Extending Maternal Care After Pregnancy Program

Mothers may face risks to their health and wellbeing for up to a year after giving birth. But getting the care and support they need is especially difficult for vulnerable women on Medicaid, as their coverage ends 60 days after delivery. Parkland Health & Hospital System is filling this gap by improving access and quality of care for mothers through the Extending Maternal Care After Pregnancy program, known as eMCAP.

The Facts

  • Medicaid coverage ends after 60 days post-delivery. More than 90% of the women who deliver at Parkland use Medicaid funding, significantly higher than other hospitals.
  • More than half of all maternal deaths in Texas occur in the gap between where Medicaid coverage ends and the first year postpartum.
  • Black women have the highest risk of pregnancy-related mortality in Texas.
  • As many as 40% of women don’t attend one postpartum visit.

The Need

After bringing new life into the world, the last thing a mother should worry about is her own death. But the risk for serious, potentially fatal health complications may last for up to one year after giving birth.

In fact, when the state of Texas began to study the deaths of new mothers (maternal mortality) several years ago, a startling fact emerged. According to a Texas Health and Human Services (HHS) 2018 report by the Maternal Mortality and Morbidity Task Force, 62% of maternal mortality cases across the state from 2012 to 2015 occurred between six weeks and one year after delivery. This issue is especially worrying considering that maternal care traditionally ends after the postpartum visit which is scheduled for 14 to 180 days after delivery.

Sadly, more than 60% of Texas mothers who passed away did so not from complications during birth but in the first year following birth. Their deaths were caused by health issues exacerbated by pregnancy such as high blood pressure, heart issues, diabetes, obesity and substance abuse. These mothers were unable to access the medical care they needed in part because their Medicaid health insurance stopped funding their care 60 days after the birth of their babies.

This is especially significant locally as more than 90% of women delivering at Parkland use Medicaid funding, which is significantly higher than other hospitals—both across the state and throughout the nation. Rates of maternal mortality are three times higher among African American women, both nationally and among women in Texas, including Dallas County. This disparity is a key finding summarized in the Dallas County Community Health Needs Assessment (CHNA) conducted by Parkland in 2019.

Our Solution

To ensure women receive the healthcare they need after childbirth to address complications before they become fatal, Parkland is filling the gap left by Medicaid, extending care a full year after delivery.

Parkland's extending Maternal Care After Pregnancy program marries the medical approach with a community-based approach to address physical, mental and environmental risks in targeted, vulnerable ZIP codes within Dallas County. Rather than asking a new mother to travel to an appointment, a multi-disciplinary team of healthcare providers is transported via a mobile health van to the woman’s home. The program will also include telehealth appointments and integration with community health workers who will offer social support and resources.

As Parkland innovates to save the lives of mothers in our community, other health systems in the nation will be watching closely, with an eye to replicate this new model of postpartum care to save lives in their communities.

You Can Help!

Providing our most vulnerable neighbors access to the care they need is critical. But we can’t do it alone; we need your help. Make your gift today to provide the quality, compassionate care that everyone deserves.

Make a Gift to Support Parkland's Extending Maternal Care After Pregnancy Program