ACOG Statement on Expansion of Medicaid for Pregnant Women in Flint, Michigan

Washington, DC—Mark S. DeFrancesco, MD, MBA, President of the American Congress of Obstetricians and Gynecologists (ACOG), released the following statement regarding the approval of the Flint Michigan Medicaid Demonstration Waiver to provide coverage to pregnant women and children served by the Flint water system:

"ACOG thanks the Centers for Medicare and Medicaid Services (CMS) for its expeditious approval of Medicaid expansion to address the health needs of the most vulnerable members of the Flint community and its willingness to further expand coverage to pregnant women who had previously been exposed to lead-contaminated water. Diagnosing and treating the complications of lead exposure in pregnant women is imperative to restoring the health of the Flint community.

"As the medical society representing women's health physicians, the American Congress of Obstetricians and Gynecologists recognizes the risk facing many women who have previously been exposed to lead-contaminated water. Because of the way lead is stored in the body and released during pregnancy and lactation, women who have been exposed to lead before pregnancy, not just during pregnancy, are at risk for poor health and birth outcomes.

"Lead may be released from bones during times of calcium stress, such as pregnancy and lactation, which elevates blood lead levels. Maternal blood lead level is an important indication of risk to the fetus and neurological problems in newborns. Elevated lead levels in pregnancy have been associated with several adverse outcomes, including gestational hypertension, spontaneous abortion, low birth weight, and impaired neurodevelopment. If maternal blood lead level is above 40 micrograms/dL in a postpartum woman, she will be unable to safely breastfeed.

"As this crisis unfolds, ACOG and its members in the Flint area will continue to work to protect and improve the health of pregnant women and their children. ACOG looks to CMS and the State of Michigan to provide ongoing coverage even after the Flint water system has been deemed safe to address the ongoing health problems associated with prior lead exposure."

For more information, Committee Opinion 533, "Lead Screening during Pregnancy and Lactation" is available.

The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation's leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of approximately 58,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization. www.acog.org