The data on US maternal health outcomes has established a clarion call for several states, and these states have pursued evidence-based strategies to improve outcomes.

First, these states have extended Medicaid postpartum coverage to one year, which enables more mothers to receive services, and at critical times. An additional 720,000 mothers (i.e., an approximately 45% increase) would be covered if all remaining states expanded postpartum coverage to one year, the period during which 50% of pregnancy-related deaths occur.[3] This extension would be especially critical for mothers with existing gaps in outcomes (e.g., postpartum depression).[4]

Secondly, these states cover additional benefits that can improve outcomes both by delivering critical care in new ways as well as providing supplementary services to improve current care delivery.  Benefits that create new care models (e.g., doula supports) can more holistically address a myriad of barriers that Medicaid mothers face, including coordination with physicians for appropriate care, among others. Studies have shown doula-supported births reduce C-Sections and increase positive birth experiences.[5] In addition, benefits like covered home visits have been shown to benefit both mother and child via decreased infant emergency room visits and increased breastfeeding rates.[6] Lastly, benefits that augment existing pathways can also target certain access gaps and specific needs outside of clinical settings (e.g., lactation consults for breastfeeding complications).[7]

Which States Are Pulling Promising Levers?

Leading states are taking a holistic view on supporting Medicaid moms and babies and are pulling the promising levers to promote better outcomes. The map and rankings below track current efforts across 50 states (and the District of Columbia) on their use of these levers.