The Role of Family Medicine in Addressing the Maternal Health Crisis in the United States

Author:

Spiess Saskia1,Owens Robert1ORCID,Charron Elizabeth2,DeMarco Mario3,Feurdean Mirela4,Gold Karen5,Murray Kathryn6,Schenk Nicholas7,Stoesser Kirsten1,Thomas Pauline4,Adediran Emmanuel1ORCID,Gardner Elena1,Fortenberry Katherine1,Whittaker Thomas Carl8,Ose Dominik19

Affiliation:

1. University of Utah, Salt Lake City, UT, USA

2. University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

3. University of Pennsylvania, Philadelphia, PA, USA

4. Rutgers Medical School, Newark, NJ, USA

5. University of Oklahoma, Oklahoma City, OK, USA

6. University of Utah Health, Salt Lake City, UT, USA

7. ProMedica Monroe Regional Hospital, Monroe, MI, USA

8. University of Utah, Community Health Centers, Inc., Salt Lake City, UT, USA

9. Westsächsische Hochschule Zwickau, Zwickau, Germany

Abstract

The United States (US) is experiencing a maternal health crisis, with high rates of maternal morbidity and mortality. The US has the highest rates of pregnancy-related mortality among industrialized nations. Maternal mortality has more than quadrupled over the last decades. Rural areas and minoritized populations are disproportionately affected. Increased pregnancy-care workforce with greater participation from family medicine, greater collaborative care, and adequate postpartum care could prevent many maternal deaths. However, more than 40% of birthing people in the US receive no postpartum care. No singular solutions can address the complex contributors to the current situation, and efforts to address the crisis must address workforce shortages and improve care during and after pregnancy. This essay explores the role family medicine (FM) can play in addressing the crisis. We discuss pregnancy care training in FM residencies as well as the threats posed by financial and medico-legal climates to the maternal health workforce. We explore how collaborative care models and comprehensive postpartum care may impact the maternal health workforce. Efforts and resources devoted to high impact solutions for which FM has considerable autonomy, including collaborative and postpartum care, are likely to have greatest impact.

Funder

Maternal and Child Health Bureau

Publisher

SAGE Publications

Reference55 articles.

1. Health E-stat: Maternal mortality rates in the United States, 2022

2. Severe Maternal Morbidity Among Delivery and Postpartum Hospitalizations in the United States

3. Koonin LM, MacKay AP, Berg CJ, et al. Pregnancy-Related Mortality Surveillance – United States, 1987-1990. Accessed July 18, 2024. https://www.cdc.gov/mmwr/preview/mmwrhtml/00048923.htm

4. American College of Obstetricians and Gynecologists. Optimizing Postpartum Care. 2018. Accessed August 4, 2023. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care

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