The Role of Family Medicine in Addressing the Maternal Health Crisis in the United States.
Saskia SpiessRobert OwensElizabeth CharronMario DeMarcoMirela FeurdeanKaren GoldKathryn MurrayNicholas SchenkKirsten StoesserPauline ThomasEmmanuel AdediranElena GardnerKatherine FortenberryThomas Carl WhittakerDominik OsePublished in: Journal of primary care & community health (2024)
The United States (US) is experiencing a maternal health crisis, with high rates of maternal morbidity and mortality. The US has the highest rates of pregnancy-related mortality among industrialized nations. Maternal mortality has more than quadrupled over the last decades. Rural areas and minoritized populations are disproportionately affected. Increased pregnancy-care workforce with greater participation from family medicine, greater collaborative care, and adequate postpartum care could prevent many maternal deaths. However, more than 40% of birthing people in the US receive no postpartum care. No singular solutions can address the complex contributors to the current situation, and efforts to address the crisis must address workforce shortages and improve care during and after pregnancy. This essay explores the role family medicine (FM) can play in addressing the crisis. We discuss pregnancy care training in FM residencies as well as the threats posed by financial and medico-legal climates to the maternal health workforce. We explore how collaborative care models and comprehensive postpartum care may impact the maternal health workforce. Efforts and resources devoted to high impact solutions for which FM has considerable autonomy, including collaborative and postpartum care, are likely to have greatest impact.
Keyphrases
- healthcare
- public health
- quality improvement
- palliative care
- pregnancy outcomes
- birth weight
- affordable care act
- mental health
- pain management
- preterm birth
- risk factors
- type diabetes
- cardiovascular disease
- cardiovascular events
- physical activity
- body mass index
- risk assessment
- gestational age
- chronic pain
- climate change
- drug induced