The destruction of numerous federal services and programs has begun and mothers and children are amongst the main targets of this Administration. No amount of rhetoric about family values can erase the fact that Congressional Republican leaders and the Administration are aiming to dismantle several life-saving maternal health programs. 

This week is Maternal Mental Health Week and instead of celebrating and building off of recent progress, we are preparing for the continued assaults on programs that serve moms and babies. One of the most terrifying are the proposed threats to slash Medicaid. Medicaid covers over 40% of births in the U.S., including nearly 50% of births in rural communities. It provides vital prenatal and postpartum care for women across the country. Given that the U.S. has a maternal death rate much higher than any other high-income nation, it seems unfathomable that the largest single payor of childbirth would be on the chopping block. 

Over the past few years it has been heartening to see the widespread expansion of Medicaid to 12 months postpartum—nearly all states have adopted this—because it is such an important time in the health of birthing people. Tragically nearly two-thirds of maternal deaths occur in the postpartum period, and mental health conditions, including substance use disorders, are the leading drivers of this crisis. With one full year of Medicaid coverage, new moms have the potential to get health care when it is most critically needed. But now with the proposed gutting of Medicaid, the lives of moms are at increased risk.

Sadly, some moms, who are already at a disadvantage, are poised to suffer disproportionately from the attacks on Medicaid. In 2020, nearly 38 rural moms out of every 100,000 births died of pregnancy-related causes, compared to 31 in other areas. This may be in part because in rural communities, maternity care deserts, counties where there are no hospitals or birth centers offering obstetric care nor any obstetric providers, are more prevalent than in urban or suburban areas. The truth is that many rural hospitals depend on the dollars brought in by Medicaid, nearly 200 are at risk of immediate closure if the cuts are implemented, making a bad situation even worse for rural moms. 

Furthermore, Medicaid provides a larger share of coverage among adults and children in rural areas compared to metropolitan areas and people in rural communities have higher rates of depression and suicide, compared to their urban counterparts, indicating that cuts to Medicaid will be a recipe for disaster for rural mental health care—with moms in the center of that storm. We have already seen many closures of vital maternal health programs, including lay-offs of staff at the National Maternal Mental Health hotline and the proposed end to residential treatment programs for pregnant and postpartum women with substance use disorders. 

Moms are squarely in the bullseye of these attacks and without pushback we will continue to be targets of this Administration. That is why in celebration of Maternal Mental Health week we invite you to tell your Congressional representatives that cuts to maternal health programs are unacceptable. And demand that this Administration keep its hands off of Medicaid. We need everyone who is a mom or has ever had a mom in this fight to protect moms and babies! 

While this struggle requires all of us, we must make sure that moms' voices, in particular, be heard and our stories be told, and so we urge you to share your story about how Medicaid (or another publicly-funded program) helped you during pregnancy or in the postpartum period. 

Lastly, we invite you to listen to our Monday May 19th discussion on Breaking Through radio show/podcast with Chuck Strand, Executive Director of Rural Minds, an organization with the mission to serve as the informed voice for mental health in rural America and provide mental health information and resources.