Boosting Maternal Health: The Role of Population Health Programs
A Maternal Mortality Crisis
The maternal mortality rate in the United States is alarmingly high. According to the CDC, there are approximately 22 maternal deaths for every 100,000 live births in the U.S. — more than double, and sometimes triple, the rate of most other high-income nations in the developed world. By contrast, in half of the countries surveyed by the OECD, there are fewer than five maternal deaths per 100,000 live births. Nearly two-thirds of maternal deaths in the U.S. occur during the postpartum period, up to 42 days following birth. Compared to women in other studied countries, U.S. women are the least likely to receive support such as mobile healthcare home visits and guaranteed paid leave during this critical time.
Racial Disparities Persist
Maternal mortality is exceptionally high among Black women in the United States. Previous research has found that African-Americans often receive lower-quality care in various aspects, including getting the care they need, the results of their treatment, and how they feel about the care they receive. Data reveal racial disparities in maternal morbidity both within and between hospitals. Inequities in access to care and patients’ experiences are often rooted in discrimination and clinician bias
Maternity Care Deserts
Despite the significant nationwide challenge, access to maternity care is decreasing in the areas that need it most. According to the March of Dimes (a nonprofit focused on maternal and infant health), 36% of counties nationwide — primarily in the Midwest and South — are classified as “maternity care deserts,” meaning they lack obstetric hospitals, birth centers, and obstetric providers. Rural areas are the hardest hit, with two-thirds of maternity care deserts located in rural counties. Despite a nearly 2% increase in the number of obstetricians and certified midwives from 2020 to 2022, only 7% of all providers serve rural areas. The report highlights that doctors often choose to practice where they prefer to live, resulting in a majority of obstetric providers preferring urban areas. Additionally, many hospitals have been forced to close maternity wards due to financial constraints.
DocGo’s Population Health Initiatives for Underserved Communities
Dr. Sherri Suozzo PhD, Senior Director of Advanced Clinical Practice at DocGo believes the company has the perfect mobile healthcare solution to reach communities lacking obstetric care. “DocGo is branching out into the pediatric and maternal health world. It’s a niche specialty, partly due to the high risks associated with maternal-fetal medicine,” says Dr. Suozzo. Although DocGo is a relatively new entrant to prenatal and immediate postpartum care, the firm is already supporting early infant care, screenings for postpartum depression, and a range of other maternal-fetal medicine (MFM) services. “Poor diagnosis of postpartum conditions has consequences, and DocGo aims to fill this gap,” Dr. Suozzo emphasizes.
Tackling Financial Toxicity by Bringing Care to You
“Financial toxicity” or financial distress associated with cancer care is well-understood, but it is less recognized in maternal-fetal medicine (MFM). Financial toxicity describes the broader or indirect financial impacts of medical care. Things as basic as transportation costs (e.g., gas, parking, tolls) and loss of income due to time off work to attend appointments can create barriers to healthcare access. A mother suffering from postpartum depression might miss critical therapy, because she simply can’t afford to go.
Insurance payers are incentivized to improve MFM outcomes, and DocGo partners with them by bringing care directly to mothers through mobile healthcare. Prenatal care clinicians offer screenings for hypertension, preeclampsia, gestational diabetes (a condition often exacerbated by poor diet). Likewise postpartum conditions, including depression, infections, and bleeding, which are currently underdiagnosed, can all be screened at home. By identifying these conditions early through patient screenings, proactive care can be offered to prevent hospital admissions and life-threatening conditions for both mothers and infants.
Building Trust and Gaining the Respect of the Community
Suozzo believes that the knowledge gap regarding alternative pathways to care is the most critical barrier to overcome. She acknowledges, “People aren’t used to DocGo’s model and may be reluctant to invite mobile healthcare providers into their homes. However, they become more receptive when they realize that they aren’t compromising their care by staying at home.“ DocGo clinicians can connect mothers to resources that raise awareness of key issues affecting underserved populations.
Suozzo, a Doctorally-Prepared Board-Certified Nurse Practitioner herself, believes that their team of Nurse Practitioners can connect with communities in ways some clinicians can’t, including addressing racial and ethnic disparities in treatment. “It is well documented in the literature that many women historically have felt ignored or dismissed by their providers. Our NPs are very attuned to listening to complaints and taking them seriously,” Suozzo notes. She is reassured that the industry is recognizing disparities and inadequacies in maternal healthcare, but feels that despite growing recognition, innovation is needed to close care deserts. She believes the most important innovation may be bringing care to patients. “These issues shouldn’t exist in the United States. We have to go to the population, not bring them to us.”
