Governor Parson Announces New Investment, Partnerships to Reduce Maternal Mortality in Missouri

DECEMBER 6, 2023

 — Today, Governor Mike Parson announced that the Missouri Department of Health and Senior Services (DHSS) will release new funding to help improve the health of pregnant women and support their care after childbirth to reduce maternal mortality and poor health outcomes. The investment includes $4.3 million in new funds proposed by Governor Parson and authorized by the Missouri General Assembly to transform the quality and increase the access of health services provided to women during pregnancy and postpartum.  

"Last year during my State of the State Address, we declared that it was unacceptable for Missouri to be ranked near the bottom when it comes to maternal care, and we're taking action," Governor Parson said. "By recognizing the need to do better for Missouri mothers, this funding will help us implement a new plan to provide needed support and save lives. We want to thank the General Assembly for approving this funding and helping foster these partnerships that will lead to better care for Missouri mothers and babies."  

In 2023, Missouri’s latest Pregnancy Associated Mortality Review (PAMR) report found that annually an average of 61 Missouri women die while pregnant or within one year of pregnancy — ranking Missouri 44th among states in maternal mortality. These deaths occurred along the continuum of pregnancy and early motherhood. Contributing factors include access to care challenges, missed clinical interventions to manage conditions like heart disease, and unaddressed or unresolved mental health conditions — including substance use disorders, which are the leading cause of death and long-term harm. 

“We must do better for Missouri mothers, and this funding is granting the state unprecedented opportunities to create greater access to quality care,” DHSS Director Paula F. Nickelson said. “It is also crucial that we make an impact with this transformation of perinatal care. The strategies we are employing are based on what has truly worked in other states.”

Missouri’s maternal mortality prevention plan includes the following five domains: Missouri Maternal Quality Care Protocols, Maternal Care Workforce, Optimize Postpartum Care, Maternal Health Access Project, and Improved Maternal Health Data.

Missouri Maternal Quality Care Protocols  |  DHSS is partnering with the Missouri Perinatal Quality Collaborative (MO PQC), led by the Missouri Hospital Association, to develop and implement standardized evidence-based protocols for maternal-fetal health care with toolkits including a collection of best practice tools and articles, care guidelines, a hospital-level implementation guide, and professional education materials.

Maternal Care Workforce  |  DHSS and MO PQC are developing standardized maternal care provider trainings on trauma-informed, responsive, culturally congruent, and linguistically appropriate care, including screening, referral, and treatment of mental health conditions and substance use disorder during and after pregnancy as well as cardiovascular disorders, gestational diabetes, and other endocrinology disorders associated with pregnancy.

Optimize Postpartum Care  |  DHSS and MO PQC are developing a standardized Postpartum Plan of Care to include an assessment for depression and anxiety, universal screening for substance use disorder, and (as appropriate) referrals to mental health professionals, social workers, community health workers, nurse-led home visiting programs, and substance use disorder treatment programs.

Maternal Health Access Project  |  DHSS is working with the University of Missouri Health System to develop and implement a hub-and-spoke model Perinatal Health Access Collaborative, inclusive of perinatal mental health. The Collaborative will provide same-day specialized consultation, patient referral to community services, over-the-phone follow-up care coordination, and access to ongoing training and education for rural healthcare providers and other providers without this specialized expertise.

Improved Maternal Health Data  |  DHSS is establishing a maternal-child health dashboard to advance data quality and accessibility.

“The PAMR finds that nearly all maternal deaths and harms are preventable,” MHA President and CEO Jon D. Doolittle said. “Delivering the right care to expecting mothers during pregnancy — and extending care and support to them after childbirth when a significant share of harm occurs — can reduce maternal mortality and improve health. MHA and the Missouri PQC are honored to be providing best practices and connecting Missouri’s expecting mothers and mothers with resources to improve their health.”

Additionally, the Missouri Department of Mental Health was awarded the Health Resources and Services Administration (HRSA) Screening and Treatment for Maternal Depression and Related Behavioral Disorders Program grant for $687,777. This additional funding will provide the ability to develop the maternal health access project infrastructure.

“Addressing mental health for pregnant and new moms begins in the primary care setting and this program is designed to give those providers access to the tools they need to respond,” Laine Young-Walker, MD, chair of psychiatry at the University of Missouri School of Medicine and principal investigator, said. “This program represents a significant opportunity to make positive progress on the leading cause of maternal mortality in our state.”