maternal health initiatives that directly address equity.
  • Tailored, person-centered solutions or community-based models could improve overall outcomes and address inequities.

Conclusion

Researchers determine that broad policy changes may be needed to dramatically improve maternal health equity. With approximately 700 women dying each year due to pregnancy-related causes, and many more experiencing maternal morbidity, broader actions across sectors beyond the healthcare system would also be needed to address underlying racial and ethnic disparities in wealth and income and disparities in environmental and occupational risks that contribute to health disparities

About the Author/Grantee

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.