As we celebrated Mother’s Day recently, I was filled with excitement and so much appreciation for my generous, intelligent, and amazingly patient mother and mentor, Brenda Gray. I’m also thankful to be a mom to two incredible young daughters, and it’s a true delight to celebrate my friends who are also on this remarkable “mommyhood” journey. (I call it “mommyhood” because Olivia – my 19-month-old – sings “Mommy!” at least 500 times every day. I can see my fellow moms nodding their heads right now!)
Unfortunately, that joy is often tempered as I reckon with a harsh reality for women in Texas: Thousands of new moms celebrate Mother’s Day knowing they lack access to lifesaving, postpartum physical and mental health care.
Currently, Texas women enrolled in Medicaid for Pregnant Women – women in families at up to 200% of the Federal Poverty Line (FPL), or with income of $2,290/month – lose that coverage 60 days after giving birth, and only those at 14% FPL (about $251 in income per month for a family of three with two parents) can extend Medicaid coverage.
In fact, between 2016 and 2018, there were an estimated 105,000 uninsured new mothers living in Texas. That means 105,000 new moms left vulnerable to life-threatening complications and health conditions that may occur within the first year postpartum.
I worry about the mom who has an infection. The mom who has a dangerously high spike in blood pressure. The mom who needs emergency surgery. The mom who finally suspects she has postpartum depression … on day 70. I worry about these moms. And I worry about their sweet babies.
The Texas Maternal Mortality and Morbidity Review Committee found that nine out of 10 pregnancy-related deaths were preventable, and one-third of maternal deaths occurred 43 days to one year after pregnancy.
The physiological strains that pregnancy puts on the body can exacerbate and have lingering effects on other unrelated (non-reproductive) systems that put a mom’s health at risk.
The most common pregnancy-related and childbirth-related causes of death are cardiovascular diseases, excessive bleeding (or hemorrhage), infection, and cerebrovascular incidents (stroke), mental health needs, and other heart issues, which require specialty care and complex treatments.
While 20% of postpartum health care spending occurs within the first 60 days, a whopping 70% of postpartum costs occur after 90 days within the first year after giving birth. This spending is on infrequent but urgent services like surgeries and hospitalizations.
Fortunately, there is hope! On April 14, the Texas House passed House Bill 133 – a bill that extends Medicaid eligibility for pregnant women from 60 days to 12 months after giving birth. This means that new moms are able to keep their health insurance for a full year after pregnancy, and it’s a key step toward preventing maternal deaths, addressing postpartum depression, and supporting healthy moms and babies. In fact, the Texas Maternal Mortality Review Committee’s number one recommendation to improve maternal health in Texas is “that health care coverage be extended to 12 months postpartum to help identify and properly manage health conditions before they become life-threatening.”
Extending postpartum Medicaid will save women’s lives. It will allow access to comprehensive healthcare services; strong and established physician provider networks; and critical services like surgery, emergency room visits, and hospitalizations.
Some contend that existing state programs – such as Healthy Texas Women (HTW) and Healthy Texas Women Plus (HTW+) – meet the same postpartum needs as Medicaid. HTW+ even includes some provisions for screening and treatment of chronic conditions (like diabetes and high blood pressure) and postpartum depression. But the services available to moms with HTW and HTW+ are limited in scope and just don’t measure up as adequate alternatives to the health insurance that Medicaid offers.
New mothers desperately need access to the full range of healthcare services that Medicaid makes possible. And new babies need care and nurturing from moms who are at their healthiest — their survival and development depend on it.
House Bill 133 passed with tremendous bi-partisan support in the House but is currently stalled in the Senate Committee on Health and Human Services. Which leads me to ask the question … Why aren’t we more motivated to ensure healthcare for new moms?
Fellow moms, think about how vulnerable you felt your first six weeks, 12 weeks … even six months after giving birth. Grandmothers, do you remember helping your adult daughters navigate those first three months with a newborn? It’s hard. It’s scary. It requires tremendous emotional and hands-on support from family. It is not the moment to pull the rug out from under new mothers most in need of societal support.
One thing that has become abundantly clear during the year of COVID is that mothers are, in fact, the foundation of our society and economy. Mothers with means. Mothers in poverty. Married moms. Single moms. Working moms. Stay-at-home moms.
Mothers watchfully nurture infants, keep them alive and healthy, and take on the task of developing resilient, self-sufficient people who grow up to become contributing adults. The least we can do is support healthcare legislation that improves the chances of survivability for new moms who need a little more help.
I want a few things for Mother’s Day this year. Healthy, thriving daughters. The laughter and delight of family and friends. And I wouldn’t turn down breakfast in bed. But it’s time to put more than flowers, jewelry, and cards in our Mother’s Day baskets. It’s time to enact legislation that tells every new mom in Texas that she is respected enough to support her full physical, psychological, and emotional recovery from bringing a new baby into this world.
Tiffiney Gray is senior content specialist for health initiatives with Prosper Waco.
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