Pregnancy and childbirth are life-changing, monumental experiences – for both parents and babies. This is, after all, how everyone starts out their life. All babies deserve the best start possible. But the United States is not doing all that we can. Our country has the highest maternal death rate among developed nations. More than 50,000 mothers have life-threatening complications from labor and delivery every year. The chance of dying in childbirth is also very different based on your race. Black mothers are three to four times more likely to die in childbirth compared to white mothers. Black mothers are also more likely to have complications from childbirth.

These disparities, high mortality rates, and the high likelihood of complications – plus the importance of birth – are why our Collaborative chose to create a bundled payment model around maternity care. Bundled payment models, where there is one payment for multiple clinical services that are usually paid for separately, can help to address preventable complications. Our workgroup has been meeting since January to develop a care pathway and a payment model to support what we know works in pregnancy, childbirth, and postpartum care.  Different types of these models are being used in other states across the country. We are learning what we can from these other models to apply to Washington state.

Our group has discussed at length long the episode should last after birth, whether the provider or the hospital should be responsible for the bundle, whether the baby’s care should be included as well as care for the gestational parent, and what services should be included. These are hard questions. Balancing what is possible in our health care system and what is ideal is difficult. We want to do the best possible for those who are pregnant and for babies and also create a system that supports providers especially those in rural areas.  We want care after the birth, post-partum care, to be more supportive of those who have given birth.

Luckily we have partners helping us to answer these questions – people and organizations that are committed to improving maternal and child health. Join us at our July meeting.

Ginny Weir, MPH
Director, Bree Collaborative