Ameliorating Access To Black Maternal Care

Joining us on the podcast is Stacey Brayboy March of Dimes Senior Vice President of Public Policy and Government Affairs. We'll be discussing public policy in the maternal health space and how March of Dimes is joining policymakers and local communities to help improve access to care.

Episode Transcript

(00:01):
Meternal done infant. We're going tocontinue to advocate, We're going to continue
to partner. So you know,my grandmother would always say that you've got
to lift up and take pride inthe winds that you have, but never
forget about the rest of the workthat you got to do back at home.
We've got a lot of work westill have to do. You're listening
to Meternal home to access and informationfor mothers of color. Joining us on

(00:23):
the podcast today is Stacy brave Boy, March of Dimes, Senior vice president
of Public Policy and Government Affairs.We'll be discussing public policy in the maternal
health space and how March of Dimesis joining policymakers and local communities to help
improve access to care. So welcometo Maternal. I am Keny Gibson,
your host, and my co host, Jay Wilson is not here today,

(00:46):
unfortunately, she has a very importantmeeting that she's tending to in regards to
maternal healthcare. But I am joinedin studio today by Stacy Brayboy, March
of Dimes, Senior vice president ofPublic Policy and Government Affairs. Welcome to
Maternal. Thank you very much,thank you, and you just had a
very extensive flight, so you reallycame here on purpose today. Yes,

(01:10):
my travel here was definitely on purposeto join you, Kenya, here because
the topic is such an important topic. But yes, a journey. But
I am here in present. Youare here and we appreciate that. So
tell me a little bit about yourrole at March of Dimes and what you
take care of their sure, So, as you stated, senior Vice president
for Public Policy and Government Affairs andMarch of Dimes, I oversee O I

(01:34):
oversee our country's government affairs and publicpolicy and advocacy initiatives, and so it
is focused across all fifty of ourstates. We focus on not only working
at the federal level, but wefocus on policies that impact moms and babies
and health at the state level aswell as the national level. That's an

(01:55):
important job, it's an exciting job. Yes, yeah, So, how
would you say policy hasn't impacted maternaland infant health in terms of the crisis
that's going on. Well, myanswer to that, Kenya is frame it
this way. It is that inthe US, one of the most well
developed nations, we still have thehighest rate of maternal mortality death rates,

(02:21):
we have children or babies that areborn that we lose within that first seven
days to twelve months of life.And I will tell you that the policies
that have are in places, it'scomplex. We can't look at one solution
in terms of how one policy willchange it. But I think you've got
to look at or how one policyhas impacted. You've got to look at

(02:44):
several. You've got to look atthe history. You've got to look at
policies that have been in place thatactually have catered towards there being some unfair
biases, there being some policies thatwill probably that were put into place that
were racist, policies that have addedto this unfair or this unequal, equalable

(03:08):
health gap that we're facing. Andso I think that we've got to look
at how you start to peel backthose policies and what we've got to be
able to do to be able toaddress them in terms of what the impact
is on moms and babies, becauseas I know, as we started talking
a few minutes ago, it isthe impact whether you are a teenage mom,

(03:30):
if you are a more mature mom, the impact in terms of their
not being adequate healthcare and access tohow to adequate healthcare depends on where you
are, depends on your education,depends on your socio economic structure, and
where you live. So all thosethings and policies that have been in place

(03:50):
in terms of where you live,what you know, what your wealth gap,
what the wealth gap is has animpact on what the health gap is.
In social determments that can have animpact on health. So policies longstanding,
and so we're starting to chip awaywith that at marching times and partnering

(04:10):
with organizations and people like you andwith Jay to look at how we address
what we're doing across the country.And we're coming right off Black Maternal Health
Week. Yes, I have theopportunity to join the Secretary of HHS just
on Monday as we ended Black MaternalHealth Week, and I will tell you
that it is at the forefront ofwhat the administration is trying to do,

(04:30):
the Biden administration, as well asthe relationships that I've been doing in my
role in terms of advocating for policyat the federal level of the state level,
working with our nation's governors. Soit is we're hitting the sounding board
in terms of what we've got tobe able to do to address the impact
and what policies and what those effectsare like. That's great and that's encouraging

(04:51):
to hear. And I want totalk a little bit about the Black Maternal
Health Momnibus Act of twenty twenty one. Can you expand upon that little bit
because I feel like sometimes it comesup on the podcast, but we've never
really liked talked about it. Sure, And the reason your listeners can't see
me smiling, but the ones whoare joining the podcast and being able to

(05:11):
look at visually, I'm smiling becauseyou know what, I get excited when
I talk about the Black mom Dabus, the MOMDBUS Act. We've got great
supporters and champions that are in Congress. We've got Representative Lauren on the Wood,
We've got Representative Adams, We've gotSenator Corey Booker, We've got we've

(05:32):
got Congressman Frank Malone as well asSenator Widen. So we've got several supporters
of the of the MOMBASAC who arepart of the Black Maternal Health Caucus.
So in the MOMDBUS Act, it'stwelve pieces of legislation that is supposed to
look at funding and regulations and lawsthat are supposed to help moms and babies

(05:57):
to be able to have access tolook at how to level where I've talked
about the health gap and looking athow you're able to address where we've got
a report card and March of Dimeswhich focuses on the maternity care deserts,
so that twelve pieces of legislation.One piece of that legislation President Biden signed
into law and that was the ProtectingMom's Act, and so there are eleven

(06:20):
pieces of that legislation that has tobe changed and we continue to advocate for
and it's through partnerships such as withiHeartRadio and yourself that we're able to get
the word out. But more importantly, it is looking at that twelve pieces
of legislation, and there's some talkabout there being a Momdibus two point zero,

(06:42):
and so we're excited about that andat March of Dimes we're going to
continue to advocate for that, andwe're going to continue to partner and get
people who have stories to share toshare those stories so that we can get
congressional members and state legislators and ourgovernors excited about what we need to be
able to do. You to addressmaternal health. That's great, And I
think the stories are so impactful andso important important because that leads to the

(07:05):
change. Right when you can hearone's journey and you can kind of visualize
that and you see how we cantake a negative and we can turn something
into a positive. I think thatthat always helps, like give people a
footprint of the change that needs tooccur. Absolutely, And so, Kenya,
what I have known, what Ihave known, what I have learned
and I've experienced, is that itstarts with grassroots. It starts with people

(07:30):
understanding and being willing to step forwardand tell their own personal story, tell
their own personal journey. It ispeeling back an onion and being open.
But by you being open, you'reable to connect with those stories. I
mean, so it is your storyconnects to how many other people? Right?
My story connects to how many otherpeople? And then you take people

(07:54):
such as Serena Williams who are ableto share their story, and so that
allows you and makes you become morevulnerable. But when you have real life
stories and real life journeys that youcan share with your congressional members, your
senators, your mayors, your governors, then they realize why Congress has to
move a little bit quicker to beable to address what we're starting to see

(08:18):
in the data in terms of mothersthat are losing their lives or children that
are being born early or premature.So again, it's the stories that's the
most impactful way, because if theydon't hear from you or me or anybody
that's here or listening or your viewers, if they don't hear from a real
story, they tend to move alittle bit slower. But when they know

(08:39):
that there's a direct impact from aconstituent that lives in their district, or
lives in their state, or livesin their city, it makes a difference.
Yeah, so long answer, butas you can see, I'm very
passional about when we start talking aboutpolicies and the impact and black maternal health
and when we start talking about maternalhealth or maternal mental health. So I

(09:01):
get excited and you said, hey, we're sitting here is there, We're
sitting at the kitchen table and we'rehaving a girlfriend conversation. And that's where
you hear this passion that I'm talkingabout, and it's great to hear,
and you bring up a great pointabout, like Serena Williams, right,
Like I think about statistically, howthe black maternal health crisis really doesn't discriminate,
right. I think about my journey, like how I started off as
a teenage mom, like very impoverished, didn't have a lot going on at

(09:24):
that particular time, didn't have alot of information and a lot of knowledge.
But then you have somebody like aSerena right, who is a fluent
has money. Right, So thisthing doesn't discriminate. It doesn't matter if
you're at the lower end of thetotal post socioeconomically or you're at the ladder
where you're in a great space.We need to have these stories and conversations
come to the forefront because it doesn'tmatter where you are, you're affected by

(09:48):
it exactly. Yeah. Yeah,So I kind of want to talk a
little bit about postpardon because you hadbrought that up, and I think with
me interestingly enough, like I wasmisdiagnosed or undiagnosed rather with Lucia and my
postpartum journey or phase of my firstpregnancy, and I think that it's a
topic that kind of gets swept underthe rug sometimes when you talk about postpartum

(10:09):
care. So I kind of wantto talk a little bit about like what
March of Dimes is doing to standon, you know, Medicaid, postpartum
coverage and the extension of that.Sure happy to share what we're doing and
working in that space, and Ismile again as I talk about it.
It's because what we have started doing. We've started something that's called March for

(10:30):
Change, and it is state advocacyDays, not only state advocacy days,
but it's advocacy days at the stateand at the federal level across the country
going in advocating on behalf of postpartumMedicaid extension, going from sixty days to
twelve months. And so when youlook at the CDC data, it tells

(10:52):
you that there's an significant that Medicaidexpansion was significantly associated with lower rates of
maternal compared to states without Medicaid expansion. And so due to that increase of
medical coverage resulting in an increase inaccess to healthcare, we have been able
to help moms and we've been ableto have an impact on children. So

(11:16):
during those March for Change advocacy days, we're bringing in advocates of Marching Times
We're bringing in moms, dads,we're bringing the aunts and uncles and in
some cases children. They're joining usat our nation's capitals to talk about why
states should opt to have on Medicaidextension or expansion go from sixty days to

(11:37):
twelve months. And what you shouldknow and what your viewers and your listeners
should know, is that all stateshave not opted in. We are not
at about thirty two states. Iheard Congresswoman Robin Kelly and Lauren Congresswoman Underwood
share on Monday and HHS that wemay have six additional states that will opt

(11:58):
in our FI. There's a crossfor that. Marchadime strongly believes that all
states should make it mandatory, andthat not only make it a mandatory,
but more importantly make it prominent sothat we're able to give that healthcare and
that access, especially as you startto focus on postpartum, because it is

(12:20):
from the seven day, from sevendays up until the first year of birth.
So that's that's something that we're continueto advocate for. Not only that
we're advocating on behalf of telehealth,and that ties into what I've shared with
you about our maternity care desert andthat Maternity Care Desert Report that will be
coming out. It is when youlook at rule health and you look at

(12:43):
moms and families that are not closeto being able to go in to see
an obstetian kind of colleges and doweekly and monthly checkups as you're going through
your pregnancy presents a challenge, andso being able to have those telehealth options
are also something else that we continueto advocate for. That's great, that's

(13:05):
great, and I love that thatis on the forefront because I feel like
there's such a crucial time after youhave a baby, right, and there's
like all these months that go andI don't I think it might be the
same, but you would go foryour six week check up, right,
But what happens after the six weeks, right, you should still have an
opportunity to check in with your doctorreally address your symptoms so that we can
really get to the core of whythis crisis is going on and how to

(13:28):
combat that for the future. Andit's also a way to also address maternal
mental health doing that stage of whenyou're going through postpartum Sure. Yes,
sure, So once a state decidesto extend Medicaid postpartum coverage from sixty days
to a year. How quickly willmedicate and really see that change firsthand?
There are three ways that they cando it, so let me just make

(13:50):
sure I'll share it with you andshare it with your listeners. It is
one you can file for something that'scalled the SAP, which is an eleven
fifteen form. Your chief executor,which is your governor. Your governor can
actually do it through an executive orderor through the executive budget. And then

(14:13):
the third way for you to beable to extend it, besides the states
being to help to mandate it.I want to make sure that I'm giving
you all the third way to beable to do it. It is your
governor can do it. Oh,it can be done through your budgets.
And then also being able to foulfor that waiver from CMS using that eleven

(14:33):
fifteen form that I mentioned. Andin the states that aren't coming on board
so quickly right with extending this postpartummedicaid coverage care, what are some of
the emerging political arguments that are forand against this, Like why do you
think that's not happening in those states? And Kenny, let me, I
want to go back before answer thatquestion. The third thing that I missed

(14:56):
is through legislative action, meaning interms of being able to take advantag of
the extension and making it permanent orit is the third thing. So the
third thing was legislative action, gotit. It was through the governor's executive
ability to do it through the statebudget and then applying for that form.
What's the political argument? So basicallyfor the yeah, so what's the political
argument? And I pause for asecond, the argument in terms of states

(15:20):
that are pushing back or not asquickly to jump on board, is they
think that it's going to be anunfair burden to the taxpayers, or they're
still looking at how you address howyou encourage states or how the states should
take advantage of finding a different pathwayfor being able being able to do it.

(15:43):
That's an interesting perspective, right,because I feel like it's a major
burden right now. It is,right, So that's interesting. I won't
get into a whole political dissertation onthat, but it's interesting that there's that
view. Yes, but that iswhat we've heard that's been some of the
pushback. So how can policymakers andlocal communities help to improve access to care

(16:04):
through partnerships, through telling your story, making sure you know, as you
and I've said earlier, it isyour story is the most impactful way.
It is taking the opportunity in thetime to be able to go to your
local elected officials, your state electedofficials, tell them that you're demanding what
we call at March of Times,You're demanding blanket change. You're holding them

(16:29):
accountable, and you're saying, here'sthe impact it is. You're asking them
to take time to look at thedata. Just like you said, it's
a burden. So look at thedata and then help them understand how that
burden of people not being able tohave access to healthcare, not being able
to have access to be able togo in and see their doctors, how

(16:49):
that's truly having an overall impact onthe entire state or the country as a
whole if we're not addressing those kindsand creating a even bigger burden. Yes,
absolutely right. So are there anyrecent policy wins that you and March
of Dimes are proud of? Absolutely? I will tell you in November,

(17:11):
I had the opportunity and so I'mas I shared with you at the beginning
of our conversation. I am verypassionate about mental health, maternal health,
moms and babies because I'm a mommyself. PWFA. So I rolled up
my sleeves it probably was the coldestday in DC and went to the Capitol

(17:33):
and so PWFA was the Pregnancy WorkersFairness Act, went to the Capitol and
joined our coalition members in terms ofjust advocating and standing in front of the
Capitol and doing these rally cries ofasking them to bring PWFA to the floor.
And so PWFA just didn't happen immediately. It has been decades, it's
been over ten years, but we'vehad wonderful sponsors in the House and in

(17:59):
the Senate that continue to push andadvocate. And actually PWFA was brought into
the Omnibus which was signed by thePresident in December. And what I will
tell you is that I remember sharingan email with leadership letting them know that
it didn't look like this was goingto be brought to the floor. And
then immediately as things all happened,and everybody knows in DC, things changed

(18:22):
quickly, and there was an amendmentthat was added to the Omnibus that allowed
PWFA to be voted on and broughtto the floor. And so PWFA,
for your listeners, is the PregnancyWorkers Fairness Act, and it is legislation
that protects is an act that protectspregnant women and allowing them to have rights

(18:44):
as they're able to be able towork during their pregnancy. There were other
legislative wins that I'd love to share. It was the Pump Act and hard
to imagine, right, and thatwe've got to give federal legislation to make
sure that lack tating moms have enoughtime and have breaks to be able to

(19:04):
lactate and produced milk to take careof their babies. Right. And the
same when it comes to being ableto have a bottle of water when you're
standing on your feet or working,or being able to take breaks. But
yeah, so those are some wins. There were several other wins in terms
of looking at the CHIP Act,legislation that looked at children health and policies

(19:30):
for two years extension in regards tothat. So there were several key wins
that we're proud of being able topartner with our partners and having those relationships
at the national Federal level and atthe state level is win. And I'm
sure it's great to just see andfeel that progress, right, you know
what a little bit of progress,But you got to continue to beat the

(19:51):
drum. And as we beat thedrum, because the reason we're having this
conversation is because we've got to continueto beat the drum because we're looking at
the number of people, the numberof moms, the number of birthing people
who are losing their lives because we'renot able to adequately address the health equity
gaps or address black maternal health inthe way that we need to write.

(20:15):
So happy and proud of those winds, we're going to continue to advocate.
We're going to continue to partner.So you know, my grandmother would always
say that you've got to lift upand take pride in the winds that you
have, but never forget about therest of the work that you got to
do back at home. So westill have a lot of work that We've
got a lot of work we stillhave to do. We sure do,
we sure do. So we're almosthalfway through twenty twenty three R What are

(20:37):
some of the key policy priorities ofMarch of Dimes for this year. So
I will tell you that we've gota couple of things that we are starting
to advocate for. We're going tocontinue to advocate. As I've shared with
you, I oversee our state legislativeand policy government affairs as well as our
advocacy and federal At the state level, we are continuing to go and meet

(20:59):
with our governors and have these Marchfor Change where we're encouraging them to look
at expansion of Medicaid postpartum extension fromthe sixth day, from the sixty days
to the twelve months. And thestates were also looking at and encouraging expansion
from Wiffery and DULAS in terms ofhow we address DULA care, how do

(21:22):
we how do we reimburse for DULAcare. We're starting to continue at the
state level and at the federal levelto look at telehealth and supporting legislation as
it relates to that. I willtell you that we recently were on the
hill for our federal March for Changeadvocacy Day, and what was exciting we
had advocates that came from across thecountry. We had advocates that actually rolled

(21:47):
the bus from Atlanta, Georgia toWashington, DC because they wanted to be
able to join our March for Change, and so we had congressional meetings with
about sixty different offices and members withtheir legislative teams. Part of what we
were talking about for twenty twenty threeis re authorization of the premiac. We've

(22:08):
been focusing on newborn health screening.We have been looking at advancing focus in
terms of medication for moms. Sowe've got a whole We've got several things
that are at the forefront of whatwe continue to beat the battle, beat
the drama on and talk to ourlegislators about at the federal and at the
state level. So they vary,but again focusing on dulas and focusing on

(22:32):
newer free care. So busy,but busy with good stuff. Busy with
good stuff, right, yeah,yeah, yeah. So how can our
listeners get involved and how do peoplein general get involved in your initiatives?
You know what I'm gonna do,I'm Kenya, is encourage your listeners to
one go to and I know I'mgonna say this, go to your go

(22:53):
to the March of Times website.Let's one get you to join our advocacy
network. Then I'm going to askall of your listeners and your viewers to
join us at our March for Change. I'm working to We're having a few
that are that are coming up.The schedule is there. We've got one
coming up that's in Texas. Wehave one that's going to be taking place

(23:15):
in California. So those are theones that come to top of mine.
We've got something taking place in NorthCarolina. So I would say for your
viewers, join us at the Marchfor Change. If you say, well,
I can't come to a March forChange, or there's not one in
my state, or one in mytown, or one in my neck of
the woods, as I would saycoming from my home state of South Carolina,

(23:37):
I would also encourage you to writeyour congressional member, send a postcard.
Put something as simple as black maternalhealth matters, support the mom to
us. I would also tell youtake a picture. I'm old school.
I believe that you got to writea letter, you gotta make a phone

(23:59):
call, got to send a postcard. But you know what to some of
our more younger and savvier listeners,because it takes a village. It's not
about whether you are a mom dad'sgrandparents, sisters, brothers, aunt's,
uncles. Everybody can participate because thisis something that impacts all of us.

(24:22):
Sit down. Everybody's got a smartphoneor some type of device. You've got
a laptop. If you don't havea laptop, you've got a library,
go into your library, pick upyour phone. Send an email to your
congressional members, r US senators.Send an email to the president, also
your governors and your mayors, andtell them why this is important and why

(24:45):
we need to be able to takea part and look at this. So
everybody can do it. Yes,and it takes multiple touch points. And
that's the reason I went old schooland I said, write a letter,
send a postcard, send an email, and you know what, I'll say
something else. Tweet about it.I mean tweet it, tell somebody to
take a look, and then ofcourse Instagram. There are ways to talk

(25:07):
about it. And there are multiplepoints. As you know being in the
media that you've got to not touchpeople one time, You've got to do
it in multiple tounch points. Andso you can do it regardless of socio
economic background. You can do itin regards to whether you're here in this
busy hustle and bustle city of NewYork. Or you can do it in
Rule America, in South Carolina whereI come from, where you don't have

(25:30):
as many Starbucks or dunkin Donuts,but you've got that community library or access
to some form of Internet. Wejust got to get it done. That's
it, and there are many waysthat you can get it done well.
I want to thank you for joiningus today on Meternal on iHeartRadio. This
was just another episode of the wonderfulconversations we've been having around the black maternal

(25:52):
health crisis. I want to thankyou for your partnership. March of Dimes
has been a great partner of thisplatform and just has been amazing with helping
us get out the right messaging,purposeful messaging to the mothers of color that
we're reaching with this platform. SoI want to thank you for that partnership,
Kenya, and let me say thankyou. Walking in, I was
excited and as I shared with you, trying to get here with the travel,

(26:15):
but knowing how important this partnership is. Knowing what you and Jay are
doing in this space and talking tomoms and focusing on maternal health is important
and the more we continue to dothis and push forward and fight for we'll
be able to change and turn thosenumbers going in the opposite direction instead of
increasing those numbers. So thank you, oh thank you. We appreciate you
saying that, and you're listening toMeternal on iHeartRadio. We were just joined

(26:38):
by Stacy Brayboy, Senior Vice presidentof Public Policy and Government Affairs for March
of Times and that was another episode. Thank you and until next time,
thank you for joining us for anotherepisode of Maternal. This conversation will help
mothers of color better understand their maternalhealth rights, get access to postpartum care,

(27:00):
and how public policy is helping toshape better health outcomes and communities of
color. Visit me eternal dot infofor additional resources for mothers of color and
how iHeartRadio and March of Dimes arepartnering together to improve health outcomes and communities
of color.