Crystal Karges Nutrition - Registered Dietitian Nutritionist in San Diego, CA

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Maternal Health Care Matters: How to Advocate For and Create Change

Did you know that the United States has the highest rate of maternal deaths in the developed world?

Did you know that up to 1 in 5 women will suffer from maternal mental health disorders like postpartum depression?

Did you know that the United States is the only developed country with no paid family leave?

My friends, numbers can’t lie. But the reality is even more stark when we experience these issues firsthand - either ourselves or through the lives of someone we love.

Personally, I was the 1 in 5 women who suffered with mental illness after the birth of my babies.

I struggled with postpartum depression after three pregnancies and suffered in silence for almost 4 years. My family suffered because I didn’t connect to the help I needed for recovery.

I didn’t know that having a history of an eating disorder put me at increased risk of maternal mental health issues, including depression and anxiety, during pregnancy and postpartum.

I felt overwhelming guilt and shame for my struggles. I didn’t know it was a mental health problem. I just thought I was severely failing at motherhood.

I didn’t know how to articulate what I was experiencing or how to ask for help.

I know that my experience with postpartum depression represents countless of mothers across our country who have had similar struggles.

When I was finally able to connect to the help and resources I needed to recover, I vowed that my experiences in motherhood would not be wasted. I promised myself that I would do everything I could to turn the tide in our country, to work alongside others to improve maternal health - for myself, for my children and future generations, and for all the mothers and families that are coming after me.

Why?

Because we have to do better.

Because more that 600,000 women will suffer from a maternal mental health disorder in the United States every year and less than 15% of those women will receive treatment.

Because maternal depression is a leading cause of maternal mortality and the most underdiagnosed obstetric complication in America.

Because maternal health issues impact the whole family, not just women.

Because it is unacceptable that the United States is the ONLY industrialized nation to see maternal mortality rates rising, with more than 60% of these deaths being preventable (according to the most recent Vital Signs report on maternal deaths from the Centers for Disease Control and Prevention).

Because moms need and deserve time to recover and bond with their babies after pregnancy and childbirth without the threat of losing their jobs.

Because it’s time to raise our voices for those who cannot speak up for themselves.

No family should ever fear preventable death as a result of pregnancy or childbirth in the United States.

We can’t wait for these dire conditions to change - we HAVE to rise up to the call and create the change we so desperately need. For ourselves and our loved ones.

How We Can Advocate For and Create Change

I recently had the opportunity to participate in Mom Congress, an incredible coalition of non-profit organizations and moms from around the country, that gathered in Washington D.C. to advocate for legislation that is designed to save and support moms.

It’s hard to articulate how impactful it was for me to gather with moms from all across the country with varied backgrounds, ethnicities, professions, and world-views to unite on our shared experience of motherhood and to collectively raise our voices to support family-centered policies.

Participating at Mom Congress 2019 in Washington, D.C.

Statistics can give the cold-hearted facts. But meeting the faces of the women, men, and families who have lived these experiences bring the reality a whole new meaning. Lived experiences transcend statistics to an inescapable reality that we are all living in and part of, whether we acknowledge it or not.

I held and cried with mothers who lost their daughters to maternal mental illness. I wept as I heard countless mothers share their near-death experiences as they faced fears of not being able to raise their child.

I related to mothers who felt oppressed by shame, guilt and fear - the lived experience of being trapped in your own head and in the lies that you are not a good mother.

The stories were endless. These are the living realities of so many mothers and families across our nation that unearth the severity of the issues at hand. There is so much at stake, and the magnitude of these problems cannot be ignored any longer.

But there is GOOD news, my friend.

I came away from this experience with a renewed sense of hope to be part of the change that is happening in our country. I felt empowered to use my story and my voice to ignite change. And the good news is that YOU can do the same, too.

If you too have been impacted by a maternal health issue or want to be part of advocacy work for change, be empowered to know that you can also make a difference.

There are several ways we can work together to create change NOW: Individually, in our families, in our communities, and in our country.

If you want to help make a difference for maternal health care, I hope you will consider joining me by advocating in the following ways:

Creating Change in Maternal Health on an Individual Level

So many of us have been directly impacted by a maternal health issue. Our stories need to be told and heard in order to raise awareness of maternal morbidity and mortality and to put faces to the issues that are affecting countless of women and families.

In the same way, when we share our stories with our loved ones, friends, and those around us, we are challenging stigmas and breaking through the shame that often keeps women silent, especially new mothers.

It took me a long time to be able to share my own story and struggle with maternal mental illness, and I understand the courage and bravery that is involved with doing so. In my vulnerability, I found strength.

Through sharing my story, I found healing and validation. I learned that I am not alone. Telling my story gave others permission to also share their struggles and find acceptance and community in something that feels so isolating.

If you want to see a change in maternal health, I would encourage you to start by sharing your story. If you haven’t been impacted personally but know someone who has, ask them about their story. Be a listening ear. Validate the struggle that is all too common among the mothers around us.

Be willing to ask the hard questions and listen:

  • How was your birth experience?

  • How are you coping?

  • How can I help you?

If your story or experience still feels too raw or painful, I would encourage you to connect with professional help and support to process what you have been through.

It’s also important to note that if you’re going to do advocacy work on the behalf of others, it’s necessary to start with yourself and believe that you are worthy and loved. I was reminded of this at the Mom Congress event. We need to believe in, heal and advocate for ourselves if we are going to work on behalf of others.

Rebuilding the Motherhood Village as Community

We need to be intentional about holding space for the mothers in our community. Motherhood was never meant to be done alone, yet mothers are more isolated today than ever before. The village that is required to raise children is gone, and families are suffering because of this.

To create positive change in the way we care for the mothers and children in our society, we need a paradigm shift in community care. Remember that digital media cannot take the place of in person interactions. We need to check up on the mothers in our lives.

If you know a mother, check in on her - ask her how she’s doing and take the time to really listen. Offer a lending hand. Educate yourself on the early warning signs of some of the common maternal health concerns, especially during pregnancy and postpartum. Be an advocate for your loved one at doctor appointments and check-ups. Let’s rebuild our village to help cover the gaps that are missing in our maternal health care system

Maternal Health Advocacy Work Through Legislation Changes

You can help support the advancement of legislation that improves our maternal health care system, even if you don’t like politics. The reality is that maternal health is a non-partisan issue, and WE have to be the voices advocating for change on a legislative level.

Maternal health is a family issue - something that will impact everyone in our nation in one way or another.

Here is what I recently learned about legislation to support maternal health and how WE can help create change in our nation (yes - YOU and me!)

Congress can play a crucial role in passing legislation that can address the many barriers women face in postpartum and prenatal care to help ensure high quality care for every mother in our country. This might include:

  • Quality measures and safety protocols that help identify and treat complications before they become life-threatening

  • Reducing medical errors and improving respectful care through workforce development and provider training on evidenced-based maternity care and implicit bias

  • Improving family’s access to care in underserved areas and communities

  • Improving culturally appropriate prenatal and postpartum support services

There is currently a bill package called the Momnibus that includes bipartisan legislation addressing these 3 main areas as it relates to maternal health:

  • The Maternal Mortality Crisis

  • Maternal Mental Health

  • Paid Family Leave (PFL)

The specific bills that have been introduced to Congress as part of the “Momnibus Package” include the following:

-H.R.1551 - Quality Care for Moms and Babies Act: Improve the quality, health outcomes, and value of maternity care under Medicaid by developing maternity care quality measure and supporting maternity care quality collaboratives.

- S.116 - MOMS Act (Modernizing Obstetric Medicine Standards): Reduce maternal mortality by standardizing the use of best practices and supporting quality improvement initiatives.

- H.R. 1897 / S.916 - MOMMA’s Act: Assist states adopting best practices in maternal mortality review; extend Medicaid coverage to a year following childbirth; expand maternity care quality improvement initiatives; and establish Centers of Excellence for implicit bias and cultural competency education in our health systems.

- S.XXX - MOMMIES ACT: Extend Medicaid coverage to a year following childbirth; pilot Maternity Care Homes, a model that provides coordinated, comprehensive, and culturally appropriate services and care; and asses and recommend strategies to expand Medicaid coverage of doula care.

We need to let our representatives know why this legislation matters and ask for their sponsorship on these bills in order to get them passed.

This is where you and I come in, and you don’t have to go to Washington, D.C. to do this!

You can do this through these simple steps:

  1. Identify the congressmen/women who represent your district and state. You can use this tool to find out what congressional district you are in and which member represents you by searching by your zip code.

  2. Check your representative’s current position on the Momnibus bill package: Once you have found your representative, find out if they are sponsoring the bills that are part of the Momnibus package. To find this information, head over to Congress.Gov, where you can pull up each of the bills above in the search bar on the home page. Once you have found the bill and clicked on it, you can see which representatives currently support the bill under the ‘CoSponsor’ tab.

  3. Ask your representative for their support: If you did not see your representative as a cosponsor of the bills that make up the Momnibus Package, there is a major opportunity for you here. Since these bills have just been introduced, there is a high chance your representative is not yet sponsoring it. By directly sharing your story and asking your representative for their support, you can be part of the change in helping these bills become law. At Mom Congress, we had the opportunity to go directly to our representative’s office in Washington D.C., but you can write a letter, email or place a direct phone call to their office. Here are some ideas that I learned from Mom Congress:

    • Prepare Your Story: The majority of us have been impacted in some way by a Maternal Health issue, whether it relates to pregnancy, postpartum, paid family leave, mental health, etc. Whether something has affected you directly or someone you love, write it out. Some of the question prompts we were given to prepare our stories included things like, “What were the 2-3 things that happened that shouldn’t have or could have led to another path?”,How did those incidents make you feel?”, or, “If you could change one thing from a policy perspective, what would it be?”. Thinking through these questions helped me process my own experiences and determine what I wanted to share with my representative.

    • Pick a Talking Point: There are so many important facts and statistics about maternal health. Sharing some of these with our representatives along with our stories puts real faces and lived experiences behind the numbers that our Congress cannot ignore. For example, since I have been personally affected by Maternal Mental Health issues, I selected statistics on postpartum depression to relay to my representative. Check out the Mom Congress Website for these infographics that break down key statistics that you can print and use to help share with your representative. Find one or two stats that resonates with you and can help you build your talking points, as it relates to your personal story. These facts can be used as a vehicle for sharing your own story.

    • Share Directly With Your Representative: Once you’ve determined what you want to say, communicate this with your representative, either via phone, email or with a letter. Most representatives have local offices in their district, so you can even arrange for an in-person visit, too. Remind your representative that you are a voter in their district when you are asking for their support. Here is some helpful information on how to set up a meeting with your member of congress (if you want to meet in person).

    • Follow-up When Possible: Following up with your representative can be helping in learning the status of their position on the Momnibus Package. If you happened to meet with your representative in person, be sure to follow up with an email to thank them for their time and to recap what you discussed together.

As a brief example, here is what I wrote down in preparation for meeting with my representative in-person. I didn’t memorize this, but it helped me formulate what I wanted to share with my representative in asking for his support on the Momnibus Package:

“My name is Crystal Karges, and I am a voting constituent in your district. Maternal Mental Health disorders have multigenerational consequences and cost the U.S. nearly $15 billion dollars per year. Maternal depression is the most common complication of childbirth and a leading cause of maternal death. I know this first hand because I suffered from postpartum depression after the births of three of my five children. As a mother of 5 and voter in your district, I am asking for your sponsorship and support of the Momnibus Bill Package, which can help address maternal mental health disorders and other critical issues that are directly impacting mothers and families in our city.”

You could use this as a template to create something similar for reaching out to your representative that reflects your individual experience and journey.

I know this seems like a lot of effort, but this is how we can start to create change on a legislative level - for ourselves, our families, and future generations.

Yes, this is going to take some time, research and effort on your part, but your voice and story deserve to be heard! Your story has not been experienced in vain. We can begin to create change when we work collectively in sharing our stories and advocating for change in how women experience maternal health in the United States. Your voice and your story can make a difference and positive impact on so many levels.

If you’re interested in learning more about this but need some extra support and guidance, please don’t hesitate to reach out - I’d be happy to help you however I can from what I learned. In addition, I recommend checking out the amazing advocacy resources offered through Mom Congress, The Blue Dot Project, and 2020 Moms.

I’m excited to also be offering more resources to help support Mothers during these critical times of pregnancy, postpartum, and raising young children - so please stay tuned for more.

In the meantime, remember that YOU matter and your voice deserves to be heard. We can make a difference by advocating for the care that mothers and families in our country need and deserve - as individuals, in our families and communities, and on a legislative level.

Let’s do this together!

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