Funding Solutions to the U.S. Maternal Health Crisis

The health of women in the United States during pregnancy and after giving birth is a priority that should concern all Americans. Women in the U.S. today are 50 percent more likely than their mothers to die in childbirth. Despite spending more money on maternity care than any other country in the world, the U.S. is one of the only nations where maternal mortality is on the rise. A new report released in September by the World Health Organization (WHO) reveals that the U.S. has the highest maternal mortality rate of any industrialized country, and according to the Centers for Disease Control and Prevention (CDC), a staggering 60 percent of those deaths are preventable.

The drivers of maternal mortality and morbidity are complex, yet there is an emerging consensus among researchers, funders, advocates, and health care leaders around the urgent need to address three interrelated concerns: unnecessary, dangerous, and costly medical interventions; inequity in maternal care and health outcomes for women of color, particularly Black and indigenous women; and inadequate prenatal and postpartum mental health care services.

Persistent silos in public health have meant that while considerable attention and resources are devoted to reproductive and infant health—the natural bookends to maternal health—there has not been adequate integration along this continuum. Sadly, moms have received the least attention in the underfunded realm of women’s health. From academia, to hospitals, to the health insurance industry, to the policy arena, the services and systems surrounding the journey to and through motherhood are desperately in need of attention and reform.

According to a recent study¹ co-funded by Yellow Chair Foundation, a PFS client, “74% of California mothers agreed that childbirth should not be interfered with unless medically necessary, but only 5% gave birth with no medical intervention.” The overmedicalization of childbirth not only contributes to maternal mortality and adverse health effects, it has astonishing fiscal ramifications. A cesarean section (or “c-section”) is the most common surgery performed in the U.S. and the rate of c-sections among American women is more than double the rate considered medically necessary by the WHO. The surgery not only carries increased risk of complications and death, health care costs due to unnecessary c-sections are estimated at a staggering $5 billion.

In the face of this growing crisis, three PFS client foundations, Yellow Chair, Bella Vista, and Pinpoint, have all made maternal health a priority, and each is deploying unique funding strategies in pursuit of meaningful change.

Yellow Chair Foundation: Funding Movement Building, Advocacy and Systems Change

Yellow Chair Foundation is working to improve maternal health outcomes and the childbirth experience in the U.S. by increasing access to the midwifery model of care and reducing unnecessary medical interventions. Their grantee partners work at the local, state, and national levels and use a range of intersecting strategies. Yellow Chair’s approach encompasses targeted support for organizations working to improve the design and delivery of health care. One such grantee, the California Maternal Quality Care Collaborative, is working to safely reduce the c-section rate in California. Simultaneously, Yellow Chair supports maternal health policy advocacy with a focus on movement building, research, and reducing health inequities through efforts such as the new national Expecting More campaign aimed at shifting the public narrative on what families should expect in childbirth.

Bella Vista Foundation: Focusing on Maternal Wellness and Healthy Bonds

Maternal health is also integral to the Bella Vista Foundation’s pioneering support for early childhood development. One of two focus areas funded by Bella Vista, the Infants & Families Connecting program focuses on developing strong bonds between parents and children 0 to 3 that will support their healthy social and emotional development. Bella Vista’s work includes support for several community-based organizations that support maternal mental health for marginalized groups, such as Homeless Prenatal Program in San Francisco and Canal Alliance in Marin County.

On the belief that “confident, informed parents and caregivers can develop strong attachment to their infants and toddlers that results in healthy emotional and cognitive development,” Bella Vista promotes programs that help parents and caregivers cope with stress by building connections with each other, their communities, and supportive local services. Bella Vista has focused on support for community-based programs that build social support and resiliency, a strategy that has shown promise in helping to reduce racial/ethnic disparities in pregnancy-related deaths.

Pinpoint Foundation: Targeting Maternal Inequity

Despite growing awareness and funding, as the data cited above illustrates, the inequities surrounding childbirth are profound for women of color. A recent update from the Centers for Disease Control and Prevention noted that the racial disparities in pregnancy-related mortality are even worse than previously known: Black and indigenous women experienced higher pregnancy-related deaths than all other groups, and Black women are four to five times more likely to die in childbirth than white women. This disproportionate risk affects Black women regardless of income, education or geography² , indicating that institutional and structural racism are influencing the standard of care. As a result of the ongoing racial disparity in health outcomes for pregnant women, the Pinpoint Foundation has spent the past year learning about organizations focused on addressing birth justice nationally, in addition to its midwifery and maternal mental health work.

Nonprofits Are Raising Awareness & Advancing Solutions

As funding and research grows, so do nonprofit sector solutions designed to give mothers more support and better options, and create greater collaboration among the individuals and groups working to improve maternal health outcomes.

One such organization is the Black Mamas Matter Alliance. A Pinpoint grantee, Black Mamas Matter is a relatively new Black-women led cross-sector organization that centers Black mothers in national research and advocacy efforts.

Another young organization helping to shine a light on maternal health is March for Moms, a national coalition of families and maternal health professionals that convenes an annual rally on the Mall in Washington, D.C. March for Moms is funded by Yellow Chair and Pinpoint and will hold its next event on May 3, 2020.

Thanks to the hard work of advocates, public interest journalists, and so many communities around the country, the public’s awareness of our national maternal health crisis is growing. Funders like Yellow Chair, Bella Vista, and Pinpoint are playing key roles in supporting solutions.

To learn more about this issue, click on the links to external resources above and visit these recent news stories:

Lost Mothers series, Pro Publica and NPR
The Rise of C-sections and What It Means, U.S. News & World Report
To Prevent Women from Dying in Childbirth, First Stop Blaming Them, Scientific American

¹ 2018 California Healthcare Foundation, National Partnership for Women & Families, Yellow Chair Foundation
² Scientific American, May 1, 2019