New Legislation Aims to Make Life Easier for Pre-and Postpartum Moms

“Too many women die, period, but definitely too many Black women,” Rep. Robin Kelly tells me as we sit in her office tucked deep inside the Rayburn office building. An array of papers is scattered across her desk, the mark of a busy woman whose to-do list is filled to its brim. Right now, the task at hand is preparing to introduce the CARE for Moms Act to Congress on September 19. 

Indeed, the death of Black women is an epidemic. The maternal mortality rate for Black women is almost three times the rate of white women, according to the most recent data from the Centers for Disease Control, a significant increase from previous years. Such grim data reflects a cruel reality, informed by a lack of comprehensive maternal care and the rampant racism in American medical establishments. As I’ve written before: 

Black women like me are more likely to receive C-sections, a procedure unpreferred by many medical providers due to an increased risk of postpartum complications, and experience a higher rate of stillbirths. Our pain is dismissed or ignored by clinicians, a common occurrence that received significant news coverage following the near-fatal birthing experience of tennis icon Serena Williams in 2018 and the death of [CDC epidemiologist Shalon] Irving.

This truth is top of mind for the Illinois congresswoman. Kelly’s new legislation builds on suggestions in her previous attempt to address maternal health at the national level, the MOMMA’s Act, such as a mandatory extension of the postpartum period from 60 days to a year for birthing folks on Medicaid—a critical healthcare need since many postpartum deaths happen after the two month coverage period ends. It’s worth noting that, on April 1, 2022, a provision in the American Rescue Plan allowed states to extend Medicaid postpartum coverage to one year. As of publication, 37 states and Washington D.C. have approved an extension, while nine states are planning to implement the measure—signaling a willingness at the state level to provide this care. 

New asks in the CARE for Moms Act include federal funds to boost the doula workforce, grants for Rural Obstetric Mobile Units to make such services more accessible in rural areas, and extending the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits, among others.

Our conversation, which is edited for length and clarity, covers the incoming bill's particulars and the congresswoman’s thoughts on the importance of care policies and why they’re crucial for birthing parents’ health, well-being, and empowerment. 

“We have got to feel empowered to advocate for ourselves. We need to be our best ambassadors and not be afraid to ask the doctor or the nurse questions. It’s important that women feel empowered—especially Black women—about their health and not just go along the program,” she said. 

“It's okay to get a second opinion. It's okay to challenge … It's okay to make sure you're heard.” 

This conversation will also be featured online as an update to our Mission: Visible special project on the challenges Black birthing people face and how this can complicate the decision to try to have a child or start a family. Mission: Visible offers stories and statistics and provides resources to help find, feature, and elevate the voices of women and people of color in the national conversation to tell a fuller, truer narrative of our national story and, instead of erasure get our complex and diverse history right, from the first draft. Please contact me if you have resources, stories, or statistics that we should feature. craven@newamerica.org

Craven: I was looking through the bill, and I wondered if there was a moment or instance that inspired the creation of it. Walk me through your thought process when you decided to pursue the issue of Black maternal health.

Rep. Kelly: To be honest, I didn't even realize it was an issue until I came to Congress. A constituent called me and shared the story of Judge Hatchett, who comes on TV, about her daughter-in-law who died having her second child. This constituent felt like she could not get attention around the matter, so she called and shared the story with me. I'm a mom. I have a daughter and two stepdaughters who hadn't had kids yet. It was very alarming. So we had a forum in DC, and it was packed. Even the photographer taking pictures had lost his daughter when she gave birth.

I kept hearing the stories. I didn't realize someone I'd worked with at Cook County had lost her daughter. Then stories from more famous people—Beyoncé, Tatyana Ali, Allyson Felix—it never ended. 

Then, we worked with a lot of professionals to see what they felt was needed. 

Craven: Tell me more about the particulars of the bill. 

Another thing that informed the bill was how my district changed tremendously since I started working on this. I was always urban, suburban, and rural, but now my district is two and a half times bigger than it was geographically. Most of the extra is rural, in that we discovered healthcare deserts and maternity deserts. So we wrote in the need for mobile units and doulas in those areas. What has happened in my area, and not only my area, but hospitals have stopped delivering. That's why we're pushing for them to alert DHHS [the Department of Health and Human Services] ahead of time if they’re going to stop—not just pull the cord or cut the string and then boom, you're done. 

Craven: Everyone in this room knows that care policies are crucial to ensuring people and their families have what they need when they need it. That's one thing that stood out to me about the bill. From expanding the postpartum period from 60 days to a year for birthing parents on Medicaid to ensuring DHHS makes all available benefits information public and in one place online, this struck me as being a very robust care package. How do thoughtful care policies help birthing people and their families thrive?

If we take care of moms and help take care of their young person with perinatal care, that’s when moms thrive, and families thrive. We have to help moms get off to a better start. Let's say you have a doula, someone who is right there advocating for you. Doulas don't end their work after you have the baby; they can continue on with you. We're helping moms, especially moms who need it more. If all of this is done, they’ll get off to a better start and have the support they need. 

Many moons ago, I was the director of a place that dealt with parents who had the propensity to abuse their kids. When they felt stressed or whatever else, they could bring their kids to the agency and leave them in our care for two or three days just to get some space. In another program we offered, we would go into their homes and work with them to develop stress management skills. 

That's how I look at this bill. We're helping moms have the health, empowerment, and resources to be the best moms they can be.

Craven: That example you gave indicates how powerful it can be when the state turns its resources toward taking care of community needs versus, say, throwing every child into the foster care system. 

Now, we obviously have to talk about race and racism. When it comes to Black maternal mortality, no socioeconomic or sociopolitical status prevents Black women from disproportionately dying in the pre-and postpartum period. We also know that systemic racism doesn't fully account for the vastness of the disparity. How will this bill help public officials and public health workers get closer to finding a more definitive answer?

We've been working on that part for a while. Whether it's through working with healthcare people to make sure their people have proper training—not that training takes care of everything, but changing the training is a part of it. We’ve heard stories about healthcare workers who think Black women can take more pain and people just not listening to women, period—but especially not listening to Black women or women of color. It also helps that allies are pushing for this, but we all need to know how and why this happens. 

So when we keep talking about it, when people testify, when people in the healthcare industry testify about it, that's what helps push us closer.