Postpartum Gray Literature

Annotation: This fact sheet outlines strategies for incorporating community-based doulas into Medicaid to improve maternal health outcomes. It describes how doulas provide emotional, physical, and informational support during pregnancy and can help reduce high-risk pregnancies, low birthweight babies, and cesarean section rates, particularly benefiting communities with high maternal mortality rates. The document presents three key strategies for state Medicaid agencies and managed care organizations to support doulas in becoming Medicaid providers: engaging doulas in benefit design and implementation, allowing diverse doula training organizations to meet community needs, and simplifying the Medicaid enrollment process. Examples from states like Maryland, New Jersey, Rhode Island, and Virginia illustrate successful approaches such as creating advisory groups, hosting stakeholder meetings, accepting both national and BIPOC-led training organizations, and providing enrollment guidance. The resource emphasizes the importance of a diverse workforce that meets the needs of birthing individuals.

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Keywords: Childbirth, Community health services, Doulas, Financing, Health insurance, Maternal mortality, Medicaid, Prevention, State initiatives

Annotation: This Medicaid Policy Cheat Sheet explores new initiatives for maternity and reproductive health care in California. The state of California is seeking to advance more whole-person care for pregnant and birthing people, and to ensure and expand access to reproductive health care. The programs described in the document can serve as models for other states.

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Keywords: California, Health equity, Maternal health, Medicaid, Policy development, Pregnancy, Pregnant women

Annotation: This Medicaid policy cheat sheet explores what states are doing to improve maternal health outcomes and what additional opportunities exist. Some strategies suggested include: extending postpartum coverage; enhancing benefits to cover evidence-based models, such as home visiting programs; developing value-based payment models that reward health outcomes and close racial and ethnic disparity gaps; and enhancing data collection on maternal mortality and morbidity. The document also provides examples of notable policies that have been implemented by states, such as payment reforms, models of care delivery, managed care organization data reporting requirements, midwifery-led care, doula services, postpartum coverage expansion, use of telemedicine, and provider bias training.

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Keywords: Federal health insurance programs, Maternal health, Medicaid, Policy analysis, Public policy, State health insurance programs

Annotation: This webinar presents a panel discussion on innovative approaches for addressing mental health and substance use disorders during pregnancy and postpartum. Hosted by Carla Silverman from the Center for Healthcare Strategies, the panel features experts including Lisa Asare (New Jersey Maternal and Infant Health Innovation Authority), Daisy Goodman (Dartmouth College), Cat Livingston (Health Share of Oregon's Project Nurture), and Yosefa Scherer (Moms Do Care Empower program). Panelists share their experiences implementing integrated care models that combine maternal healthcare with mental health and addiction services, highlighting the importance of peer support, doula care, multidisciplinary teams, and addressing social determinants of health. The discussion covers challenges in sustainable funding, workforce development, stigma reduction, and care coordination. The webinar emphasizes the need for culturally responsive, trauma-informed approaches to improve maternal health outcomes and reduce disparities, particularly for people served by Medicaid.

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Keywords: Substance abusing pregnant women, Disorders, Initiatives, Mental health, Model programs, Perinatal addiction, Perinatal care, Postpartum care, Service integration, Substance use disorders

Annotation: This report examines the critical impact of mental health and substance use disorders on maternal mortality and morbidity in the United States, highlighting how suicide and substance use-related overdoses account for over 20 percent of postpartum deaths. It presents promising approaches from states including Massachusetts, New Jersey, Oregon, New Hampshire, and California that integrate maternity care with behavioral health services and social supports. The report outlines six key recommendations for improving care: supporting dedicated multidisciplinary care teams, centering people with lived experience to drive health equity, normalizing substance use care, training all staff on bias and stigma, expanding the community-based workforce including doulas and peer recovery specialists, and implementing harm reduction and street medicine approaches. The authors emphasize that with nearly every state now providing 12 months of postpartum Medicaid coverage, there are unprecedented opportunities to implement integrated, trauma-informed, non-punitive care models that can significantly reduce maternal mortality and improve outcomes for families.

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Keywords: Substance abusing pregnant women, Community participation, Disorders, Health care reform, Initiatives, Maternal morbidity, Maternal mortality, Medicaid, Mental health, Model programs, Perinatal addiction, Perinatal care, Postpartum care, Quality improvement, Risk factors, Service integration, Substance use disorders