The CDC says 87% of maternal deaths are preventable.
Cara Osborne told KSMU, “if that's true, then what is it that's keeping us from preventing them?
Osborne is a Senior Fellow for health and wellness at Heartland Forward, a Bentonville based nonprofit that Osborne described as a “think-and-do tank.”
As Osborne explained, “this work is really saying, how do we prevent things that are preventable. This is such an important outcome, not just for the mom herself, of course, but for the whole family. And how do we really generate a few things, the focus, the funding and the political will to prevent preventable deaths.”
Heartland Forward is focused on economic growth in the heartland, from Ohio to Kansas and Texas to the Dakotas. Osborne says they act as a convener for an eight-state health caucus within that region. That caucus of stakeholders has been driving Heartland’s focus on maternal health.
As part of that work, this May they are releasing what they call the “Healthy Moms, Healthy Babies,” call to action.
“We think of the strategies in three buckets,” Osborne said. “The first one is having tailored prenatal care in the US. We've taken a pretty one-size-fits-all to prenatal care. And really looking at how policy and practice can change to meet the individual needs of an individual mom and family, not just provide sort of a one size fits all solution.”
Osborne said their second focus is postpartum care, making sure new moms get the checkups and support they need, whether in person or via telehealth. The third focus is looking at the business model of maternal care, starting with care providers.
“That has a lot to do with the way that they're reimbursed for the care they give,” she explained, “And that certainly has federal and state policy implications. But also working with the private insurance companies to ensure that we're investing in moms and babies. Because if a baby is born healthy, they have such a better chance at maintaining that health. And if a baby's not born healthy, they're starting from behind and it's hard to catch up.”
Osborne said that economics can be important for connecting with policy makers., “looking at the economic impact of adverse events and poor maternal health outcomes and sort of how, not only when we prevent those outcomes, are we preventing true tragedies for families, but we're also saving the system money.”
In their 2024 report Heartland Forward found almost $2 billion in economic impact related to “undesirable pregnancy related outcomes” in Arkansas. They found over $165 billion in impact nationwide.
Osborne says maternal health outcomes are worse now than when her mom gave birth. She says that fact is hard for some to accept.
“I think one of the things that is so important is that it is getting worse, she said. “We anticipate that some of the changes to the Medicaid programs that are coming down the pike could make that trajectory even more alarming.”
Provisions in last year’s Big Beautiful Bill passed by Congress are widely reported to equate to $1 trillion dollars in cuts to Medicaid and federally funded health care programs over the coming years. In 2024, Medicaid reported it paid for 41% of births in the US.
Osborne said though, that their mission at Heartland Forward is shifting the terms of the conversation “from one of sort of death and despair to hope and really saying, this is preventable and we have strategies to prevent it, let's do it.”
Bringing stakeholders and the public in on that conversation is a key part of their new initiative.
“We are formally launching the Healthy Moms, Healthy Babies America initiative on Mother's Day,” Osborne said, “and we'll have a new website up starting on the Monday after the 11th with ways for folks to engage and just be aware, but really it's keeping it top of mind and taking care of the new moms in our communities and in our own families, and really seeing it as a shared responsibility.”