Chiquita Brooks-LaSure is the administrator for the Centers for Medicare and Medicaid Services. In this position, she takes on the role of overseeing programs such as Medicare, Medicaid, the Children’s Health Insurance Program, and the HealthCare.gov health insurance marketplace.
During Black Maternal Health Week, Brooks-LaSure shared her expertise with rolling out to promote maternal health. As a mother and government official, she shared the importance of taking action toward this cause through initiatives and how the community can also get involved.
What does the acronym CMS stand for?
CMS stands for the Centers for Medicare and Medicaid Services. So, it’s the agency that is responsible for health care for really almost half of the country.
Can you break down the importance of Black Maternal Health Week?
We are absolutely in a crisis and I think it’s two-fold, certainly for Black women. Sometimes it is income related. Black women are at least three times more likely to die from childbirth than their White counterparts. But it’s not always income related, it’s broader than that. Just to use personal examples, I am one of the few Black mothers that I know, well-educated women with insurance, who have not had a difficult childbirth, who didn’t have complications. This really is impacting Black women across this country, regardless of income. We are absolutely at a crisis level. But the administration, certainly from the President who created Black Maternal Health Week, declared it. But but we are really [at a crisis level] from the leadership of our Vice President and Ambassador Susan Rice. We are making [the act of] addressing Black maternal health a priority to really try to move the needle on this initiative.
What do you suggest Black women do as it relates to having advocates during doctor visits?
I think this is a multi-pronged issue that we need to address. Certainly, at the time that you deliver, you want to make sure that you have someone who can speak on your behalf. It could be your spouse, it could be a doula, or it could be that you trust your provider who knows you. It’s not just in that moment, but you thinking about childbirth. It is the most vulnerable time, you as a person who could have been really healthy, but you’re having this moment, and you need help. So, that’s one piece of it. As a Black woman, you want to make sure you have someone who you can trust with you as you’re delivering but it’s so much broader than that. Some of the things that we are trying to do in the government are making sure that women have coverage. So, before you get pregnant you’re able to see your doctor, you’re having regular checkups during pregnancy, and then after pregnancy. Because some of the deaths are not actually at the time of giving birth. It’s after it’s a couple of months in when you’re juggling [the] baby, cleaning the house, and going back to work. All of the things that we have to navigate. That’s why some of the things we’re really focused on are getting states to cover women 12 months postpartum. We have over half the states that have done so and we want to keep pushing until all the states do.
How does health equity play a role in maternal mortality?
Health equity, the way we think about this, is trying to make sure that everyone has the best opportunity to obtain optimal health. There are disparities in our healthcare system. They existed before the COVID-19 pandemic, and they will continue as long as we have some of the systemic issues we have in our country. These are things like different access to doctors and nurses. It’s things like people not having health insurance coverage. It’s things like people having to choose between health insurance, going to the doctor, putting food on the table, rent, and housing; but it’s also how you are treated. What’s your experience when you go see the doctor and when you go to care? We are working, using as many levers as we can to try to address that. I’ve talked a little bit about how we’re trying to make sure that states cover people, we’re also focused on making sure that women have a safe delivery. So, we started a birthing-friendly designation for hospitals that are agreeing to make maternal health a focus and are entering into ways to try to improve maternal care. Starting this Fall, hospitals and private sector health plans are partnering with us to show little icons you can see and know whether your hospital has a birthing-friendly designation.
How should women share their experiences with family members?
So many times throughout our history, women’s symptoms have been dismissed and we’ve been ignored. The healthcare system has ignored people being in pain and symptoms, [saying] it’s in [their] head, and there’s so much new happening. When you give birth and you have a baby there, you can have symptoms you’ve never experienced. So, it is critical if anything feels abnormal, [such as] bleeding [and] certainly your emotions. I mean, mental health is a real issue in terms of postpartum depression. We could go on and on about your question, but what should we do? Talk until you get someone to listen. So, tell your partner, tell your family, call your doctor, [and] call people if they’re not giving you what you need. Because it’s so easy to overlook the symptoms, and it’s critical. Two out of three deaths are preventable. It’s again, not just deaths, it’s also just lowering what we call morbidity of not having the same level of health. You know, like they used to say, she was never the same after having a baby. We want women to be healthy and joyous. I was just meeting with the Howard Men’s basketball team, and a group of young men and women [were] listening to them talk about why they were interested in maternal health and why they took this initiative. They talked about how childbirth should be a time of joy and I loved that. I thought that’s right, it should not be something that you’re afraid of and you’re fearful. For too many women, it is something they’re afraid of. So, that’s a long way of saying we have to work as an entire community to make sure we’re addressing maternal health. Part of that is by women not feeling alone, not feeling like they need to hold in what’s happening to them, but they can share that. Share that more broadly.
How can we as a community check in with new mothers?
I think it’s so critical that we do as you’re saying but really think more holistically. It’s not just a blip; this moment you give birth, it’s over. You’re having a life change. A new life has been brought into the world and that means a community. I think one of the reasons why we’re seeing so many disparities is because we don’t have the village in the same way. So it’s crucial that we all recognize how this can be a challenging time for women and make sure that we’re supporting the entire family.