Summary
The maternal mortality rate in the United States is higher than any comparable high-income nation. One third of pregnancy-related deaths occur from one week to one year postpartum (the “fourth trimester”) and more than half are preventable. Beyond mortality, many more postpartum people experience morbidities from physical and mental health conditions in the year after childbirth.
Medicaid, the public health insurance program for low-income Americans that covers nearly half of all U.S. births, has been an underused tool in the effort to reduce postpartum maternal mortality and morbidity. This is partly the result of the lack of systematic data available to help direct and prioritize policymakers’ efforts to improve health in the postpartum period.
This project aims to drive the development and evaluation of evidence-based Medicaid and other social policies to improve the health of postpartum people in the year after a child is born. In 2020, we started recruitment for the Postpartum Assessment of Health Survey (PAHS), a first-of-its-kind multi-state survey on health outcomes, overall well-being, experience of care, as well as health care access, quality, costs, and barriers in the postpartum year. This data will be used to help advocacy organizations, governments and medical professional organizations develop recommendations for improvements to health and social policy – and the Medicaid program in particular – that have the potential to meaningfully affect maternal health.
In Partnership With:
- Kansas Department of Health & Environment
- Michigan Department of Health and Human Services
- New Jersey Department of Health
- New York City Department of Health and Mental Hygiene
- Pennsylvania Department of Health
- Utah Department of Health
- Virginia Department of Health
Team
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Heidi L. Allen, MSW, PhD
Columbia UniversityProject LeadRead Full Bio arrow_right_altHeidi L. Allen, MSW, PhD is an Associate Professor at Columbia University’s School of Social Work, and is a nationally recognized expert on Medicaid policy.
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Jamie Daw, PhD
Columbia UniversityProject LeadRead Full Bio arrow_right_altJamie Daw, PhD is an Assistant Professor of Health Policy and Management at Columbia University’s Mailman School of Public Health. She is a quantitative health services researcher whose...
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Zohn Rosen, PhD.
Columbia UniversityProject TeamRead Full Bio arrow_right_altZohn Rosen, Ph.D. is a Lecturer in Health Policy and Management at the Columbia University Mailman School of Public Health. Dr. Rosen is an experimental psychologist, and is currently...
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Kristen Underhill, JD, DPhil
Cornell UniversityProject LeadRead Full Bio arrow_right_altKristen Underhill, JD, DPhil is an Associate Professor of Law at Cornell Law School. Her expertise is in both law and public health, including legal research, survey methods, and qualitative data collection.
Background
Statistics
- 1 in 3pregnancy-related deaths occur occurs in the year after delivery
- 87-94percent of birthing people report at least one health problem in the first three months postpartum
- 1 in 2pregnancy-related deaths are estimated to be preventable
Go Deeper
Publications
Jamie R. Daw, Kristen Underhill, Chen Liu, and Heidi L. Allen. (2023). The Health And Social Needs Of Medicaid Beneficiaries In The Postpartum Year: Evidence From A Multistate Survey. Health Affairs, 42:11, 1575-1585.
Jamie R. Daw, Tyler N. A. Winkelman, Vanessa K. Dalton, Katy B. Kozhimannil, and Lindsay K. Admon. (2020). Medicaid Expansion Improved Perinatal Insurance Continuity For Low-Income Women. Health Affairs, 39, No. 9, 1531-1539.
Jamie R. Daw, Emily Eckert, Heidi L. Allen, Kristen Underhill. (2021). Extending Postpartum Medicaid: State and Federal Policy Options during and after COVID-19. Journal of Health Politics, Policy and law, Vol. 46, No. 3, 505-526.
Erica L. Eliason. (2019). Adoption of Medicaid Expansion is Associated with Lower Maternal Mortality. Women’s Health Issues, 30-3, 147-152.
State and City data (Factsheets)
- Kansas – state statistics and PAHS data summary
- Michigan – state statistics and PAHS data summary
- New Jersey – state statistics and PAHS data summary
- New York City – city statistics and PAHS data summary
- Pennsylvania – state statistics and PAHS data summary
- Utah – state statistics and PAHS data summary
- Virginia – state statistics and PAHS data summary