News you may not have heard

California has consistently had some of the lowest infant and maternal mortality rates in the United States. For example, in 2020, California had an infant mortality rate of 3.29 while the worst states – Mississippi and Arkansas – had 8.12 and 7.38 respectively.

California’s maternal mortality rate was 10.1 while the worst states – again, Mississippi and Arkansas, had 43.0 and 43.5 respectively, both four times more than California’s! There are several reasons for this success.

First, California has expanded access to prenatal and postpartum care through programs like Medi-Cal, which provides free or low-cost health insurance to low-income women who are pregnant or have young children.

California also allows eligible women to stay on Medi-Cal for a full year after giving birth, while other states cut off Medicaid coverage 60 days after delivery. This continued access to care helps women manage conditions that could lead to poor birth outcomes.

Second, California has robust public health programs aimed at improving outcomes for mothers and babies. For example, the state's Black Infant Health Program provides support services like counseling, childbirth education, and case management to African American women who are pregnant or caring for infants. Targeted programs like this help address persistent disparities in infant and maternal mortality among different racial/ethnic groups.

Third, California has less teen pregnancies compared to other states. Teen mothers are more likely to have preterm births and low birth weight babies. California mandates comprehensive sex education in public schools and has expanded access to contraception – two evidence-based strategies for reducing unintended pregnancy among teens.

Finally, California has enacted a range of policies around maternity care quality and safety. The state requires hospitals to have certain protocols in place to prevent maternal hemorrhage and responds aggressively to data showing racial or ethnic disparities in mortality. Ongoing efforts aim to make childbirth safer and eliminate preventable deaths.

I say “Bravo, California!”, leader and exemplar in yet another field.

John H. Terrell