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By listening to patients and respecting their preferences, healthcare providers can improve the birth outcomes for parents and children.

Many women do not have access to care where they feel seen, heard, and supported regardless of education or income. But actively listening to patients and acting on their preferences and concerns can improve access to care and birth outcomes, especially for Black women who often report discrimination from their providers.

One example is Olympic medalist Allyson Felix, who survived pregnancy complications because her doctor listened to her concerns and quickly responded to them. By understanding Allyson’s symptoms and carefully considering her perspective, the doctor saved Allyson’s and her child’s lives.

When care teams provide high-quality, respectful care at every stage of the reproductive journey, they reduce health risks while promoting joy. Additional ways to improve comprehensive care and postpartum support include:

Recruiting a diverse healthcare workforce to ensure mothers are cared for by someone who looks like them
Adequately paying physicians who work in marginalized communities
Partnering with communities to create solutions to improve care and health outcomes

A Maternity Action Plan created in New Jersey provides policy goals and recommendations community members, stakeholders, and policymakers can replicate in their own states.

Equity efforts should eventually lead to sustainable policy change to ensure long-term success. This Maternity Action Plan provides effective policy examples that support reproductive justice efforts and illustrate how long-term change is possible in communities.

Policy goals and recommendations include:

Build the Workforce Needed for Birth Equity
- Address structural racism in medical education and training
- Increase financial support for doulas, midwives, lactation consultants, and others
Improve Data Collection and Use
- Share changes in quality measurement data with the public
- Use timelier data to inform changes to pilot programs and payment models
Reform Payment and Care Systems
- Restructure payment models so that providers are incentivized to meet quality targets
- Test payment systems that reward prevention-focused care and utilize prenatal risk factor assessments
Improve Social Supports
- Increase financial assistance for families; lower the cost of living
- Increase awareness and utilization of social services

The Urban Institute and Policies for Action hosted a discussion about achieving maternal health equity. Researchers, policymakers, advocates, and providers explored evidence, experience, and policy considerations for systemic change.

Achieving maternal health equity remains a challenge in the United States. Black, Hispanic, and American Indian and Alaska Native communities continue to experience poor maternal health outcomes. Contributing factors include systemic and social barriers, discrimination, bias, language differences, and location.

Evidence-based solutions can help close the equity gap and lead to better care for all. Suggested policy solutions to reduce maternal health disparities include:

Using community-based midwifery care models and reducing Medicaid reimbursement barriers
Increasing Medicaid and Indian Health Service funding to ensure continuous maternal healthcare access before, during, and after pregnancy
Improving language access infrastructure
Strengthening rural health care infrastructure

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By 2050, Birth Center Equity hopes 50% of babies will be born with the help of midwives.

Maternal mortality is a big concern within reproductive care. Midwives can play a critical role in improving birth outcomes, improving care experience and equity. Less than 20% of U.S. births currently involve midwives.

Positive birth outcomes in the Unites States trail behind other developed countries, such as France, Japan, and the United Kingdom, likely because of differences in availability of midwives. Midwifery provides a path to delivering high-quality healthcare, with continuous support and guidance across all stages of maternity care.

Implementing midwifery into health systems includes:

Providing access to community birth centers
Centering midwives in birth care teams
Creating and supporting policies for midwifery

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