Three things Northam wants to do to lower maternal mortality rates

Black women in Virginia are three times more likely to die after giving birth than white women, a disparity Gov. Ralph Northam has said he wants to eliminate by 2025.

To do that, Northam has come up with a $22 million, two-year plan he introduced Monday in a room of toddlers, babies and their parents.

“It is unacceptable that in our country and in our commonwealth, maternal mortality rates are on the rise,” said the governor, a pediatric neurologist.

His proposals came from a series of listening sessions administration officials held around the state in recent months to discuss maternal and infant mortality.

Medicaid expansion has helped a number of women, Northam said, but added that his budget proposals will help reduce the rate further.

Among his ideas:

• Extend post-partum Medicaid coverage to a year after birth. Right now, women using Medicaid are covered during pregnancy and up to 60 days after birth. But many women who die because of childbirth do so more than 43 days after giving birth, Northam said. “We believe that these preventable deaths are … women being left to navigate a complex health care system on their own,” he said. Black women die most often after giving birth because of cardiac problems, according to data from the Department of Health.

Makunda Abdul-Mbacke, an OBGYN in Martinsville and Henry County, said Northam’s proposal gives women a chance to “breathe” after having a baby.

“You have no idea how difficult it is to try to wrap up someone’s post-partum depression, to wrap up their hypertensive crisis, to wrap up their heart issues and so many things … that need to get wrapped up in a 60-day period after they deliver,” Abdul-Mbacke said.

• Allow home visits to be reimbursed by Medicaid. The most expensive of Northam’s proposals was a $12.8 million plan to include a home visitation program in Medicaid coverage.

“We know home visiting programs help parents be more resilient, they help coordinate care and services and teach parents the skills they need,” he said.

Home visits can help parents with a range of things, including breastfeeding, helping parents further their own education or find work and managing children’s behavior.

• Study the possibility of covering doula services under Medicaid. This change doesn’t require money, but requires adding some language in the budget to instruct the Secretary of Health and Human Resources to make recommendations for creating a doula benefit for women who use Medicaid.

Doulas aren’t doctors, but assist women through pregnancy, childbirth and post-partum. They can provide some medical support to women as well as home services, like cleaning, cooking and child care.

In his administration’s listening tours, many people spoke positively of doulas, Northam said. But not everyone has access to them: According to various Virginia-based doula companies’ websites, it can cost anywhere from $600 to more than $1,000 to hire a doula.

And some others: Northam’s announcement included other proposals related to women’s health, including $4 million to bolster the Long-Acting Reversible Contraception Program. The program provides low-income women with contraception. Anti-abortion advocates have criticized the program, calling it a “slush fund for Planned Parenthood.”

According to the Virginia Department of Health, LARCs can reduce the rate of unintended pregnancies and abortions. “It is time for us to allow women to decide if and when they want to start families,” Northam said.

He also included $660,000 more dollars for a program that helps mothers with addictions seek treatment; $879,000 for continued work on reducing racial inequities in maternal and infant health; and $400,000 for bundled payments.