Enhancing Consumer Awareness Improves Access to Risk-Appropriate Care

May 28, 2024 | Lexa Giragosian

Risk-appropriate care (RAC) is a strategy to ensure that pregnant women and infants with high risk of complications receive care at facilities with personnel and services that can provide the required level of specialized care. States can utilize the process of perinatal regionalization to create coordinated care systems based on levels of maternal care (LoMC) to support RAC access. Implementing and strengthening maternal RAC systems as well as enhancing consumer awareness can improve health outcomes for pregnant and birthing populations and reduce the incidence of severe maternal morbidity and mortality.

Maternal Mortality in the United States

The U.S. maternal mortality rate nearly doubled between 2018 and 2021, with the starkest increases occurring among American Indian/Alaska Native and Black populations. Among other high-income nations, the United States has one of the highest maternal mortality rates and is continually increasing. According to the Maternal Mortality Review Committee's most recent data, over 80% of pregnancy-related deaths are preventable, and barriers such as low consumer awareness can inhibit the prevention of pregnancy-related deaths.

The Importance of Consumer Awareness

Consumer awareness refers to patient’s knowledge, attitudes, and awareness about their health. There is a gap in understanding among pregnant and non-pregnant women of the major health risks associated with pregnancy or what can pose a risk during pregnancy. There are also challenges surrounding consumer awareness of what levels of maternal care are, and which level is right for everyone. More specifically, there is a common misconception that higher levels are always the safest level to receive care. A lack of consumer awareness is associated with poor health outcomes and can create gaps in access to RAC.

Providers have an important role in improving consumer awareness by educating their patients about their pregnancy risk factors and levels of maternal care, while also having adequate awareness about levels of maternal care themselves. Provider awareness about levels of maternal care can promote RAC accessibility since providers are often the main point of contact for pregnant women and are responsible for ensuring the patient receives care at the appropriate level.

State Success Strategies

1. Support and work with communities to build capacity for addressing consumer awareness.
   • Promote community organizations’ ability to improve pregnant women’s understanding and usage of health information (literacy, language instruction, social support, etc.) to enhance consumer awareness and corresponding health outcomes. Specifically, supporting women of color-led community organizations will foster equitable consumer awareness.
   • Implement and support policies that make doulas and community health workers more accessible within communities.
2. Develop and disburse public health campaigns about maternal health.
   • Utilize effective health communication techniques rooted in health equity.
     • CDC’s Hear Her Campaign is an effective public health campaign that increases awareness of pregnancy complications and warning signs, empowers pregnant people to raise their concerns to their provider, encourages support systems to listen to pregnant people’s concerns, and provides the tools needed to foster communication between providers and patients.
   • Ensure that health education materials are accessible and consider the social factors affecting the priority population.
     • Inclusive and preferred language in educational materials should be applied and understandable, actionable, and culturally sensitive.
3. Form partnerships with providers, hospitals, foundations, and professional associations to take a collaborative approach toward improving consumer awareness.
   • Create resources with these relevant partners to inform patients about how to choose a provider and a hospital based on the level of care their pregnancy risks indicate.
     • The National Accreta Foundation has a myriad of resources to help patients navigate the care process and ensure their access to RAC.
   • Utilize partnerships with key stakeholders to disseminate materials in prenatal care settings such as provider offices or hospitals that outline RAC and the care coordination system in place at that location.
     • Ensure that transferred/referred patients are receiving materials about the reason for their transfer/referral and about the new level of care they are entering.