Improving Maternal Health

Maternal health is an important indicator for the overall health of our nation, states, and local communities.

Action to improve women’s health includes closing the outcomes disparities gap among black, Hispanic, and white women; eliminating barriers to risk-appropriate care including depression and substance use disorder screening and treatment; ensuring safe obstetric access in rural areas; funding for research to inform evidence-based interventions and quality measures; and reducing maternal deaths and severe pregnancy complications.

Maternal Mortality Prevention
Substance Use Disorder in Pregnancy
Perinatal Depression
Women’s Health Research

Maternal Mortality Prevention

The U.S. ranks highest among industrialized nations in maternal mortality; rates are rising and significant and widening disparities persist with black women three to four times more likely than white women to die during pregnancy and the postpartum period. More than 700 women die each year in the U.S. as a result of pregnancy or delivery complications; over half (59%) of these deaths are preventable.    

ACOG has long prioritized efforts to reduce maternal mortality and severe morbidity and supports confidential, non-punitive, systematic review of maternal deaths to improve processes, systems and knowledge and give us actionable, data-driven recommendations to eliminate preventable maternal deaths and near-misses. 

At the federal level, ACOG spearheads national initiatives to mobilize clinical and public health resources to improve maternal safety and identify opportunities for prevention and systems improvement, including funding for state-based and regional maternal death reviews, support for perinatal quality collaboratives, and efforts to address rural health shortages.

At the state level, ACOG recommends that all states pass legislation establishing a maternal mortality review committee with authority to access records and confidentiality protections for review proceedings and members. ACOG also supports legislation to implement prevention recommendations including risk-appropriate, regional designation of maternity care facilities.

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Substance Use Disorder in Pregnancy

ACOG joins every leading medical and public health organization in approaching the problem of drug and alcohol use during pregnancy as a health concern that’s best addressed through education, prevention, and community-based treatment, not through punitive drug testing and reporting laws, or criminal prosecution.  Research shows that obtaining prenatal care, staying connected to the health care system, and being able to speak openly with a physician about drug problems helps improve birth outcomes.

At the federal and state levels, ACOG supports policy prescriptions that prioritize a healthy outcome for both mother and baby including expanding Medicaid coverage from 60 days to one year after delivery, including for SUD and mental health screening and treatment, and case management and outreach services; access to medically-assisted treatment (opioid agonist pharmacotherapy); adequate postpartum psychosocial support services including SUD treatment and relapse prevention programs; safe prescribing practices; and an increased focus on curbing alcohol and tobacco use during pregnancy.

Routine urine drug screening is controversial. ACOG recommends testing be performed only with the patient’s consent and a positive test not be a deterrent to care, a disqualifier for coverage under publicly-funded programs, or the sole factor in determining family separation.

ACOG calls on federal and state legislators to look to science-based guidelines and decades of medical evidence to craft appropriate public health interventions that will optimize health outcomes for moms and babies. 

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Perinatal Depression

One in five women will experience a behavioral health need in her lifetime, and pregnant and postpartum women are less likely to be appropriately screened and receive treatment for mental health concerns.  Stigma, under-treatment, inadequate referral mechanisms and lack of treatment capacity have stymied prevention efforts.  ACOG supports improved, culturally appropriate treatment capacity for perinatal mental health and substance use disorders.

At the federal level, ACOG continues to call for a comprehensive federal commitment to combating perinatal depression through research, public and provider education, and grants to states and public and nonprofit private entities to innovate and increase screening and treatment capacity.

At the state level, ACOG supports strategies -- like the successful Massachusetts Child Psychiatry Access Program for Moms (MCPAP) -- to improve identification and treatment of women with and at risk for perinatal depression; measures that improve systems capacity to ensure statewide and timely access to screening and treatment including postpartum home visiting; increased use of tele-behavioral health services especially in rural and medically underserved areas; and elimination of patient and provider barriers including lack of coverage and reimbursement.

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Women’s Health Research

Inclusion of women, including pregnant women, in research studies is necessary for valid inferences about health and disease in women. As a standing member of the Executive Committee of the Friends of the National Institute of Child Health and Human Development (NICHD), and a founding member of the Coalition to Advance Maternal Therapeutics, ACOG is at the forefront of efforts to advance women’s health research.

ACOG advocates for increased federal funding for women’s health research, increased representation of women in research – from basic science research to post-market trials, and a reduction in barriers for pregnant women’s participation in clinical trials. In addition, ACOG advocates for funding for the Department of Defense Congressionally Directed Medical Research Programs, including to advance ovarian cancer research.

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American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188
Mailing Address: PO Box 96920, Washington, DC 20024-9998