Chair DeLauro Statement at the Addressing Maternal Health Hearing

2021-03-23 11:15

House Appropriations Committee Chair and Labor, Health and Human Services, Education, and Related Agencies Appropriations Subcommittee Chair Rosa DeLauro (CT-03) delivered the following remarks at the subcommittee's hearing on Addressing the Maternal Health Crisis.

Today we are here to examine the maternal health crisis in this country, which, frankly, I think amounts to a national disgrace.

When Stacy Ann Walker of Hartford Connecticut was preparing to have her first child, she was 29, healthy, and excited to become a mom. But when she started experiencing shortness of breath, exhaustion, and swelling in her legs, her doctor brushed her concerns aside, saying these were the normal aches and pains of pregnancy.

Soon Ms. Walker’s baby developed life-threatening complications that required an emergency C-section that left both mom and baby fighting for their lives. The baby weighed 2 pounds, 12 ounces at delivery and Ms. Walker developed heart valve problems and heart failure.

Ms. Walker, who is a black woman, was lucky to come out of that ordeal alive. The CDC estimates that roughly 700 women die from pregnancy-related complications a year in the United States.

Sixteen years ago, my daughter Kathryn went in with what was expected to be a normal delivery of our grandaughter. When she was ready to deliver the baby they discovered an infection. The infection led to sepsis and the infection spread to both my daughter and to my grandaughter, Rigby. They both were in the hospital in intensive care, and it wasn't clear whether if either one of them would survive. With the grace of God, both of them survived. Rigby today is 16-years-old and Kathryn is thriving. I say that because often times we don't think about childbirth with the implications that are attended to it, and how dangerous it can be. And we just take it as a matter of routine. I think today's session helps us to focus on what are the kind of things that we need to do. 

Even before the COVID-19 pandemic, the maternal mortality rate in the United States was already more than double the rate of many other industrialized nations. Shamefully, our maternal mortality rate is higher than it is in Kazakhstan and Kuwait.

This is partly because our maternal health outcomes vary drastically by race. Black women, American Indian, and Alaska Native women are 2 to 3 times as likely to die from a pregnancy-related cause than White women in the United States. And these racial disparities persist regardless of income, education, and access to care.

Worse, for every woman in the US who dies from pregnancy-related complications, 71 women suffer from unexpected labor or delivery complications that have a significant impact on their health. However, it is important to note that this number does not include women who suffer from pregnancy-related mental health conditions. They are left out. I believe our question should be, why? The definition of severe maternal morbitity does not include mental health conditions such as depression, anxiety, and substance use disorders. Maternal mental health conditions are the most common complications of pregnancy. Suicide and overdose are a leading cause of death for women within one year of giving birth. So those mental health related complications and deaths are in addition.

Of course, the COVID-19 pandemic has only exacerbated these long-standing problems. Because of the pandemic, pregnant women, mothers, and their families are now less likely to pursue prenatal care, screenings and other postpartum and perinatal care.

Social determinants of health have a profound impact on maternal outcomes as well. These issues do not exist in isolation from each other; none of this happens in a vacuum. Substandard housing, food insecurity, maternal healthcare deserts. All of these challenges contribute to maternal health disparities and can have a devastating impact on the health of our nation’s mothers. That is why I am especially proud that we created a new pilot program last year to help State and local health departments to develop plans to address social determinants of health in their communities. I want to give a shoutout to Congresswoman Bustos for her focus on these social determinants of health and where we need to try to go with these issues. 

As a proud founder of the bipartisan Congressional Baby Caucus and an inaugural member of the Congressional Black Maternal Health Caucus, I am committed to ensuring the health and safety of our mothers and their babies.

I also want to highlight two Members of this subcommittee for their tireless work to improve maternal health and maternity care. Chairwoman Roybal-Allard and Rep. Herrera Beutler are the founding Co-Chairs of the Congressional Caucus on Maternity Care, which is a bipartisan congressional caucus.

This issue has been a priority for many other Members of this Committee as well. Chairwoman Lee and Rep. Watson Coleman have been passionate advocates for reducing health disparities in all areas, including maternal health and maternal mortality. And, while she is not a Member of this subcommittee, I am excited to welcome Rep. Lauren Underwood to the Appropriations Committee. She has been a leader in assembling a bill known as the “Momnibus” which includes many new initiatives to address maternal health and maternal mortality.

Over the past two years, this subcommittee has been instrumental on a bipartisan basis in increasing funding for grants and programs to improve maternal health. We increased funding for the Maternal and Child Block Grant, the Alliance for Innovation in Maternal Health’s maternal safety bundles, the Maternal Mortality Review Committees, and for the Healthy Start program. We also provided funding for midwife training scholarships and for State Maternal Health Innovation grants to promote state-level coordination and innovation in maternal health care.

Additionally, I am pleased that the American Rescue Plan extended Medicaid coverage for low-income mothers from two months after birth to 12 months after birth, an expansion that is critical to improving access to care for vulnerable new mothers. But there is still so much more work to be done, as 12 states have yet to expand Medicaid. And beyond that, while it is a topic for the authorizing committees, we need to increase reimbursement rates. Those cannot wait.

Today we will hear from our witnesses about some of the reasons why maternal health outcomes in the United States lag behind other industrialized countries and why disparities in maternal health outcomes persist. We will also hear about promising strategies to improve maternal health and how the programs funded in the Labor-HHS-Education bill can support these strategies and improve maternal health outcomes in all communities.

Our mothers are the lifeblood of our families, our nation, and our world. And those 1,000 days between the beginning of a woman’s pregnancy to the second birthday of her child are already incredibly stressful, challenging, and life changing. But now for the first time in history women are more likely to die during childbirth than their mothers were before them. This is unacceptable. As I said at the outset, this is a national disgrace. As a nation we are supposed to value freedom, motherhood, and yes apple pie. But we have to ask ourselves, if the United States is at the bottom of the barrel when it comes to maternal mortality rates among industrialized countries—countries we consider our peers—then are we really a nation that values the lives of mothers? As 700 women are dying every year and thousands more are suffering from either labor or delivery complications or pregnancy related mental health conditions can we really say our nation values mothers or the lives of those that they sustain?

We owe it to our nation’s mothers and to all our families and communities to ensure that not one more woman, not one more mother dies as a result of childbirth. We are fortunate that we are in a powerful position to help with this subcommittee. And I hope that this hearing will give all of us a better understanding of what solutions there are and what we are able to do from an Appropriations standpoint to address this inexcusable problem.

117th Congress