Two changes will help NC’s maternal health, but abortion limits are a setback | Opinion

In North Carolina, giving birth is exceptionally dangerous, especially for Black women and infants.

The higher risk is a shameful and surprisingly stubborn problem for a state with such wealth and resources. Nationally, North Carolina’s infant mortality rate ranks near the top and its maternal mortality rate is near the middle. The News & Observer has explored the state’s higher maternal death rate in which Black women are more than twice as likely to die from pregnancy-related complications than white women.

But two developments last week offer North Carolina opportunities to significantly lower preventable deaths of infants and mothers.

The first big step was the passage of the state budget, which will allow, at long last, the expansion of Medicaid. The health insurance program will now cover hundreds of thousands of working, but low-income North Carolinians who lack health insurance.

The change will improve the health of women of child-bearing age and, in turn, improve the health of their infants and their own ability to survive in the months after childbirth.

Pregnant women were already covered by Medicaid, but lack of health insurance often left them with health problems prior to pregnancy and less able to recover from childbirth. How many women and infants died during the decade that North Carolina’s Republican lawmakers refused to expand Medicaid is unknown, but surely it took a toll.

The second positive development last week was the announcement that the federal government will spend more than $4 million to reduce North Carolina’s maternal death rate. The funding from the Health Resources and Services Administration (HRSA) will make maternal health care more available, address the often overlooked problem of postpartum depression and train and deploy more nurse midwives.

HRSA Administrator Carole Johnson said her agency will “double down on our partnership with North Carolina” to reduce maternal mortality and illness by targeting the root causes. “The overall message is that a lot of this is preventable,” she said.

North Carolina Department of Health and Human Services Secretary Kody Kinsley welcomed the additional federal support. He said, “Supporting mothers before, during, and after pregnancy is the best way to ensure healthy births.”

Medicaid expansion and well-targeted federal funds will help North Carolina reduce its high rates of infant and maternal mortality. But it will take more to eliminate preventable deaths related to pregnancy.

However, the Republican-led General Assembly is working against the progress that will come with Medicaid expansion and more funding for maternal health care. The state budget allocates the most money ever for crisis pregnancy centers and doesn’t allow funding to go to reproductive health clinics that happen to provide abortions, even if they also provide other services to help pregnant people.

The new limits on abortion access may drive up maternal mortality rates. A 2021 study by researchers at Tulane University found that, “States with more restrictive abortion policy climates have higher total maternal mortality, measured as a death during pregnancy or within one year following the end of a pregnancy.”

Meanwhile, the new state budget includes $1.2 billion in income tax cuts. What a difference it would make to instead invest that $1.2 billion to improve public health services, including prenatal care. But that won’t happen with this legislature. Only elections will change that.

This story was originally published September 26, 2023 at 4:30 AM with the headline "Two changes will help NC’s maternal health, but abortion limits are a setback | Opinion."