Indiana could reduce maternal deaths with COVID-19 relief

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INDIANAPOLIS — The recently passed COVID-19 relief bill provides critical aid for all Americans, but it also offers an avenue for states to reduce maternal deaths by expanding postpartum care under Medicaid for a year. 

State Representative Rita Fleming (D-Jeffersonville) urges the governor and the Family and Social Services Administration to investigate how Indiana can get approval from Washington now that the relief bill cuts the time and paperwork needed. 

“We have the way, and now it’s a question of if there’s a will,” Fleming, a retired obstetrician, said. “The maternal mortality rate in our state and across the nation is shameful, and we need to act upon the federal government’s recent decision to cut down the bureaucracy and save Hoosier women’s lives.”

Indiana currently has the third highest maternal mortality rate in the country, and the 2020 Maternal Mortality Report found the majority of the 63 pregnancy-related deaths occurred postpartum. The most common contributing factor was substance abuse disorder, with accidental overdose the overwhelmingly leading cause of death, particularly in the postpartum period.

Fleming has written extensively and proposed legislation every session about decreasing the maternal and infant death rate by preventing unintended pregnancies in the first place. Indiana could increase access to birth control for women with a drug addiction at emergency departments or through syringe exchange programs, or allow pharmacists to prescribe birth control for all women. Expanded access to contraceptives for everyone is important, since a short interval between pregnancies is associated with poorer outcomes for infants and women in a subsequent pregnancy.

“If women receive postpartum coverage for a full year, that also offers the opportunity for them to stay in drug treatment and get contraceptives, ultimately resulting in better care for women who are too often judged and wrongly blamed,” Fleming said. “We need to look at maternal health during pregnancy, childbirth and postpartum for the lives of these mothers and also for the babies they will raise.”

One of the report’s key recommendations for the state was to extend postpartum coverage under Medicaid, which covers 42% of births, the largest single payer of maternity care in the U.S. 

According to the report: “The potential life-saving impact from extending the availability of Medicaid, as well as expanding services to include behavioral health treatment and recovery resources, cannot be overstated. Ensuring that low-income women have continuous comprehensive coverage would support improvements in infant and maternal outcomes.”

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