
Maternal Health Toolkit
Introduction
This toolkit provides a summary of the Blueprint for Addressing the Maternal Health Crisis; access to key resources through the Maternal Health Learning and Innovation Center (MHLIC); and MCH Library resources in support of the blueprint.
The Blueprint focuses on a framework organized by federal agencies and in support of entities and individuals on the front lines of maternal care—including health care systems; physicians, nurses, licensed midwives, doulas, intake workers, and other staff; insurers; technology and other private companies; academic institutions; scholars; faith-based and community-based organizations; state and local governments; and advocates—to improve maternal health for people across the country.
A Policy Brief by the Congressional Black Caucus Foundation examines the repercussions of the maternal health crisis and offers a detailed analysis of the strategies proposed in the Blueprint.
Key Resources
The Maternal Health Blueprint focuses on five goals. The Maternal Health Learning and Innovation Center (MHLIC) has developed an Explainer Video as well as Evidence-to-Action Briefs for all populations, each overall goal, and specific briefs on actions that Title V can implement to improve maternal health outcomes:
- Overall Population Brief for Addressing the Maternal Health Crisis
- Goal 1: Increase Access to and Coverage of Comprehensive High-Quality Maternal Health Services, Including Behavioral Health Services
- Goal 2: Ensure Those Giving Birth are Heard and are Decisionmakers in Accountable Systems of Care
- Goal 3: Advance Data Collection, Standardization, Harmonization, Transparency, and Research
- Goal 4: Expand and Diversify the Perinatal Workforce
- Goal 5: Strengthen Economic and Social Supports for People Before, During, and After Pregnancy
In addition, the MHLIC developed a series of Issue Briefs:
- How Freestanding Birth Centers can help solve the maternal health crisis in the US
- Increasing Access to Obstetric Simulation
- Leveraging Medicaid Policy to Advance Doula Care
- Leveraging Medicaid Policy to Support Doula Care
- Using Earned Income Tax Credits to Promote Maternal Health
- Using Systems Thinking Tools to Improve Maternal Health
MCH Library Resources in Support of the Blueprint
Goal 1: Increase Access to and Coverage of Comprehensive High-Quality Maternal Health Services, Including Behavioral Health Services
Strategies
- 1.1. Work to ensure women have comprehensive, continuous maternal health insurance. coverage during pregnancy, and for no less than one year afterwards.
- 1.2. Serve as a model employer for maternal health care coverage.
- 1.3. Improve rural obstetric readiness at hospitals and IHS facilities.
- 1.4. Strengthen risk-appropriate care in rural and urban areas.
- 1.5. Expand access to family planning services, including pre-pregnancy health and contraception.
- 1.6. Reduce uncontrolled hypertension.
- 1.7. Improve quality of care provided to pregnant and postpartum women with or at risk for hypertensive disorders of pregnancy.
- 1.8. Facilitate continuity of care for service members and veterans.
- 1.9. Ensure veterans return to primary care after they deliver.
- 1.10. Strengthen supports and access to perinatal addiction services for individuals with substance use disorder (SUD).
- 1.11. Keep mothers and infants together.
- 1.12. Expand the National Maternal Mental Health Hotline for pregnant individuals and new mothers facing mental health challenges to increase access to mental health care.
- 1.13. Appoint a head of women’s mental health and substance use.
- 1.14. Expand capacity to screen, assess, treat, and refer for maternal depression and related behavioral disorders.
- 1.15. Integrate behavioral health supports in community settings.
MCH Library Resources
- Maternal Health Learning and Innovation Center. 2024. The practical playbook III: Working together to improve maternal health. Chapel Hill, NC: Maternal Health Learning and Innovation Center, 665 pp.
- Maternal Health Learning and Innovation Center. 2023. Increase access to and coverage of comprehensive high-quality maternal health services, Including behavioral health services. Chapel Hill, NC: Maternal Health Learning and Innovation Center, 13 pp. (White House blueprint evidence to action briefs)
- Clark M, Millette M. 2023. State opportunities to leverage Medicaid and CHIP coverage to improve maternal health and eliminate racial inequities. Washington, DC: Georgetown University Health Policy Institute, Center for Children and Families.
- American College of Obstetricians and Gynecologists . 2023. Perinatal mental health toolkit. Washington, DC: American College of Obstetricians and Gynecologists.
- Giragosian L . 2023. Addressing hypertension in pregnancy to reduce maternal morbidity and mortality. Arlington, VA: Association of State and Territorial Health Officials, 2 pp.
- Tully KP, Quist-Nelson JR, Stuebe AM . [2023]. Increasing access to obstetric simulation to improve the quality of clinical practice for maternal and infant health. Chapel Hill, NC: Maternal Health Learning and Innovation Center, 4 pp.
- Centers for Medicare & Medicaid Services, Office of Minority Health. 2022. Advancing rural maternal health equity. Baltimore, MD: U.S. Centers for Medicare & Medicaid Services, 21 pp.
- March of Dimes. 2022. Nowhere to go: Maternity care deserts across the U.S.. White Plains, NY: March of Dimes, 36 pp.
- Ranji U, Gomez I, and Salganicoff A (KFF); Rosenzweig C, Kellenberg R, Gifford K (Health Management Associates). 2022. Medicaid coverage of family planning benefits: Findings from a 2021 state survey. Menlo Park, CA: Kaiser Family Foundation, 54 pp.
- Office of National Drug Control Policy, White House Executive Office of the President. 2022. Substance use disorder in pregnancy: Improving outcomes for families., 18 pp.
- U.S. Centers for Medicare & Medicaid Services. 2020. State Medicaid & CHIP telehealth tooklit: Policy considerations for states expanding use of telehealth (COVID-19 version). Baltimore, MD: U.S. Centers for Medicare & Medicaid Services, 2 items.
- Association of Maternal and Child Health Programs; Georgia Health Policy Center. 2020. Promoting access to care for women of reproductive age with mental health and substance use disorders in rural communities. Washington, DC: Association of Maternal and Child Health Programs, 12 pp.
- Commonwealth Fund. 2021. Closing gaps in maternal health coverage: Assessing the potential of a postpartum Medicaid/CHIP expansion. New York, NY: Commonwealth Fund.
- Commonwealth Fund . 2021. Restoring access to maternity care in rural America. New York, NY: Commonwealth Fund.
- Rural Health Information Hub. 2021. Rural maternal health toolkit. Grand Forks, ND: Rural Health Information Hub, multiple items.
- Association of Maternal and Child Health Programs . 2021. Addressing mental health in BIPOC communities: Key cultural considerations for MCH. Washington, DC: Association of Maternal and Child Health Programs.
- U.S. Office of the Surgeon General. 2020. The Surgeon General's call to action to improve maternal health. Rockville, MD: U.S. Office of the Surgeon General, 70 pp. (exec. summ. 5 pp.).
- Hostetter M, Klein S. 2019. Improving health for women by better supporting them through pregnancy and beyond. New York, NY: Commonwealth Fund.
- U.S. Centers for Medicare and Medicaid Services . [2019]. A conversation on maternal healthcare in rural communities: Charting a path to improved access, quality, and outcomes. [Washington, DC: U.S. Centers for Medicare and Medicaid Services (CMS)], 18 pp.
Goal 2: Ensure Those Giving Birth are Heard and are Decisionmakers in Accountable Systems of Care
Strategies
- 2.1. Propose requiring hospital participation in maternal health quality improvement activities and urge hospitals to provide equitable, high-quality care and improve accountability.
- 2.2. Bolster the voice of communities of color to better understand pregnancy-related death.
- 2.3. Empower AI/AN pregnant and postpartum people and educate providers.
- 2.4. Make insurance coverage and costs of pregnancy-related care transparent and easy to understand.
- 2.5. Empower women with access to their own data.
- 2.6. Train providers on culturally and linguistically appropriate care, respectful care, and implicit biases.
- 2.7. Address systemic discrimination in health care.
- 2.8. Encourage the removal of structural barriers that prevent women with disabilities from receiving adequate reproductive care.
- 2.9. Embed equity into Quality Family Planning Guidelines.
- 2.10. Support care coordination.
- 2.11. Support state innovation efforts.
- 2.12. Reduce the stigma of postpartum depression and other mental health disorders.
- 2.13. Support breastfeeding.
- 2.14. Work with states, cities, and counties to improve quality of care and prevent unnecessary deaths.
MCH Library Resources
- Maternal Health Learning and Innovation Center. 2024. The practical playbook III: Working together to improve maternal health. Chapel Hill, NC: Maternal Health Learning and Innovation Center, 665 pp.
- Maternal Health Learning and Innovation Center. 2023 . Ensure those giving birth are heard and are decisionmakers in accountable systems of care. Chapel Hill, NC: Maternal Health Learning and Innovation Center, 14 pp. (White House blueprint evidence to action briefs)
- Association of State and Territorial Health Officials. 2023. Health equity policy toolkit. Arlington, VA: Association of State and Territorial Health Officials, 28 pp.
- U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation . 2023. Leading practices to advance equity and support of underserved communities throughout health and human services. Washington, DC: Office of the Assistant Secretary for Planning and Evaluation.
- Alderman L, Dills J, Mullenix A. 2023. Using systems thinking tools to improve maternal health. Maternal Health Learning and Innovation Center, 11 pp.
- Executives for Health Innovation. 2022. Maternal health disparities: Challenges, trends, and the way forward. Washington, DC: Executives for Health Innovation, 12 pp.
- Alliance for Innovation on Maternal Health; National Healthy Start Initiative. 2022. Inculcating equity, health equity framework. Washington, DC: Alliance for Innovation on Maternal Health.
- Taylor E, Sayles J, Bailit M. 2021. Promising approaches to reducing disparities in birth-related health outcomes in Medicaid.Princeton, NJ: State Health and Value Strategies, 10 pp.
- Commonwealth Fund . 2021. Community-based models to improve maternal health outcomes and promote health equity. New York, New York: Commonwealth Fund.
- Taylor J, Novoa C, Hamm K, and Phadke S. 2019 . Eliminating racial disparities in maternal and infant mortality: A comprehensive policy blueprint. Washington, DC: Center for American Progress, 96 pp.
- Feltner C, Weber RP, Stuebe A, Grodensky CA, Orr C, Viswanathan M. 2018. Breastfeeding programs and policies, breastfeeding uptake, and maternal health outcomes in developed countries. Rockville, MD: U.S. Agency for Healthcare Research and Quality, 524 pp.
Goal 3: Advance Data Collection, Standardization, Harmonization, Transparency, and Research
Strategies
- 3.1. Improve data collection in states, hospitals, health centers, and insurance programs to support better surveillance and quality measurement, and improve outcomes.
- 3.2. Bolster research and build the next generation of maternal health researchers.
- 3.3. Better understand conditions that impact pregnancy.
MCH Library Resources
- Maternal Health Learning and Innovation Center. 2024. The practical playbook III: Working together to improve maternal health. Chapel Hill, NC: Maternal Health Learning and Innovation Center, 665 pp.
- Eunice Kennedy hriver National Institute of Child Health and Human Development. 2024. Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE) Initiative. Rockville, MD: Eunice Kennedy hriver National Institute of Child Health and Human Development.
- Maternal Health Learning and Innovation Center. 2013. Advance data collection, standardization, harmonization, transparency,research, and analysis. Chapel Hill, NC: Maternal Health Learning and Innovation Center, 13 pp. (White House blueprint evidence to action brief)
- Massachusetts Department of Public Health, Office of Health Equity. 2023. Racial equity data road map: Data as a tool towards ending structural racism. Boston, MA: Massachusetts Department of Public Health, Office of Health Equity, 68 pp.
- Latoya Hill L, Artiga S, and Ranji U. 2023. Racial disparities in maternal and infant health: Current status and efforts to address them. Menlo Park, CA.
- RAND Health Care . 2023 . Linking state Medicaid data and birth certificates for maternal health research. Washington, DC: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, 40 pp.
- [U.S. Maternal and Child Health Bureau]. 2022. Federally available data (FAD) resource document (rev ed). [Rockville, MD: U.S. Maternal and Child Health Bureau], 173 pp.
- U.S. Centers for Medicare & Medicaid Services. 2022. CMS framework for health equity 2022-2032. Baltimore, MD: U.S. Centers for Medicare & Medicaid Services, 39 pp.
- Actionable Intelligence for Social Policy . 2021. A toolkit for centering racial equity throughout data integration. Philadelphia, PA: Actionable Intelligence for Social Policy.
- U.S. Office of the Surgeon General. 2020. The Surgeon General's call to action to improve maternal health. Rockville, MD: U.S. Office of the Surgeon General, 70 pp. (exec. summ. 5 pp.).
- Epstein D. 2020. Navigating data systems when integrating home visiting data. Bethesda, MD: Early Childhood Data Collaborative, 5 pp.
- Center for Open Data Enterprise. 2019. Leveraging data on the social determinants of health. [Washington, DC: Center for Open Data Enterprise], 50 pp. (Roundtable report)
- Taylor J, Novoa C, Hamm K, and Phadke S. 2019 . Eliminating racial disparities in maternal and infant mortality: A comprehensive policy blueprint. Washington, DC: Center for American Progress, 96 pp.
- RAND Health Care . 2022. Linking Medicaid claims, birth certificates, and other sources to advance maternal and infant health.Washington, DC: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, 60 pp.
Goal 4: Expand and Diversify the Perinatal Workforce
Strategies
- 4.1. Train more family medicine and OB/GYN providers in underserved settings.
- 4.2. Expand and diversify the number of nurses and certified midwives in underserved areas.
- 4.3. Increase the number of community health workers and health support workers in underserved areas.
- 4.4. Expand access to freestanding birth centers, licensed midwives, and doulas.
- 4.5. Evaluate the impact of doulas and lactation support on service members and their families.
- 4.6. Identify areas within primary care Health Professional Shortage Areas with the highest need for maternity care health professionals and target resources there.
MCH Library Resources
- Maternal Health Learning and Innovation Center. 2024. The practical playbook III: Working together to improve maternal health. Chapel Hill, NC: Maternal Health Learning and Innovation Center, 665 pp.
- D’Alessandro M, Higgins E, Wilkniss S. 2024. Trends in state policies that support the community health worker workforce.Portland, ME: National Academy for State Health Policy.
- Maternal Health Learning and Innovation Center. 2023. Expand and diversify the perinatal workforce. Chapel Hill, NC: Maternal Health Learning and Innovation Center, 14 pp. (White House blueprint evidence to action briefs )
- Williams T, Bixiones C, Standard V, Orton R. [2023]. How freestanding birth centers can help solve the maternal crisis in the U.S.. Chapel Hill, NC: Maternal Health Learning and Innovation Center, 6 pp.
- Commonwealth Fund . 2023. How expanding the role of midwives in U.S. health care could help address the maternal health crisis. New York, NY: Commonwealth Fund.
- Thomas N, Bever J, Biviji R, Moton H, Lober A. 2023 . Addressing perinatal mental health with a diverse workforce: A national call to action. Bethesda, MD: Project HOPE: The People-to-People Foundation.
- Patterson S, Williams T, Snyder A . [2023]. Leveraging Medicaid policy to advance doula care. Chapel Hill: Maternal Health Learning and Innovation Center, 6 pp.
- Pedersen S, Downing L, and Younger K . 2023. Advancing perinatal health equity through Medicaid coverage of Doulas. Arlington, VA: American Institutes for Research, 12 pp.
- National Center for Health Workforce Analysis . 2022. State of maternal health workforce brief. Rockville, MD: National Center for Health Workforce Analysis, 10 pp.
- Katon JG, Enquobahrie DA, Jacobsen K, Zephyrin LC. 2021. Policies for reducing maternal morbidity and mortality and enhancing equity in maternal health: A review of the evidence. New York: Commonwealth Fund ,
- U.S. Office of the Surgeon General. 2020. The Surgeon General's call to action to improve maternal health. Rockville, MD: U.S. Office of the Surgeon General, 70 pp. (exec. summ. 5 pp.).
- Bakst C, Moore JE, George KE, Shea K. 2020 . Community-based maternal support services: The role of doulas and community health workers in Medicaid. Washington, DC: Institute for Medicaid Innovation, 23 pp.
- Ellmann N. 2020. Community-based doulas and midwives. Washington, DC: Center for American Progress, 37 pp.
- Bey A, Brill A, Porchia-Albert C, Gradilla M, Strauss N. 2019. Advancing birth justice: Community-based doula models as a standard of care for ending racial disparities. [Brooklyn, NY]: Ancient Song Doula Services; Village Birth International; Every Mother Counts, 33 pp.
- Strauss N. 2018. Maximizing midwifery to achieve high-value maternity care in New York. New York, NY: Choices in Childbirth, 69 pp.
Goal 5: Strengthen Economic and Social Supports for People Before, During, and After Pregnancy
Strategies
- 5.1. Streamline federal benefit programs that offer services like housing, child care, financial assistance, and food.
- 5.2. Address the social determinants of maternal health.
- 5.3 Increase awareness of workplace benefits and protections.
- 5.4. Prevent violence against pregnant and postpartum individuals.
- 5.5. Standardize leave recommendations for pregnancy loss and neonatal health complications for the Military Health System (MHS).
- 5.6. Screen veterans for homelessness, food insecurity, post-traumatic stress disorder, and other factors.
- 5.7. Address adverse effects on maternal health from climate change and other environmental stressors.
- 5.8. Educate providers on the impact of environmental exposures.
- 5.9. Replace lead service lines.
- 5.10. Communicate wildfire risks.
- 5.11. Eliminate barriers to well-being, retention, and career advancement for service members.
- 5.12. Hold, for the first time in over 50 years, a White House Conference on Hunger, Nutrition, and Health.
MCH Library Resources
- Maternal Health Learning and Innovation Center. 2024. The practical playbook III: Working together to improve maternal health. Chapel Hill, NC: Maternal Health Learning and Innovation Center, 665 pp.
- Crumley D. 2024. Understanding new federal guidance on Medicaid coverage of health-related social needs services. Hamilton, NJ: Center for Health Care Strategies, 3 pp
- Maternal Health Learning and Innovation Center. 2023. Strengthen economic and social supports for people before, during, and after pregnancy. Chapel Hill, NC: Maternal Health Learning and Innovation Center, 18 pp. (White House blueprint evidence to action briefs )
- Bryant K, Dills J, Hergenrother L, Major M. 2023. Using Earned Income Tax Credits to promote maternal health. Chapel Hill, NC: Maternal Health Learning and Innovation Center, 10 pp.
- Clark M. 2023. State trends to leverage Medicaid extended postpartum coverage, benefits and payment policies to improve maternal health. Washington, DC: Center for Children and Families,
- Clark M, Millette M. 2023. State opportunities to leverage Medicaid and CHIP coverage to improve maternal health and eliminate racial inequities. Washington, DC: Georgetown University Health Policy Institute, Center for Children and Families.
- White House. 2022. Biden-Harris Administration national strategy on hunger, nutrition, and health = White House national strategy on hunger, nutrition, and health. Washington, DC: White House, 44 pp.
- Taylor E, Sayles J, Bailit M. 2021. Promising approaches to reducing disparities in birth-related health outcomes in Medicaid.Princeton, NJ: State Health and Value Strategies, 10 pp.
- Beers A, Finisse V, Moses K, Crumley D, Sullivan D. 2021. Fighting hunger by connecting cross-sector partners and centering lived expertise. Hamilton, NJ: Center for Health Care Strategies, 29 pp.
- Association of Maternal and Child Health Programs. 2020. Housing as a platform for treatment and recovery: Opportunities for Title V at the intersection of stable housing, mental health, and substance use. Washington, DC: Association of Maternal and Child Health Programs, 14 pp.
- U.S. Office of the Surgeon General. 2020. The Surgeon General's call to action to improve maternal health. Rockville, MD: U.S. Office of the Surgeon General, 70 pp. (exec. summ. 5 pp.).
Related MCH Library Resources
- AIDS/HIV in Pregnancy
- Assisted Reproductive Technologies
- Breastfeeding and Working Mothers
- Childbirth
- Depression During and After Pregnancy
- Fertility and Infertility
- Intimate Partner Violence
- Maternal Distress in the Perinatal Period and Child Outcomes
- Maternal Morbidity and Mortality
- Nutrition and Physical Activity for Women
- Nutrition During Preconception and Pregnancy
- Preconception and Pregnancy
- Tobacco, Alcohol, and Substance Use During Preconception and Pregnancy
- Women's Health
Maternal Health Toolkit (May 2024).
Authors: Beth DeFrancis Sun, M.L.S.; John Richards, M.A., MCH Digital Library
Reviewer: Leslie deRosset, MSPH, MPH, Maternal Health Learning and Innovation Center