Maternal Health Innovation

The United States has the highest rate of maternal mortality among high-income countries, with persistent racial and geographic disparities. Solving this crisis demands an integrated approach to care delivery, research, policy, and advocacy. Effective models, evidence, and solutions already exist, but scaling these proven approaches requires greater investment, coordination, and political will.

What We’re Doing

The Clinton Policy Institute (CPI) brings together maternal health experts, providers, advocates, public officials, philanthropists, and private sector leaders to develop policy solutions to address the maternal health crisis and to highlight the programs, policies, and investments that can eliminate disparities and improve maternal health outcomes.

Expand Access to Maternal Health Care

More than 35 percent of US counties are considered maternity care deserts, with no obstetric care, birth centers, or perinatal providers. Some states and localities are increasing access to care through innovative delivery models, including home visiting, telehealth and remote monitoring, birth centers, and community-based birth workers. Building off of the Momnibus Act introduced in Congress, 14 states have passed or partially passed Momnibus bills to address the maternal mortality and morbidity crisis by expanding access to care. These packages encompass bills that increase access to doula and midwifery care, birth centers, maternal mental health and substance use disorder treatment, lactation support, and telehealth. Care delivery models and programs that directly address social determinants of health, such as economic security, transportation, and nutrition, are also essential. Measures such as unconditional cash support, rental assistance, and paid family leave are proven to improve perinatal outcomes and reduce disparities.

Safeguard Affordability and Coverage

Medicaid covers more than 40% of all births in the US, meaning that policy decisions surrounding coverage, billing, and reimbursement directly influence the care families receive. Forty-nine states and DC have extended their postpartum Medicaid coverage to 12 months as a result of the American Rescue Plan option, which has led to improved postpartum health for low-income birthing people and reduced maternal mortality. Instead of building on this success, H.R. 1 cut Medicaid dramatically, jeopardizing pregnancy and postpartum coverage and resulting in closures of health care clinics and labor and delivery units. Some states are working to safeguard coverage by expanding Medicaid and private insurance coverage of doula and midwifery care and allowing for Medicaid presumptive eligibility for pregnant women.

Prioritize Equity

The maternal health crisis disproportionately impacts communities of color. Black women are three times more likely to die from pregnancy-related causes than white women and American Indian and Alaskan Native women are two times more likely. Federal rollbacks of programs designed to address equitable access to care and the dismantling of pregnancy risk-monitoring databases have only exacerbated racial disparities in maternal health outcomes. Public officials can take action to reduce racial disparities by mandating implicit bias training for maternal health care providers, funding community-based health organizations that are led by and serve people of color, and requiring all health data be disaggregated by race and ethnicity.

Coordination and Collaboration is Essential

While solutions exist to address the maternal health crisis, the coordination to deploy them at scale is often absent. Breaking down silos across clinical care, community organizations, social services, and public agencies is what turns effective programs into effective systems. Interstate collaboration also remains underutilized: states often face the same challenges and develop the same solutions independently, when information sharing, cross-state arrangements, and jointly funded technical assistance could accelerate progress toward the shared goal of zero preventable maternal deaths.

Ongoing Work

CPI will release a maternal health state policy playbook to help states adopt and scale the programs and policies proven to reduce disparities and improve outcomes for mothers and infants, drawing on the models and evidence that already exist. CPI will continue to convene and work with states to drive evidence-based maternal health policy through increased collaboration, information sharing, and technical assistance.