Improve Maternal Health by Expanding Access to Care

Testimony by Emily Briggs, MD   

Senate Finance Committee
Article II
Texas Health and Human Services Commission 

February 6, 2019

Testimony Submitted on behalf of
Texas Medical Association
Texas Academy of Family Physicians
Texas Pediatric Society
American College of Obstetricians and Gynecologists – District XI (Texas)
Texas Association of Obstetricians and Gynecologists 

Good afternoon, Chair Nelson and committee members. Thank you for the opportunity to testify. I am Emily Briggs, MD, a family physician practicing in New Braunfels, speaking today on behalf of the Texas Medical Association, Texas Academy of Family Physicians, Texas Pediatrics Society, Texas Association of Obstetricians and Gynecologists, and American College of Obstetricians and Gynecologists, Texas Chapter 

I am here today to respectfully ask for your continued investment in efforts to improve maternal health by supporting funding that provides low-income women of reproductive age comprehensive health benefits before and after pregnancy.   

Childbirth, one of life’s greatest joys, can turn into tragedy when the infant’s mother dies.  

Pregnancy-related complications also interfere with a new mother’s ability to care for her baby and may influence the child’s development.  

According to the state’s September 2018 report on maternal mortality and morbidity, women’s lack of access to regular preventive, primary, and specialty care before and after pregnancy contributes to Texas’ high rates of poor maternal health outcomes. Moreover:  

  • The vast majority of pregnancy-related deaths are potentially preventable.
  • Most maternal deaths occur 60 days or more postpartum, a time when many women lose their pregnancy-related Medicaid services.
  • Drug overdoses continue to be the No. 1 cause for maternal death after 60 days postpartum.
  • Smoking during pregnancy or the presence of an underlying chronic condition(s), such as diabetes or hypertension, puts women at greater risk of maternal death or postpartum complications, key indicators that lack of prepregnancy coverage remains a barrier to improving women’s health.
  • Black women experience the highest rate of maternal death and severe illness. 
  • Factors that contribute to health inequities, including low educational attainment, contribute to poor maternal health outcomes. 

Maternal deaths are only one part of the story. For every one maternal death, 50 to 100 women suffer a severe illness or complication.

Through the legislature’s ongoing bipartisan commitment to improving maternal health, Texas has the will and ability to change. And it is making strides. Nevertheless, to make dramatic gains in maternal health outcomes, the legislature also must build on previous maternal health initiatives, starting with ensuring that women have access to preventive, primary, and specialty care before and after pregnancy.  

 To that end, we ask you to support funding for: 

  • Promoting better birth outcomes by improving health care coverage
    • Pursue federal authority to implement a tailored health benefits program for eligible uninsured women of childbearing age that provides 12 months’ continuous coverage for preventive, primary, and specialty care coverage, including behavioral health services, to women before and after pregnancy.
    • Establish a process to automatically and seamlessly enroll young women into the Healthy Texas Women program when they lose children’s Medicaid or the Children’s Health Insurance Program (CHIP) as a result of age. 
    • Ensure women losing CHIP-Perinatal connect to the Family Planning Program to avoid gaps in preventive health care.
    • Implement initiatives that improve early-entry prenatal care, including a statewide campaign on the importance of prenatal care during the first trimester, expediting Medicaid eligibility and enrollment for pregnant women, promoting use of telemedicine for routine prenatal care, and reforming the Medicaid transportation program to ensure pregnant women with young children can travel with their children to obtain preventive services.  
  • Improving availability of accurate, reliable maternal health information 
    • Support comprehensive efforts to improve the state’s surveillance of maternal mortality, and ensure Texas’ maternal death records have accurate information on the factors associated with maternal deaths.
    • Provide funding to Texas Department of State Health Services to develop training and educational materials for physicians and other medical certifiers to accurately report maternal deaths. 

Thank you for the opportunity to testify. 

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Last Updated On

February 07, 2019