This Connecticut Bill Aims to Change Maternal Health Outcomes

Maternal health in the U.S. is in crisis. In 2018, the National Center for Health Statistics reported that the maternal mortality rate in the U.S. was 17.4 per 100,000 live births, which is more than double the rate in France and Canada.

However, legislators in my home state of Connecticut are trying to address this problem. Senate Bill 986 (SB-986) implements evidence-based practices such as mental health support, access to quality health care, and extensive postpartum care inspired by countries with some of the best maternal health outcomes in the world, such as Sweden and the Netherlands.

Among many other things, SB-986 establishes a doula certification and stresses the importance of doulas in prenatal care. I interviewed a local doula about the bill, and she provided a firsthand account of her job's difficulty while emphasizing her immense positive impact on pregnant people through her extensive support. The one-on-one emotional encouragement that doulas offer drastically improves birth outcomes, with studies verifying reductions in labor lengths (25%), using oxytocin (40%), the overall cesarean rate (50%), and epidural requests (60%). Moreover, a doula provides personalized advice and techniques for pain relief and comfort throughout the pregnancy. Not only do birthing outcomes improve, but the bill also increases the profession's visibility and recognizes doulas as valuable members of a birthing team. SB-986 offers routes pregnant people can take for assistance and amplifies the voices of doulas.

The bill also opens birth centers for low-risk patients throughout the state, ensuring pregnant people of all different backgrounds receive improved care. According to researchers from the American Heart Journal, Black parents and infants consistently see the highest rates of poor birth outcomes throughout all measures. Birth centers engage with external care providers, as including different delivery types correlates with better results for Black patients. Furthermore, the bill extends Medicaid coverage for access to proper care for a healthy pregnancy regardless of socioeconomic status.

Acknowledging the significance of postpartum care, SB-986 also employs a nurse home-visiting program, which consists of one minimum visit during a newborn's first three months of life. Additional visits and services address each family’s individual needs. Medicaid coverage extends for 60 days to a year postpartum to ensure mental and physical health is monitored and cared for. Deidre S. Gifford, the executive director of the Office of Health Strategy, stated on March 13, 2023, "This program will be designed to improve outcomes in child safety, child health, and development, family economic self-sufficiency … reducing child maltreatment, reducing family violence, and parent-infant bonding."

Although the nurse home-visiting program needs funds, constant monitoring of the newborn post-pregnancy allows for early detection of postpartum complications, reducing the cost of unwanted medical interventions for both the state and hospitals in the long term, which offsets the program's cost. Take, for example, the Office of Early Childhood, a pilot program in Bridgeport, Connecticut, started in 2021, which has successfully resulted in lower Department of Children and Families investigations (44%), a reduction in postpartum depression (30%), fewer emergency room visits (50%), and an increase in community connections (15%). Since all families receive this opportunity, it lessens unwanted stigma and boosts community participation.

SB-986 is widely supported by well-recognized health agencies throughout the state, such as the Office of Early Childhood, the Department of Public Health, the Connecticut Hospital Association, and more. The bill aligns with a vision of society that values the health and well-being of pregnant people. Healthier parents and children lead to healthier families and communities. A prosperous community creates a better environment for child health, reduces health care disparities, and improves the overall well-being of everyone.