By Mark F. Gray

Expectant mothers face challenges when seeking quality prenatal care in the District of Columbia.  Economic and transportation barriers contribute to the District’s infant mortality rate which is amongst the worst in the nation. In 2018 there were an average of 36.1 deaths for every 100,000 live births while nationally the rate is 20.7.

The D.C. City Council is pondering a bill that pushes for better maternal health care services that would be covered under all forms of insurance in an attempt to provide better prenatal care for expectant mothers in the District.

Ward 6 Councilmember Charles Allen introduced legislation that proposes expanding the list of medical care provisions for expectant mothers. The Maternal Health Care Improvement and Expansion Act of 2019 would also create a Center for Maternal Wellness and includes a travel stipend to aid in transportation so patients can reach their preferred health care provider consistently during pregnancy.

“We know women need more access to health care during and after a pregnancy,” Allen said in his statement. “We know community-centered health care can improve outcomes.”

However, Black mothers are facing more dangerous outcomes during their pregnancies.  Figures reported by Allen’s office state Black women are dying at a rate that is three to four times higher than White expectant mothers.  Low income mothers are struggling to gain consistent regular preventive, prenatal and postpartum care which is contributing to the D.C.’s high maternal mortality rate also.

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“Last year, this Council created a Maternal Mortality Review Committee, but we don’t have to wait for results to make improvements,” said Allen.

The bill, which was co-sponsored by Councilmember Vincent Gray, would require private insurers, Medicaid, and the D.C. Healthcare Alliance to add pre and post natal services to it’s benefits.  It would cover at least two postpartum health care visits and home visits for maternal care and fertility preservation services. Currently, Medicaid only includes one postpartum visit after six weeks and ends postpartum medical coverage at 60 days.

Allen’s proposal addresses the barriers facing patients who find it difficult when traveling to their health care provider by offering financial assistance for travel to and from prenatal and postpartum visits.  Transportation availability is seen as a vital cog in the hope of improving infant survival rates in D.C.

“We know for some women transportation is a barrier,” Allen stated. “That’s why this bill also includes a travel stipend to get to their preferred health care provider. If we can’t get people there, none of these other changes will make a difference.”

This bill would extend coverage to one full year for extremely low income residents who are living well below the federal poverty line.

The bill also calls for establishing a Center on Maternal Health and Wellness. Allen wants to build community among women who are pregnant and would consolidate a portion of services to be conveniently available in one location.  The Center would offer childcare onsite while making its services available through telehealth and online.

At the Center, a group of maternal care coordinators would advise pregnant mothers on how to navigate through the services available in the District during pregnancy and postpartum.  It will promote maternal support groups and provide health and nutrition counseling, and distribute prenatal vitamins. Group counseling services would also be available for individuals or family members who have been impacted by an infant’s or mother’s death. This is similar to the District’s comprehensive breastfeeding center. 

“We know a sense of community can help pregnant women and new mothers talk through challenges,” said Allen.

This article originally appeared in The Afro. 

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