HHS Announces Critical Steps to Improve Maternity Care and Outcomes
On Dec. 14, the U.S. Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (CMS) announced via a press release that it is taking critical steps to ensure pregnant and postpartum individuals have access to equitable, comprehensive maternity care.
We reported on Dec. 8, that on the previous day the White House issued a statement in which Vice President Kamala Harris announced a call to action to reduce maternal mortality and morbidity. In support of this call to action, CMS is encouraging hospitals to implement “evidence-based patient safety practices for managing obstetric emergencies along with interventions to address other key contributors to maternal health disparities.”
The release states that “In support of delivering equitable, high-quality maternity care, CMS encourages hospitals to review their policies and procedures for incorporation, where appropriate, of best practices.”
Further, “One such evidence-based practice for improving patient safety and quality of care, referred to as ‘maternal safety bundles,’ has been successful in driving improvements—particularly with obstetric hemorrhage, severe hypertension in pregnancy, and non-medically indicated Cesarean deliveries. These bundles have also been associated with narrowing the racial disparity gap in certain perinatal outcomes.”
CMS Administrator Chiquita Brooks-LaSure was quoted in the release saying that “There is no greater priority than ensuring pregnant and postpartum individuals receive the best possible care, and the Biden-Harris Administration is committed to working with the provider community and beyond to make that happen. Too many individuals—a disproportionate share of them people of color—experience unnecessary pregnancy-related complications and deaths. We must do everything we can to change that.”
This guidance is the most recent in a series of actions CMS has pursued to advance the safety and quality of maternal care. CMS, as part of Vice President Harris’s call to action, announced the intent to propose designation to further drive hospital improvements in perinatal health outcomes and maternal health equity. Starting October 1, 2021, CMS adopted new quality measures for the Hospital Inpatient Quality Reporting Program. The Hospital Inpatient Quality Reporting Program asks hospitals to “attest if they participate in a statewide or national perinatal quality improvement collaborative, and whether they have implemented patient safety practices or bundles to improve maternal outcomes.”
“Each year in the U.S., approximately 700 women die from pregnancy-related complications, and over 25,000 experience severe complications of pregnancy,” the release adds. “There are significant racial, ethnic, and geographic disparities in maternal morbidity and mortality as well: Black and American Indian/Alaska Native women die from pregnancy-related causes at a rate two to three times higher and experience severe complications at a rate nearly two times higher than their white, Asian Pacific Islander, and Hispanic counterparts. Pregnant people who live in rural communities are at higher risk for severe maternal morbidity and about 60 percent more likely to die from pregnancy-related causes than those living in urban settings. However, two out of three pregnancy-related deaths are considered preventable.”
