Doctors at MUSC Health are applauding a change that will give moms on Medicaid an extension in coverage. Instead of being covered for two months after giving birth, they are now covered for a year. “I think it’ll save lives,” said David Soper, M.D., senior medical director of Women’s Health.
“Traditionally, obstetricians have focused on prenatal care and intrapartum care.” Intrapartum refers to the time during labor and delivery. “The goal is to deliver a healthy baby safely. Once this is accomplished, there’s a tendency to breathe a sigh of relief and think that everything else is going to be just fine. But we know that more than half of all pregnancy-related morbidity and mortality occurs postpartum,” Soper said.
The South Carolina Department of Health and Human Services recognized that risk in pushing for the extension, which takes effect this month. The change is possible under the $1.9 trillion American Rescue Plan Act of 2021. It has the potential to affect a lot of people, because Medicaid covers almost half of all births across the country, according to a report by the Kaiser Family Foundation.
Soper said it can help those women transition from seeing OB-GYNs to primary care doctors, who will be able to help with a range of potential problems. “Women who develop medical complications of pregnancy, for example hypertension or diabetes, are at risk to develop those conditions later in their lives when they are not pregnant. And some new mothers will note a persistence of their hypertension or diabetes despite the delivery.”
So they need continuing care, Soper said. “Newly recognized high blood pressure and heart failure, along with diseases associated with blood clots, can require more continuing care than the first eight weeks of coverage.”
Mental health issues can also continue or crop up after childbirth. Postpartum depression, also called peripartum depression by the American Psychiatric Association because it can begin during pregnancy, affects an estimated one in seven women. It can be treated with psychotherapy and medication. Soper said the Medicaid extension will increase the odds that women suffering from mental health problems after childbirth will get help through resources such as MUSC Health’s Reproductive Behavioral Health Division.
“We have a very organized approach to depression, anxiety and other mental disorders that occur during pregnancy. The extension will allow these patients to continue care after the immediate postpartum period.”
Soper said his team is thrilled to see mothers get more of the care they need, whatever category they fall into. “I think the Medicaid extension will play a very important role in the long-term health of mothers. They no longer need to ignore themselves while they care for their newborn. By paying attention to the mother’s medical conditions, we can ensure that mother and baby remain healthy well after delivery.”