By Katie Horneffer, Intern, Care4Carolina
Our children are our future, and our state has an important role to play in keeping babies and their mothers healthy. Knowing this, North Carolina provides health coverage to low-income women during and immediately after pregnancy. Yet many women do not have access to affordable health insurance before pregnancy, leaving them with unmet health needs and unmanaged chronic conditions. Currently, 15.7% of North Carolina women of childbearing age are uninsured. Closing the coverage gap would provide more young women with health insurance before they become pregnant, improving maternal and infant health outcomes for North Carolinians.
Medicaid provides health insurance to eligible women while they’re pregnant and for 60 days after they give birth. This program provides important prenatal and perinatal services, including education, counseling, behavioral intervention, and medical home visits. For example, participating women can access postpartum depression screenings and counseling, participate in tobacco cessation programs, and visit a doctor for concerns following the birth of their child. By providing North Carolina mothers with healthcare access, this program helps improve the health of women and children in our state.
Yet the current available healthcare coverage is not enough. Compared to the national average, North Carolina mothers are more likely to die from complications of pregnancy and childbirth. There are also stark racial disparities, with Black women having higher rates of maternal deaths compared to white women. Clearly, there is more that must be done to keep North Carolina’s mothers healthy and safe.
Pre-conception health plays an important role in influencing maternal and infant health outcomes. But many young women who may be thinking about starting a family don’t have access to affordable health insurance before they become pregnant. Closing the coverage gap represents an important opportunity to ensure that women are healthy before conception and in the early stages of pregnancy, increasing the likelihood of a safe and healthy birth.
By increasing access to preventive care and educational resources before pregnancy, closing the coverage gap can improve the health of young women who are planning to start a family. In states that have closed their coverage gap, young women have fewer barriers to healthcare, better self-rated health, and decreased dangerous drinking habits. These states have higher rates of pre-conception health counseling—which can address issues like smoking, depression, and high blood pressure. Women in these states are 10% more likely to take daily folic acid in the month before conception. And women in these states are also less likely to have multiple pregnancies that are close together, which is a known risk factor for poor maternal and child health outcomes.
Closing the coverage gap doesn’t just improve women’s pre-conception health: pregnant women also have better healthcare in the early stages of pregnancy. One Ohio study found that, after the state closed its coverage gap, women had better access to high-quality prenatal care during the first 16 weeks of pregnancy, were more likely to get recommended health screens, and were much more likely to receive prenatal vitamins.
All of these factors can come together to impact the most important maternal health outcome: mortality. Closing the coverage gap saves mothers’ lives. Some studies suggest that states that have closed their coverage gap save as many as 7 maternal lives per 100,000 births, with Black mothers in particular benefitting from the improved access to and quality of care. Healthier mothers lead to healthier babies, too. States that closed their coverage gap saw a 50% greater decline in infant mortality, compared to states that haven’t.
With all of the stress and responsibility that comes with being a new mother, the last thing a woman should have to worry about is accessing the care she needs to keep herself and her baby safe. Healthy babies start with healthy mothers—and by closing the coverage gap, North Carolina can help future mothers access services and resources they need to thrive.