Sep 18 Thriving PA Releases County Fact Sheets on Perinatal Health

Sep 18h in Bold Voices by

(September 18, 2023)

Research shows that healthy moms are more likely to raise healthy babies. Thriving PA is a non-partisan, statewide advocacy campaign that seeks to improve the quality of and increase equitable access to a coordinated system of health supports, including access to comprehensive perinatal health services, children’s health insurance, nutrition supports, Early Intervention Part C and lead screening and abatement. Thriving PA recently released its first-ever maternal health county fact sheets as a part of this work.

The fact sheets show each county across the commonwealth’s overall perinatal vulnerability index (PVI), which shows data across five domains: behavioral health, environmental context, healthcare availability, pregnancy and birth outcomes, and social stratification. In Allegheny County, the PVI was 36.2, with environmental context and healthcare availability rated as the most significant factors in Perinatal Vulnerability. Neighboring counties Greene and Fayette, are rated a PVI of 49.9 and 48.5, respectively. The most significant factor in Greene’s score was behavioral health while Fayette’s leaned more toward healthcare availability.

Race has persistently emerged as a theme driving the LBW rate, specifically the rate of non-Hispanic Black women. The fact sheets also highlight data about prenatal care and the percentage of low birth weight births*, as research shows the links between maternal health and birth weight. In 2020:

  • 9% of births in Allegheny County were less than 5.5 lbs and 1% were less than 3.5 lbs.
  • 10% of births in Fayette County were less than 5.5 lbs and 2% were less than 3.5 lbs.
  • 9% of births in Greene County were less than 5.5 lbs and <1% were less than 3.5 lbs.

Maternal and infant mortality occurs disproportionally across racial/ethnic groups. Compared to white women, Black women are 3 to 4 times more likely to die from a pregnancy-related cause, while American Indian and Alaska Native (AIAN) women are 2 times more likely to die from a pregnancy-related cause. Black and AIAN women also have higher rates of preterm births, low birth weight, and births for which they received late or no prenatal care.

Access to prenatal and postpartum health care is vital to ensuring we are giving our youngest children opportunities to succeed. Unfortunately, the United States has the highest maternal mortality rate among high-income countries. Racial disparities plague the healthcare system for Black and Brown women, and women in sparsely populated areas are now facing increased risk. According to a recent report in the Wall Street Journal, the pandemic amplified a years-long trend in maternal deaths to the highest rate in almost 60 years.

Policy is a vital element in changing these unacceptable health outcomes for women, birthing parents, and their children. Some recent policy wins for maternal health include:

  • The PUMP Act requires employers to provide reasonable accommodations for employees related to breastfeeding, chestfeeding, and lactation
  • Pregnant Workers Fairness Act (PWFA) covered employers must provide “reasonable accommodations to the known limitations related to the pregnancy, childbirth, or related medical conditions of a qualified employee” unless the accommodation “would impose an undue hardship on the operation of the business.”
  • Medicaid Postpartum Coverage Extension in Pennsylvania. This allows states to extend Medicaid postpartum coverage to 12 months via a state plan amendment (SPA), which we have done in PA.

Implementation and outreach of these policies will be key to their successful impact on health outcomes for moms and babies.

While some great strides have recently been made, more work needs to be done to both implement these policies and to further improve existing systems. Thriving PA supports building a comprehensive and coordinated system of care and supports for Pennsylvania moms and birthing people by:

  • Establishing a perinatal psychiatric access pilot program.
  • Ensuring every birthing person has access to coverage during pregnancy by advocating for CHIP coverage for pregnant immigrants and their babies.
  • Collaborating with DHS to expand and ensure the sustainability of the Managed Care Home Visiting initiative.
  • Monitoring progress toward Medicaid reimbursement for Doula services.
  • Supporting campaigns advocating for universal paid leave in PA and a state Earned Income Tax Credit.

At Allies for Children, as a lead in the Thriving PA nutrition subgroup, we know that perinatal health and nutrition are inextricably linked. While we continue our WIC nutrition policy work, we also see the great importance that the health of moms and birthing people play in our overall goals at Thriving PA of improving perinatal and child health in Pennsylvania.

* Low Birthweight (LBW) birth less than 2,500 grams (5 pounds, 8 ounces)
* Very Low Birthweight (VLBW) birth less than 1,500 grams (3 pounds, 4 ounces)

Cristina Codario, Allies for Children Policy Director