USofCare Launches New Interactive Maps Resource Highlighting Dire Gaps in Postpartum Care Nationwide, Notably Alarming in the South

Washington, D.C. — Today, United States of Care unveiled an interactive maps resource visualizing major gaps and barriers in the postpartum maternal health care landscape across the United States. This new resource, accompanied with a data report, allows us to see the state of postpartum care access across states and highlights four main takeaways: 

• The South remains consistently worse in postpartum outcomes than other geographic regions with higher rates of postpartum depression, fetal mortality, and fewer perinatal health workers. 
• The availability of postpartum data is inconsistent and generally not available as it relates to postpartum mental health. 
• Employers must do better to enhance postpartum care for women that are insured through them. 
• Sustaining and expanding Medicaid access is crucial to bettering maternal health outcomes. 

With the uncertainty surrounding the future of the Pregnancy Risk Assessment Monitoring System (PRAMS) – a federal database for tracking various maternal health outcomes that was used in the building of this resource – the importance of addressing the gaps demonstrated by these maps is even higher.  

“Seeing maternal health care as just the 40 weeks of pregnancy is a dangerous mistake, and our new state postpartum maps resource shows us just how dangerous,” said Natalie Davis, CEO & Co-Founder of United States of Care. “For far too long, the critical postpartum period – when most maternal deaths occur – has been overlooked and undersupported by our health care system for millions of families. These maps should be a message to every policymaker and employer in every state – if we want to improve the health of our nation’s families, we need to better care for women after they are no longer pregnant.”

The resource visualizes four major gaps across states: 

• Maternal mental health support in the postpartum period is lacking: Across states, higher rates of prenatal and postpartum depression screenings at provider visits are associated with lower rates of postpartum depression symptoms. While some states do have better screening rates, all states can improve their screening practices and report rates of screening consistently year over year. We also found that the South has the highest average rates of self-reported postpartum depression symptoms (15%) compared to other regions of the United States.
  
• There are serious disparities across states in access to postpartum information through perinatal health workers: Having a higher number of perinatal health workers available leads to improved maternal and child health outcomes and access to postpartum care. We found that women living in the South or Midwest are much more likely to live in a maternity care desert county than the West or Northeast, and that for every woman in a maternity care desert in the Northeast, there are more than 50 women facing the same barriers in the South.
  
• Coverage of postpartum services varies significantly between states, but gaps exist everywhere: While Medicaid expansion and the extension of Medicaid coverage to 12 months postpartum have strengthened access to critical postpartum services and provided longer coverage durations, states that haven’t yet adopted these policies offer limited access to these services. States that have expanded Medicaid have a three times higher rate of coverage for doula reimbursement and a 25% higher rate of coverage for outpatient lactation consultant reimbursement. Since 7 out of the 10 states that haven’t expanded Medicaid are in the South, these coverage gaps disproportionately affect maternal health outcomes for mothers in the South.
  
• Large variations also exist among states with regards to late-stage pregnancy loss, with significantly higher rates in Southern states: From the little data available on late-stage pregnancy loss across the nation, we found a wide variation in fetal mortality rates across the country. Notably, we found that Southern states have almost 3x the likelihood of the statewide fetal mortality rate being above the national average compared to other regions of the United States.

“While these maps demonstrate that there are some very concerning patterns in the South, we should be clear that there is room for improvement across the United States – especially now that PRAMS won’t be available to help us track these gaps in the future,” said Davis. “What these maps show us is clear – the status quo of postpartum care is failing women. State and federal policymakers, along with employers, have a responsibility to understand these trends and translate the postpartum care gaps into actionable policy solutions. By keeping current access to coverage reliable, consistently collecting data on postpartum mental health screenings to measure progress, expanding access to postpartum benefits like doulas and lactation consultants, and ensuring women are screened for postpartum depression by their providers, policymakers and employers across the country can help deliver a better postpartum care experience for every mother.”

A Visualization of Data Gaps in Postpartum Care
Since early 2023, United States of Care has conducted extensive listening work to understand the challenges and experiences of women from early pregnancy through the postpartum period. Through community listening sessions and one-on-one interviews, women identified four areas of need that define the often-neglected postpartum experience: improved access to mental health support, postpartum information from perinatal health workers, postpartum health coverage, and pregnancy loss support.

To align these priorities with actionable solutions, United States of Care partnered with ZS Associates from February 2024 and March 2024 to analyze state-level data on maternal mental health, access to perinatal health workers, postpartum care coverage, and stillbirth rates. To help visualize these gaps and the lack of data in every state, United States of Care created an interactive map offering a state-by-state breakdown. 

Explore the interactive maps here, and read the data report here. 

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