As a maternity nurse for over a decade, Meagan Daigle has seen it all. But it wasn’t until she battled her own postpartum health issues that she truly understood the full scope of the maternal health journey.
Mental health issues, including postpartum depression, anxiety and even post-traumatic stress, are very common among new mothers but are often overlooked or forgotten.
Daigle is the regional director of maternal-newborn and pediatrics services at Ochsner Lafayette General Medical Center in Lafayette, Louisiana.
“I never thought in a million years that I would be in that pool,” she told Newsweek. “As a postpartum nurse, [I] should know all about this.”
But she said her experience helped her gain empathy and insight into what her patients are dealing with every day.
“There were things before I had kids that I felt like would never happen to me, and it was so eye-opening—I have such a different outlook now, it’s really a 180,” she said. “I cannot tell you how much it has helped me to empathize with our patients and come from a place of understanding and no judgment whatsoever.”
While pregnancy is a common and natural process, it is far from simple.
Dr. Christopher Morosky, an OB-GYN and professor at UConn Health, told Newsweek that women’s reproductive health care is “chronically” underfunded in this country because it “doesn’t generate a lot of revenue.” A 2021 study found that the National Institutes of Health (NIH) “applies a disproportionate share of its resources to diseases that affect primarily men, at the expense of those that affect primarily women.”
At a time when maternal mortality and morbidity remain serious and prevalent issues in the U.S., access to health care before, during and especially after pregnancy are essential for supporting mothers and families across the country.
Maternal Health Across the U.S.
The United States has one the highest maternal mortality rates among high-income countries. As of 2022, the maternal mortality rate in the U.S. was 22.3 deaths per 100,000 live births, down from a rate of 32.9 in 2021, according to the CDC.
The Commonwealth Fund, a private foundation dedicated to improving the health care system, particularly for vulnerable populations, estimates that the U.S. rate is more than double, and in some cases triple, the rate for most other high-income countries in the world.
Maternal mortality rates include pregnancy-related deaths, which include deaths during pregnancy or within one year of pregnancy from a pregnancy complication, a chain of events initiated by pregnancy or the aggravation of an unrelated condition by the physiological effects of pregnancy.
Many states have their own maternal health monitoring departments and organizations, which are often funded by the CDC, to provide data to track maternal mortality across different demographics. This includes 36 state Perinatal Quality Collaboratives (PQCs) and several state and local Maternal Mortality Review Committees (MMRCs).
These organizations are important, especially since maternal mortality rates vary greatly among states. Places like Alabama, Arkansas, Mississippi and Kentucky have rates close to 40 per 100,000 live births, while states like California, Minnesota, Connecticut and Wisconsin have rates well below the national average.
Many of the states with the highest rates of maternal deaths also have some of the strictest abortion laws in the country. As reproductive health care becomes more inaccessible, the risk of maternal and infant deaths increases.
“In the states that have made abortion very hard to access, you’re going to see a rise in maternal mortality rates for no other reason than there’s going to be more pregnancies happening,” Dr. Richard Wagner, an OB/GYN and professor at UConn John Dempsey Hospital, told Newsweek.
Photo-illustration by Newsweek/Getty/Photo-illustration by Newsweek/Getty
Newsweek recently published its ranking of America’s Best Maternity Hospitals 2025, highlighting the top maternal health care providers across the country. Hospitals on the list received a four- or five-ribbon rating, based on hospital quality metrics, patient surveys and nationwide recommendations.
Any clinician working in maternal health care knows that the best care begins before a patient is even pregnant.
Dr. Ann Windsor is the vice president of women’s health for the Midwest region of Advocate Health, which oversees the five-ribbon Aurora Medical Center in Summit, Wisconsin.
“Maternal health starts prior to the pregnancy,” she told Newsweek. “Optimizing health before pregnancy really helps us manage any condition that a woman might have so that the pregnancy can begin in a healthy place.”
Taking care of patients goes beyond providing standard medical care—it’s about working as a team. Windsor said clinicians also need to help patients understand the medical complexities and reasons behind their recommendations.
“We’re there to take care of patients, that’s our job,” she said. “Listening, establishing trust and respectful maternal care, elevating the voices of women so patients speak up, and developing mutual respect for patients and for the health care system [are] key.”
Good Maternal Health Requires Holistic Care
Many mothers have underlying health conditions or comorbidities that can impact their pregnancy and delivery. Chronic health conditions are a major hurdle for physicians and often require monitoring beyond obstetrics and gynecology.
As a maternal-fetal medicine expert, Wagner said, “There is not a single medical problem that gets better when you get pregnant, except maybe endometriosis.” Physicians, therefore, must employ a holistic approach to care in collaboration with specialists in areas like cardiology or rheumatology.
“I think we’re privileged [at UConn] to have a whole, integrated health care system to help us care for these patients,” he said. “It’s not just one specialty providing all of this [care]. I couldn’t do what I do without all of my other specialists helping me take care of these patients.”
According to the CDC, the leading causes of maternal deaths include cardiovascular conditions, infection, hemorrhage, hypertension and mental health conditions. More than 80 percent of pregnancy-related deaths in 2020 were preventable, the CDC found.
Race plays a significant role in maternal health, as women from different racial or ethnic backgrounds have unique health conditions, risk factors and experiences within the health care system.
As of 2022, Black women in the U.S. had a significantly higher rate of maternal mortality, at nearly 50 percent, compared to white women at 19, Hispanic women at 17 and Asian women at 13.
Dr. Christopher Morosky of UConn John Dempsey said that due to systemic racism and implicit bias within the health care system, providers are more likely to brush off concerns from Black women, as opposed to male and/or non-Black patients.
“The system doesn’t listen to Black women when they speak up with concerns and complaints, and they are pushed aside,” Morosky said. “If you don’t actively work on listening to the people in your communities, particularly pregnant and postpartum Black women, then you’re going to miss out on the opportunity to provide an intervention that’s going to save patients’ lives or their babies’ lives.”
Postpartum Care Is Critical to Protecting Maternal Health
Maternal health care doesn’t end once the baby is delivered. After the three trimesters of pregnancy, there is the postpartum period, known as the “fourth trimester,” that extends up until a year after birth.
A majority of pregnancy-related deaths occur after the baby is born. According to the CDC, about 16 percent of deaths happen in the first week postpartum and 47 percent happen seven to 365 days later.
Dr. Richard Wagner spent the first 11 years of his career in the U.S. Army doing an alumni residency and fellowship training before moving to private practice. He notes that the best resources for maternal health he ever worked with were in the military because “everybody had health insurance.” This enabled patients to seek treatment for chronic issues and pick up necessary medication, he said.
He also said that when he practiced in Tennessee, patients were often insured through TennCare, the state Medicaid program designed to provide coverage for low-income residents.
Patients would typically sign up for TennCare once they were pregnant and receive the pulmonary or cardiovascular care they needed for hypertension or other chronic health issues that might have existed before the pregnancy.
“[Patients] got really good care while they were pregnant, at least at my practice,” Wagner said. “The problem came once they delivered and fell off TennCare. We do a good job delivering pregnancy care and safely delivering babies in hospital, but [patients] deliver and go home, and they’re not going to the doctor every week.”
Even in Connecticut, where the population is mostly insured, Wagner said patients have their own postpartum challenges, like substance abuse and mental health conditions that are both stigmatized and underfunded.
Working in different states and witnessing firsthand the struggles mothers face day to day had a profound impact on Wagner’s outlook on maternal care and the health care system as a whole.
“If you would have talked to me 20 years ago when I was coming out of the military, I would have already told you that I did not support socialized medicine or national health care,” he said. “But I’ve done a 180 on that.”
He said eliminating maternal mortality is a tall order in our current system. While the state and federal government cannot fix the underlying socioeconomic issues immediately, there are steps that can be taken.
“We’re not going to solve poverty [right away], but if we could at least get some basic level of health care that everyone has, that would be [a solution],” Wagner said. “Education only goes so far. You can educate these patients all you want about their need to establish primary care, but if they don’t have insurance, how are they getting primary care?”
UConn Health
Socioeconomic Factors Impacting Mothers
Outside of insurance, there are many other non-health factors that impact the well-being of mothers and babies in the postpartum period. UConn’s Morosky said mothers have a hard time getting out of the house to go to doctor appointments.
“We need to talk to our people in their communities and engage them and ask them what they need, and we need to build trust,” he said.
This includes “meeting patients where they are coming from” and investing in preventative care, doula and midwifery programs to provide prenatal care and perform low-risk deliveries, deploying lactation consultants, providing transportation and increasing communication about the care and resources available for new mothers.
Morosky adds that it is the responsibility of local, state and federal governments as well as nonprofit organizations to ensure mothers have stable, safe housing and access to food and other essential supplies.
“If you are living in a place under chronic stress because of housing for you and your family, that’s really going to be impactful to your pregnancy, your birth and raising children,” he said.
State and Local Partnerships Help Hospitals Deliver Better Care
State, local and federal policies also have a significant impact on women’s health and well-being. For example, Morosky credits Connecticut’s 12-week parental leave program, access to contraception and abortion and cooperation with state representatives as key reasons why the state maintains a low maternal mortality rate.
In Louisiana, Daigle, of Ochsner Lafayette General Medical Center, said her state has “come a long way” with maternal health outcomes by improving management of chronic health conditions and monitoring social determinants of health, including poverty, limited education, food insecurity and housing instability, through the Louisiana Perinatal Quality Collaborative.
“The access, the outcomes, all of those can fluctuate depending on the status of the patient,” she said. “Many rural areas lack providers that offer maternity care, that’s what’s called maternity deserts.”
Over 35 percent of counties in the U.S. are considered a maternity desert, according to a 2024 report from the nonprofit March of Dimes, meaning more than 5.5 million women live in areas with little to no access to maternal care services.
Ochsner American Legion Hospital announced last year that it was opening a facility in Jennings, Louisiana, to enhance equitable care in rural areas, eliminate disparities and create a “more seamless and supportive patient experience.” (Ochsner Health System also operates two safety net hospitals in Shreveport and Monroe to provide care to all patients, regardless of insurance status or ability to pay.)
Through partnerships with local and state organizations, like the Louisiana Perinatal Quality Collaborative, Daigle said, the hospital system is moving toward “continuous improvement” to adhere to “rigorous standards.”
“We are always raising the bar because that’s what our patients deserve,” Daigle said. “We really try to highlight working within the state collaboratives [and] offering a really great clinical experience, but now we are adding that compassionate care and looking for what the patients’ want and not just [what they] need.”
