Detroit’s maternal death rate is three times the national average and pregnant Black women are 4.5 times more likely to die than non-Hispanic white women. And 44% of pregnancy-related deaths were preventable, according to a recent analysis by the Michigan Maternal Mortality Surveillance Committee (MMMS).
Those are some sobering statistics for Michigan that have sparked Gov. Gretchen Whitmer’s “Healthy Moms, Healthy Babies” plan that she’ll announce Wednesday night during her second State of the State speech at the Capitol.
“I think that making Michigan a place that is a state that is good for moms and babies should be an obvious thing that everyone should promote,” she told the Michigan Advance in an exclusive interview on Tuesday. “We’ve got work to do.”
The governor’s plan will be part of her Fiscal Year 2021 budget proposal that she’s set to roll out on Feb. 6. Whitmer spokeswoman Tiffany Brown said the cost of “Healthy Moms, Healthy Babies” will be announced then, as well.
Whitmer’s plan aims to improve care women need to have a healthy pregnancy, including mental health; combat medical bias against women of color; increase access to effective birth control; and expand access to evidence-based home visiting programs.
Bipartisan victories have been in short supply during the Democratic governor’s first year while contending with a GOP-led Legislature, particularly during the drawn-out Fiscal Year 2020 budget process. The Advance asked Whitmer if she expected to have bipartisan support for this initiative.
“Everyone in this Capitol talks about how much they care about the children of Michigan — and babies in particular — and so this is an opportunity to really show that commitment,” Whitmer said. “So I would hope that it would be bipartisan, and enthusiastic, frankly.”
The statistics in Michigan on maternal mortality are part of a larger trend. The United States has the highest maternal death rate in the developed world. Black women are three times more likely to die from pregnancy-related causes than white women. And maternal mortality rates more than doubled in the United States between 1990 and 2013, the World Health Organization (WHO) reports.
On Tuesday, the national crisis was the subject of a hearing on Capitol Hill, with several Michigan lawmakers expressing concern about Black infant and mortality rates in the state.
The Advance asked Whitmer if she’ll be emphasizing her plan in areas like Detroit and Flint, where several mothers miscarried during the water crisis and young children had elevated lead levels.
“Yes, absolutely,” Whitmer said. “This is obviously statewide policy, because no matter where you are, you should have access to enhanced supports during the beginning of a child’s life. But certainly for moms in Flint who have confronted some unique manmade challenges, we’re mindful of how important it is that we continue to wrap kids around with the supports they need to be successful.”
Under Whitmer’s plan, the state would partner with providers and universities to address health disparities for women of color and train future doctors and nurses in implicit bias. She told the Advance that’s critical because it “contributes to three times the rate of possibility of pregnancy-related death that women of color — Black women in particular — confront in real life in Michigan.”
Michigan State University Dean of Nursing Randolph Rasch and Dr. Audrey Gregory, CEO of the Detroit Medical Center, who are both African American, will lead the effort, Whitmer told the Advance. She said they’re both “passionate about attacking implicit bias and improving outcomes for women and babies of color to come up with an informed curriculum, as well as protocol in the current practice of health care in Michigan.”
Black babies are more than twice as likely to die before they’re 1 than white babies, according to data from the U.S. Centers for Disease Control and Prevention. American Indian infants are about twice as likely to die as white infants. Hispanic families also have a higher infant mortality rate than white families.
Whitmer wants to expand health care coverage for low-income new mothers for a full year after giving birth. She said that would “empower women to have the support they need if they want to go back — or if they need to go back work — after having a child.”
The first postpartum visit would be within three weeks, with a comprehensive visit within 12 weeks. The goal is to help new moms work through postpartum depression and anxiety, substance use disorder treatment, challenges with breastfeeding, and other health care needs. That’s important, since perinatal mood and anxiety disorders are the leading pregnancy complication in the nation and one in seven women have postpartum depression or anxiety.
To improve outcomes for mothers and babies, Whitmer also wants to increase access to evidence-based home visiting programs and connect more families with services to better address housing, food security and safety.
The CDC estimates more than half of pregnancies for women of all ages in Michigan are unintended. Health care costs for mothers and their infants are typically higher in those cases due to the increased likelihood that mothers become pregnant without seeking medical care in preparation or making and healthy lifestyle changes.
As a result, Whitmer wants women to be able to pick birth control that works for them, ensure they can get it in one visit and provide coverage for it. She said access to family planning and contraception is better for women’s health and the health of their babies.
The governor said this comprehensive approach is a win-win.
“When we make Michigan a good place for moms and babies,” she said, “everyone benefits.”