By Nitzan Gabel Eyal, MD, SWHR Science Policy Fellow
In 2022, the pregnancy-related mortality ratio in the United States was 22.3 per 100,000 live births – the highest among 13 other high-income countries. Maternal morbidity and mortality disproportionally affect women from racial and ethnic minority groups, with Black women experiencing more than double the national maternal mortality rate, at 49.5 per 100,000 live births. Maternal mortality is only one of the many crucial issues surrounding maternal health; maternal morbidity, birth risks, infant outcomes, and other adverse health consequences, such as exacerbating existing chronic health conditions, all have significant lifelong impacts for women and their families.
In February, the Society for Women’s Health Research (SWHR) hosted the roundtable meeting, “Inclusive Motherhood: Empowering Maternal Health for All Women,” to discuss maternal health disparities across all stages of pregnancy, from preconception to the postpartum period. Participants identified strategies to engage pregnant individuals in patient-centered care and equip them with the necessary tools and knowledge to participate meaningfully in their health journey. SWHR deeply appreciates the participants of the Maternal Health Working Group members, each of whom played a vital role in this thought-provoking and insightful discussion.
The meeting began with overwhelming agreement on the need to support underserved populations seeking maternal health care. The group emphasized the importance of building trust in health care encounters, ensuring patients feel heard, and aligning patients’ health goals and personal priorities with those of their health care providers. Catherine Limperopoulos, PhD, Director of the Center for Prenatal, Neonatal & Maternal Health Research at Children’s National Hospital, reiterated this notion, commenting that “a key word is trust, in all levels of engagement.” Other related themes included bridging the gap between patients’ expectations and their experiences; providing continuous and consistent messaging to women to reinforce that they are not alone in their pregnancy and postpartum journey; and addressing barriers to care such as financial constraints, access limitations, and language obstacles.
Working group members explored maternal health challenges and opportunities across science, education, and policy. Concerns over scientific and clinical gaps included the importance of engaging mothers during the period between pregnancies as an opportunity for preconception health and as a potential role of care providers beyond OB/GYNs, particularly pediatricians, in supporting maternal health through family planning conversations. Fragmentation of care was another major concern; working group members stressed that patients are often referred to multiple providers during pregnancy, disrupting continuity of care, which can negatively affect maternal health outcomes – particularly postpartum, when gaps in care can lead to overlooked health concerns. A final concern raised was the lack of standardized postpartum care guidelines. Participants advocated for shifting the focus from the quantity of postpartum visits to the quality of care provided, emphasizing the importance of extending postpartum observation beyond the traditional six-week period to better support long-term maternal health.
Following the discussion on clinical and research concerns, the group turned to educational opportunities throughout the stages of pregnancy. Preconception health was cited as a subject with low awareness, as it is typically an area of limited patient experience and interest. Members suggested leveraging contraception visits as an opportunity to introduce preconception health conversations. However, they also stressed that initiating these conversations is not enough to create a meaningful dialogue; conversations must be framed in a way that respects patients as experts of their own bodies. Ebony Marcelle, DNP CNM, Director of Midwifery at Community of Hope, highlighted this approach, stating that providers must “ask women, ‘What does health look like to you? What is important to you?’ How [do we] engage folks in a way that respects them as experts of their bodies?” Other recommendations included using pre-visit educational materials to enhance prenatal and perinatal care visits, leveraging a dyadic approach that provides complementary resources for patients and providers. Patient materials would aim to empower women to set an agenda for their visits, while clinician materials would guide them in strategies to provide prenatal and postpartum care that promotes informed participation. The role of social media as a health information source was also discussed, with warnings around the frequent disconnect between intended messaging and public perception and the need to tread carefully when educating on social media to avoid perpetuating misinformation.
Roundtable participants also underscored the urgent need for direct policy efforts. The group emphasized the importance of improving access to maternal health care resources by addressing transportation challenges, language barriers, food insecurity, housing instability, and insurance coverage gaps. Returning to the issue of system fragmentation, participants highlighted the need to raise awareness of available local, state, and federal programs, ensuring that these resources are clearly communicated to the public to increase their use and accessibility.
As a final reflection, all working group members stressed the importance of providing accurate, reliable information to pregnant women, particularly regarding adverse pregnancy outcomes. When the information is not always easily accessible, mothers’ and babies’ lives are at risk. SWHR will be releasing a new maternal health care roadmap resource this summer, based on the roundtable insights and building on the Society’s history of maternal health, fertility, and genetic screening resources. Follow the #SWHRtalksMaternalHealth tag on social media and stay tuned for additional information throughout the year!