Table 4.

Implementing the Agenda: Tasks by Constituency

What Each Constituency Can Do:

Government and state/federal agencies

Pass federal and state legislation to extend Medicaid coverate to 12 months post-partum with automatic enrollment, and promote women’s medical homes for continuity and integration of care pre-pregnancy through the postpartum year; Workforce development: Incentivize entry to primary care, home visiting for postpartum women and team-based care; Actively support inclusion of community-based organizations in state and local planning; Co-locate information and resources for the postpartum year; at sites where women gather and trainstaff to refer; and Fund a National Workforce Development Center to increase the number of Black and Latinx health care providers. Researchers and funders Develop requests for proposals to fund knowledge gaps; Evaluate new models of care; Develop/fund templates for discharge to primary care; and Study the long-term impact of pregnancy complications and social predictors of health on future health. Foundations Fund and grow community-based organizations to bridge the chasm; and Allocate significant dollars for infrastructure support (training and resources).

Health care organizations

Require anti-racism training and assessment; Develop flexible postpartum models of support and wrap-around care (doulas, community health workers and navigators) Negotiate with national electronic medical systems to develop a template for transfer of pregnancy history to primary care and record handoffs to primary care at discharge from the obstetrical service; Implement a Mother’s Health Book for personal record keeping and instructions for transfer to primary care; Support women to share their stories with providers and motivate providers to listen; and Promote a Centering Model of Care for the postpartum year, especially after pregnancy complications.

Professional organizations

Develop guidelines for integrated care in the postpartum year and require them for accreditation; Educate members about the need to develop research that ties pregnancy complications to future health outcomes, especially chronic disease; Collaborate to associate new quality metrics with outcomes that can be tied to accreditation; and Require anti-racism training for professional licensure and renewal. Corporations and businesses Create woman-friendly practices and policies for the postpartum year (flexible hours, paid family leave, etc.).

Quality measure developers

Create standards of care for the postpartum year; and Design and promote quality metrics and pay for performance measures that promote warm handoff to primary care and metrics that incorporate the patient experience.

Advocacy organizations and community-based organizations

Advocate for state and federal legislation to exptend the postpartum period to 1 year with coverage and support; Lobby state and local agencies for participation in planning processes; Testify at legislative hearings to highlight the impact of pregnancy experiences on future health; and Lead anti-racism education efforts.

Educators

Form inter-professional collaborations for continuing medical education offerings that connect pregnancy experiences with future health; Develop and implement anti-racism training and assessment; and Create innovative technologies to connect women to each other, to providers, and to resources.

Media experts

Develop public service announcements to enhance the value of women’s health to society; Create an anti-racism campaign to address inequities in maternal morbidity and mortality and the health of Black, Latina, Native and Asian women over the life cycle; and Develop fundraising videos for community-based organizations that demonstrate accomplishments that can increase fundability.