Health care's solvable problem: maternal mortality
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The exceptionally high U.S. maternal mortality rate may be a grim topic, but it's also one of health care's solvable problems that can rally widespread bipartisan support.
Why it matters: While health policy is notorious for creating winners and losers, making a dent in maternal mortality stands out for its lack of downsides.
- And the upfront costs could be recouped through reduced future health care spending and higher economic output.
- "There is a positive dollar [return on investment] to making these investments," Health and Human Services chief counselor Chris Klomp, who attended a recent Axios-sponsored lunch on the subject, told attendees.
- "What is the cheapest care? It's the care you never needed to render in the first place," he added.
By the numbers: As of December, the Centers for Disease Control and Prevention estimates the maternal mortality rate at 16.6 deaths per 100,000 live births. In 2024, 649 women died during pregnancy or within 42 days of the pregnancy ending.
- More than 80% of those deaths are preventable, the agency said.
- Top causes of death include severe bleeding, infection or sepsis, and cardiovascular conditions, according to the Commonwealth Fund.
Where it stands: Heartland Forward's Healthy Moms, Healthy Babies America launched its campaign this week to cut the rate in half over the next five years. (Heartland Forward sponsored the Axios lunch, though it had nothing to do with me writing about this.)
- It announced a partnership with HHS that will take an evidence-based approach to the issue, including by expanding a federal perinatal improvement collaborative.
- HHS also rolled out Moms.gov, an informational site that attempts to connect new and expecting mothers to resources. The website drew controversy from some corners for its anti-abortion ties.
Details: The Perinatal Improvement Collaborative is a network of more than 220 hospitals and health care teams that are trying to improve maternal and infant health and measure the outcomes.
- In its first four years, it saw a 41.5% reduction in mortality, Klomp said, and severe neonatal complications were reduced by nearly 60%.
- "You want to pay for a program, there's your answer right there. It's paid for because those are really expensive cases," he said.
Yes, but: Reducing maternal deaths is one thing, but truly eliminating the preventable ones requires solving some of health care's thorniest systemic problems.
- Expanding access to care and narrowing maternity deserts tie into much bigger issues around insurance coverage, payment policy, workforce issues and the future of rural health care.
- And addressing those issues is where things can get political, fast.
Plus, some experts argue that the Trump administration's actions have actually undercut its stated commitment to reducing maternal mortality.
- "Cutting maternal mortality in half in five years won't happen if the policy prescriptions are to expand narrowly focused pilot programs while cutting federal funding for Medicaid and cancelling research, grants and programs in the name of ending DEI," said Jennifer Klein, professor of professional practice at Columbia University and chair of the Clinton Policy Institute.
My thought bubble: Maternal mortality is one of those things everyone agrees is bad and should be worked on — and yet U.S. death rates are still high relative to other nations.
- Caring about the issue is one thing, and acting on it is another. But that's why the Perinatal Improvement Collaborative is interesting — it appears to be a genuinely successful effort that could be replicable on a larger scale.
- Its reduction in the mortality rate makes Heartland Forward's goal of reducing deaths by half in the next five years sound less audacious.
