Women Everywhere Deserve Access to High-Quality Pregnancy and Perinatal Care


By: Rebecca TeKolste

Women4 Change Public Policy Committee Member

Put simply: “When a woman doesn’t get the care she needs before, during and after pregnancy, her health and that of her baby—is put at risk.” 

When I served as a U.S. Peace Corps Volunteer in Guatemala, my charge was to work with local health officials to ensure that women have healthy pregnancies and that the babies they bear have the opportunity to develop their bodies and brains during their pregnancies and during the first years after birth. 

In that time, I saw mothers die in childbirth. I saw children too small for their age, not getting enough nutrients during early life to grow to their full potential. I saw children so acutely hungry they couldn’t focus their eyes. Witnessing these health outcomes showed me firsthand the urgent need for strong medical care for pregnant women and infants, especially the most economically vulnerable.

Health and nutrition during pregnancy and the first years after birth have been demonstrated to be critical for childhood development. The advocacy group Thousand Days calls this period the “foundation for all the days that follow.” During this period, babies develop cognition, social-emotional skills, and dexterity. Lack of access to healthcare and nutritious foods during this period can set children’s development back for life. By providing high-quality healthcare and strong nutrition, we sought to provide all children regardless of race or socioeconomic status access to a fair start.

The level of wealth in Guatemala is much lower than in the United States, though racial and social inequalities are equally as relevant. Even with competing priorities and limited resources, the government of Guatemala sees the need to specifically protect mothers and babies in the most critical time for development. During my service and in partnership with the public health sector, we provided vaccines, free health screenings, and supplemental nutrition for children, pregnant women, and breastfeeding mothers to ensure that infants had the best possible chance of developing their minds and bodies fully. 

Why would we not want the same support to be available to the most vulnerable Hoosier children?

The bleak picture I saw in Guatemala is not at all far removed from the reality of mothers in the US and in Indiana. In the US, outcomes in women’s and infant health are currently the worst among peer nations. Since 1987, the amount of pregnancy-related deaths in the US has more than doubled. These impacts are racially disproportionate; more people of color die in pregnancy and childbirth than white women.

At the state level, Indiana has been identified as the state with the third-highest maternal mortality rate in the country with approximately 86% of maternal deaths occurring postpartum. Due to these findings, the State of Indiana recommended the extension of postpartum coverage for Medicaid recipients to ensure access to lifesaving services. 

The lifelong impact of HB 1140 is clear. Increases in perinatal Medicaid coverage have been linked to a decrease in racial disparities in access to medical care. In turn, increased insurance enrollment correlates to better childhood health and development outcomes and even better reading scores. By expanding Medicaid coverage to include mothers for 12 months after the birth of the child, we take a step toward ensuring better health for both mothers and babies across our state.

House Bill 1140 gives Hoosiers a rare opportunity to support a truly bipartisan solution. No matter which district you live in; no matter your party; no matter who your representative, we can all support lifesaving care for mothers and babies. Call your representative and urge them to support this bill.

The health--and lives--of mothers and babies across our state depends on it. 

W4C