Addressing the ongoing U.S. maternal and infant health crisis accelerated by COVID-19

(BPT) - For any new mother, one of the most important steps she can take is finding a prenatal care provider who can help ensure a healthy pregnancy for herself and her baby. Unfortunately, far too many women in the United States have limited or no access to prenatal care providers — a dangerous reality for mothers-to-be and other women of childbearing age.

Our nation remains among the most dangerous in the developed world to give birth and unequal access to healthcare is a contributing factor. More than 54% of counties across the U.S. have limited access to maternity care and 7 million women of childbearing age live there. While the majority of maternity care deserts are in rural counties, urban environments do not equate to better care where 740,000 women have no access to maternity care.

To address these maternal health disparities and the challenges that many women in these areas face, RB’s Enfa portfolio of brands and March of Dimes partnered to create Better Starts for All — a series of on-the-ground and virtual maternal health services targeting areas of great need. This program is designed to help all moms and babies have the best start in life regardless of social, cultural and economic challenges.

“The U.S. is in the midst of a maternal and infant health crisis, which is exacerbated by the COVID-19 pandemic. Women living in maternity care deserts are at particular risk due to limited access to care,” said Dr. Rahul Gupta, Chief Medical and Health Officer, Senior Vice President and Interim Chief Scientific Officer at March of Dimes. “A woman dies every 12 hours from pregnancy-related causes, and the CDC reports that 60 percent are preventable. Through the Better Starts for All partnership, we are piloting innovative strategies to improve access and health outcomes in maternity care deserts.

How the Pandemic is Impacting Access to Maternity Care

The strains of the pandemic have intensified the obstacles women in maternity care deserts face, making it increasingly difficult for moms to access proper care. Expecting mothers may miss prenatal care appointments due to fear of exposure to COVID-19, which can lead to missed or delayed diagnoses and increase the risk of maternal morbidity and mortality. In fact, a recent report found that one in four pregnant women have skipped a prenatal care appointment since the beginning of the pandemic.[1] Some barriers to care are increasing during the pandemic:

  • Transportation: Women living in rural areas may have to travel long distances to access providers and those in urban areas rely on public transportation. Without access to a vehicle and with some forms of public transportation being limited due to COVID-19 restrictions, both rural and urban women are unable to attend appointments.
  • Insurance coverage: Women without health insurance are less likely to receive preventative and prenatal care, putting them at higher risk for poor health outcomes. Access to care has worsened during the pandemic due to loss of jobs and employee-sponsored health insurance. Black and Latina women have disproportionately experienced job loss throughout the pandemic, increasing the disparity in access to care and the risk of pregnancy-related health problems.[2]
  • Internet access: While telemedicine is becoming more widely adopted by the health care industry, there are disparities in internet coverage and cell service that particularly impact rural and low-income communities making it difficult to access care virtually.

Better Starts for All is Closing the Gap in Maternal Health Disparities

“RB is extremely proud to partner with March of Dimes on the Better Starts for All initiative to provide women with fundamental access to prenatal care,” said Patrick Sly, Senior Vice President, North America & Europe Nutrition, RB. “With the pandemic creating an even more difficult situation for new moms, this partnership allows us to make a meaningful difference in addressing maternal care inequities where it is needed most, to ensure all moms and babies have access to the education, resources and care they need and deserve.”

Better Starts for All will first focus on improving access to care for more than 7,000 pregnant women in 10 counties in Southeast Ohio as well as Wards 7 and 8 in Washington, D.C., two communities that historically face several socioeconomic and health obstacles that contribute to poorer outcomes for moms and babies. The program will offer a series of interventions to bring support, education and clinical care to communities in need, including:

  • Mobile Health Services: A mobile health vehicle that brings prenatal care and related maternal health services to areas where access to services is limited.
  • Supportive Pregnancy Care (SPC): Group prenatal care model that provides clinical care, education and support in a group setting.
  • Virtual Moderated Education: Online prenatal education for moderated groups that is tailored to the needs of the community.
  • Community Coalition: A coalition of community providers that develops and implements innovative strategies to increase access to care in maternity care deserts.
  • Virtual Supportive Pregnancy Care: Fully functional telemedicine solution to virtualize OB care in hard-to-reach communities.

Better Starts for All strives to raise awareness of the maternal and infant health crisis and inspire the public to get involved and work towards eliminating maternity care deserts in the U.S. To learn more and to find out how to participate in this powerful movement, please visit BetterStartsForAll.com.

Both RB’s Enfa portfolio of brands and March of Dimes support the World Health Organization’s recommendation for exclusive breastfeeding in the first six months of life, and we encourage continued breastfeeding for up to two years and beyond.


[1] Trends in pregnancy and childbirth complications in the U.S. (2020, June 17). Retrieved February 11, 2021, from https://www.bcbs.com/the-health-of-america/reports/trends-in-pregnancy-and-childbirth-complications-in-the-us.

[2] Ewing-Nelson C. June Brings 2.9 Million Women’s Jobs Back, Many of Which are at Risk of Being Lost Again. National Women’s Law Center. July 2, 2020. Available at: https://nwlc.org/resources/june-jobs-report/

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