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Maternal health matters, locally and globally

Written by Luna Jiang-Qin, BA candidate in Government & Legal Studies and Biology at Bowdoin College, Cora Faith Walker Scholar in the 2024 Institute for Public Health Summer Research Program

As a participant in the Public and Global Health Track of the Institute for Public Health Summer Research Program and under the mentorship of Abigail Barker, PhD, I have had the opportunity to dive into maternal health access in Missouri, as well as many other states and countries.

Since I attend a liberal arts college, most of my classes have focused on government systems and political behavior. This summer at WashU gives me a chance to take my learning a step further and tie it directly to public policy in health care. The ultimate goal of my summer project is to develop a set of recommendations for improving access to prenatal care in Missouri, especially in the state’s Medicaid program. But before narrowing in on Missouri, I’ve started by learning about maternal health programs in other places across the U.S. and the globe. In these explorations, I’ve truly been able to apply my previous studies in comparative politics and U.S. politics.

The U.S. has the highest maternal mortality rate among high-income countries, with even greater disparities by race and geographic location. This makes it crucial to learn from different health-care systems and improve access to care throughout pregnancy and following birth. One of the major strategies that I’ve learned about is perinatal regionalization, or making sure that each person has access to the right level of maternity care depending on their risk. This strategy involves making clear standards of care and building connections across health-care providers in a region. 

Map of Missouri birthing facilities by level of care | Photo: Missouri Department of Health and Senior Services 

Some places like Canada and England have had regional networks since the 1970s. Many U.S. states are developing or strengthening their own regional networks, starting with identifying what level of care each birthing facility can provide. While these countries, and even the U.S., may have very different health-care systems, there are still important lessons to be learned. My next step is to identify which examples make the most sense in the context of Missouri.  As someone who hopes to pursue a career in medicine and health-care policy, this program has been a wonderful opportunity to get a systems-level perspective on health-care delivery. I am grateful to the Institute for Public Health and the Cora Faith Walker Foundation for making this possible, and I am excited to learn more in the coming weeks!