by Brandon Jarvis

Gov. Glenn Youngkin and General Assembly Democrats laid out their own plans for addressing maternal health issues in Virginia this week. They both have similarities in what they believe needs to be addressed, and they both are taking action.

After hearing from a mother of three who suffered a heart attack just days after having her third child, and state Sen. Emily Jordan, R-Isle of Wright, who just recently was hospitalized with eclampsia after having her third child, Youngkin took the stage to lay out his plans that include a new Executive Directive.

“I do feel a bit out of place to stand here as a dad, a husband and a son,” he said. “It is very different than standing here as a mother, and I understand that.”

There were 64 pregnancy-related deaths in 2021, which is the latest information available Youngkin said.

In order to address the delay in information available, Youngkin announced that he is signing Executive Directive 11, which is intended to accelerate and strengthen the collection and publication of maternal morbidity data.

“This directive instructs the Virginia Department of Health to enhance the Maternal and Child Health Data Dashboard,” he said. “We’re taking it statewide to include actionable data on pregnancy-associated and pregnancy-related mortality and causes. And to establish a centralized maternal health website to provide families essential resources in one accessible location.”

Youngkin is directing the Office of Transformation to use $1 million of already appropriated funds to support the implementation of the directive.

He also directing the Department of Medical Assistant Services (DMAS) to form a workgroup to ensure that Medicaid patients are actually receiving the prenatal and postpartum care already funded.

“We must work to make sure that moms who have health insurance coverage are actually receiving the care that that coverage provides, and our managed care organizations must be at the front of making that happen,” he said.

The governor said he wants to work with the General Assembly to require all hospitals to implement safety bundles designed by the Virginia Neonatal and Perinatal Collaborative at VCU.

The VNPC provides assistance to hospitals and obstetric providers in performing quality improvement initiatives designed to improve pregnancy outcomes. They provide hospital-specific data for participating hospitals to help them accomplish quality improvement goals.

“This means that hospitals will adopt standardized management protocols to implement communication among providers and lead to improved clinical outcomes,” Youngkin said.

In the budget proposal that Youngkin will release Wednesday, he will include four maternal health-related initiatives.

First, he will include $2.5 million in funding for perinatal Health Hub pilots.

“These hubs will target coordinated care and community engagement with outcomes evaluated through comprehensive reporting,” he said.

Second, he will include $500,000 for educational campaigns to provide moms with information about maternal health, warning signs, behavioral health screenings and preeclampsia prevention.

Third, he is proposing an incremental $1 million investment to expand doula and community health worker programs, prioritizing localities with the highest maternal mortality rates.

And fourth, he is proposing increased payments for psychiatric and OB-GYN graduate medical residencies.

“We need more doctors, and that’s what we’re supporting,” he said.

Democratic legislators have their own proposals and held a “Momnibus” press conference Monday to talk about their slate of maternal health-related bills.

Their proposals include unconscious bias training for nurses, remote monitoring for hypertension and diabetes in expecting mothers, expanding Medicaid coverage and establishing a women’s health commission.

SB 740 from Sen. Mamie Locke, D-Hampton, would direct the Board of Medicine to require unconscious bias and cultural competency training as part of the continuing education requirements for renewal of licensure.

Youngkin vetoed similar legislation from Locke earlier this year.

He noted the disparities that exist, however, in his press conference Tuesday.

“There should not be a single single mother who is lost because of health conditions while she is either pregnant or in postpartum,” he said. “We know that there’s a disparate outcome between Black women and white women, between Hispanic women and white women, between Native American women.”

Both Youngkin and Democrats seem to agree that work needs to be done in rural communities on maternal healthcare access.

Democrats said their slate of bills is designed to “improve health outcomes for mothers before, during, and after childbirth, with a particular focus on supporting rural and under-resourced communities.”

SB 758 from Locke looks to help bridge the divide between the patient and the doctor.

The bill would expand the provision for payment of medical assistance for remote patient monitoring services provided via telemedicine to include all pregnant and postpartum women. Under the current law, only high-risk pregnancies are covered.

Youngkin acknowledged this disparity Tuesday, a sign that he might be on board with SB 758.

“We know there’s a disparate outcome between mothers in rural communities where there is a maternal health desert,” he said.

The legislative session begins Jan. 8.