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The U.S. healthcare system is in the midst of a crisis. Despite being among the richest nations in the world, it consistently for maternal health outcomes -- and that's before you begin digging into the health disparities women of color face in this nation.
Pregnancy-related complications kill Black mothers as white and Hispanic women, and of the deaths are preventable. When you do the math, that's we could've saved in 2020 alone!
But things keep worsening year over year, especially in the wake of the COVID-19 pandemic. Perhaps artificial intelligence (AI) is the solution for this epidemic.
Advances in AI help doctors identify pregnant mothers who are at risk
There are so many applications for AI, as this technology continues to evolve and advance. One of the most exciting applications of AI is for improving maternal health outcomes.
Some AI tools developed recently analyze patient data to identify pregnant mothers who are at risk for complications. One of the biggest red flags AI measures is the risk for premature birth, but it also recognizes other prenatal and postpartum risks for both mom and baby.
One of the biggest threats to maternal and infant health is the unmet needs within the social determinants of health, which often directly influence mothers' ability to access healthcare services. If a pregnant woman doesn't have access to reliable transportation to get her to and from the doctor or lives a significant distance from one, AI can measure how that might impact health outcomes for her and her unborn child. Then, it can flag it for her doctor or health plan so they can help solve these issues before they cause larger problems.
The result? Reduced racial disparities for maternal health, fewer preterm births and neonatal intensive care unit (NICU) admissions, and shorter NICU stays. But even with these improvements and technological advancements, there are still gaps because maternal and infant health outcomes differ from state to state.
Where pregnant and postpartum women live influences their maternal health outcomes.
conducted an analysis of maternal health outcomes in each state, as well as Washington, D.C. and Puerto Rico in 2022. They gave each state and territory a grade. Their findings were sobering, to say the least:
- Nine states and Puerto Rico received an F
- Fifteen states received a D
- Eighteen states and the District of Columbia received a C
- Seven states received a B
That leaves just one state that earned an A for maternal and infant health outcomes. It begs the question: What is happening in the states with the best outcomes versus those with the worst?
, the only state that earned an A on the March of Dimes Report Card, had a preterm birth rate of just 8.0%. and weren't far behind, with 8.5% and 8.9%, respectively. The rates for infant mortality and inadequate prenatal care in these states were all significantly lower than the U.S. average. Vermont and Oregon also had lower cesarean birth rates than the national average.
On the other hand, has the worst maternal and infant health outcomes, with a 15% preterm birth rate. The next highest preterm birth rates belonged to at 13.5% and at 13.1%. These states also had higher rates of cesarean section and infant mortality than the national average.
With this added perspective of just how systemic the maternal health crisis is, it's more imperative than ever to do something about it. So, Congress sprung into action.
The American Rescue Plan Act allows states to expand Medicaid coverage for postpartum moms
When Congress passed the American Rescue Plan Act to help everyday Americans and small businesses weather the beginning of the COVID-19 pandemic, they included a provision that allows states to expand Medicaid coverage to moms up to a year postpartum. These expanded Medicaid services went into effect in 2022.
As of August, 37 states have implemented 12 months of . Nine others have plans to do so, while Utah and Wisconsin have plans for limited coverage extensions.
While this expanded coverage isn't available yet in all states, it's a step in the right direction. Harnessing new technology, expanding and prioritizing healthcare for mothers, and identifying factors that increase their risk for adverse maternal and infant health outcomes will hopefully move the needle in the right direction.
Matt Eakins, MD, is a physician executive.
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