Taking steps to cut maternal mortality in Virginia

April 20, 2021 12:02 am

Tiffany Casby cradles her newborn son Zayne, shortly after birthing him at Embrace Midwifery & Birth Center in Richmond in 2017. (Photo by Cheyenne Varner).

By Cheryl Harris Sutton

Uncertainty. Fear. Worry.

These are just a few of the thoughts and emotions that run through the minds of almost every expecting mother.  For many expecting Black moms, those feelings can be more acute.

That’s because for many, having a child is ultimately a life and death struggle.

Last week was Black Maternal Health Week, making this topic timely. It’s time for everyone to understand this, speak out about it, and then do something about it. Thankfully, we can make a difference.

What seems unreal is that this country has the highest maternal mortality rate of any high-income country in the world — three times higher than the U.K., the next highest country.

For Black women, the rate is more glaring. Black women in the United States have a mortality rate three times higher than that of White women. Black women are also twice as likely to lose an infant to premature death.

Our numbers in Virginia are better than the national average, but Black women in the Commonwealth are still more than twice as likely to suffer a pregnancy-related death than White women.

And many of these deaths are preventable. One comprehensive study found that 60 percent of pregnancy-related deaths in the United State are preventable.

That same report found that access to quality care is a key step to reversing this trend. We can save lives if we ensure access to health care before, during and after pregnancy. This is especially important for low-income women and women of color.

U.S. health policies have too frequently failed to recognize the needs of pregnant women. State Medicaid programs across the country have neglected to comprehensively cover associated health needs following the end of pregnancy.

But here in Virginia, policymakers have taken notice — and action. Pregnant women will continue to receive the comprehensive pregnant women dental benefit for the duration of pregnancy and for 60 days postpartum, like many other state Medicaid programs. What will be lifechanging is the new adult Medicaid benefit recently approved by the General Assembly.

Starting July 1, after the 60th day postpartum, coverage will transition to this new adult benefit, which includes a variety of benefits — different from postpartum coverage — for all adults in Virginia. Of note? The new dental benefit.

Did you know good oral health plays an essential, and underappreciated, role in protecting the health of babies and their mothers?

The state and partners like DentaQuest and the Virginia Health Catalyst are working to increase the number of dental visits by pregnant women through education, promotion, and community-led action. And now all adults eligible for Medicaid will have covered oral health care leading up to pregnancy, which can truly mean the difference between life and death.

Four in 10 of all pregnant women have tooth decay or gum disease from changing hormones, and those that do are at higher risk for poor birth outcomes such as low birth weight, preterm delivery and risk of preeclampsia. Poor oral health raises a pregnant woman’s risk of high blood pressure, a precursor to preeclampsia, which can lead to major complications and even death.  And children are three times more likely to have dental disease if their mother was not able to receive dental care during pregnancy. What’s more, children who have dental disease are four times more likely to receive poor grades in school, perpetuating longstanding inequities for communities of color.

It’s no coincidence that Black women who face the highest mortality rates also face some of the highest rates of oral disease.

Virginia has certainly taken steps in the right direction, but more must be done to ensure our policies demonstrate that we value the lives of Black moms and Black babies here and nationwide.

The act of having a child should be one of the most joyous blessings of any mother’s life. Let’s work together to address the maternal health crisis in our state and remove some of the fear and anxiety that Black mothers feel here and across this country.

We need a revolution in patient care — integrating medical, dental and behavioral health. And we must better leverage technology, like telemedicine, as not just a crisis tool but a long-term solution to increase access and reduce costs, namely by ensuring people of color can get ongoing preventive care.

We’ve taken huge strides with the upcoming adult Medicaid dental benefit. Now, the question is – what’s next?

Cheryl Harris Sutton of Newport News is the east regional vice president for client engagement at DentaQuest, the nation’s leading purpose-driven oral health organization with the mission to improve the oral health of all. She is also a mom and has years of experience leading the administration of Medicaid oral health programs and developing client and community stakeholder partnerships in Virginia, in particular.

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