Pennsylvania ranks among the top 10 states with the lowest maternal mortality rates, according to March of Dimes, a national nonprofit focused on improving the health of mothers and babies.
Yet the nonprofit still only graded Pennsylvania a “C” on its 2025 report card.
Black mothers in Pennsylvania were two times more likely to die a pregnancy-related death than white mothers in 2021, according to the Governor’s office.
And, behavioral health conditions including drug-related overdose deaths and deaths by suicide were the leading cause for pregnancy-related deaths that same year.
Gov. Josh Shapiro’s administration launched the ‘Healthy Moms, Vibrant Futures’ maternal health strategic action plan this spring to improve maternal health outcomes.
The plan, a result of a five-year grant from the federal Health Resources and Services Administration and 16 listening sessions across the state, will focus on reducing maternal mortality and morbidity.
“The Maternal Health Strategic Action Plan is really a collaborative effort, where I am here at Human Services, and we worked with the Department of Health, the Department of Drug and Alcohol Programs and the Department of Insurance, very collaboratively to put together the plan, with a lot of help from a lot of people within each of those four agencies, as well as stakeholders, advocates and a number of other community based organizations that we got involved over time, as well as all the wonderful people with lived expertise who we saw and heard from when we did our 16 listening sessions around the state,” said Sara Goulet, special advisor to the secretary of the Pennsylvania Department of Human Services.
The state of Maternal health in Pennsylvania
Pennsylvania also faces a widening maternity care gap. Twenty-three of the state’s 67 counties do not have a hospital offering labor and delivery services. The Center for Rural Pennsylvania classified all 23 of those counties as rural.
March of Dimes found that 35.2% of live births were paid for by Medicaid in 2024. President Donald Trump’s One Big Beautiful Bill Act makes changes to Medicaid, with work requirements expected to take effect in 2027.
KFF Health News found that over 10 years, federal Medicaid spending is expected to be reduced by $911 billion. The changes are estimated to increase the number of uninsured Americans by 7.5 million by 2034. In rural areas, KFF estimates that federal Medicaid spending will decline by $137 billion. In Pennsylvania, that number is estimated to be around $5.5 billion.
Maternal and Family Health Services participated in the state’s listening sessions ahead of the plan’s launch. The organization’s president and CEO Maria Montoro Edwards sees now as an important time to dedicate resources and research to improving maternal health access and outcomes.
“Having this plan at this time is really going to help us address maternity morbidity and mortality, because so many of those things are preventable, and we're really at a point of intervening early on in a pregnancy, so that we can address those challenges,” Montoro Edwards said.
The plan focuses on five priorities:
1. Improving detection and treatment of behavioral health conditions, including both mental health and substance use disorders
2. Improving coordination and access to care in rural areas and maternity care deserts
3. Increasing access to high-quality care
4. Integrating initiatives to address health-related social needs into health care
5. Expanding and diversifying the maternal health workforce
Perinatal Action Collaborative to implement plan
The plan will be implemented by the Perinatal Action Collaborative, established by the Jewish Healthcare Foundation.
“The perinatal action Collaborative has organized what we refer to as five priority teams that coincide with the five focus areas of the strategic plan. And those teams have created 21 actionable strategies involving over 160 people in the collaborative,” said Carolyn Byrnes, who works as the policy director at the Jewish Healthcare Foundation and the manager of the Perinatal Action Collaborative.
There are currently 14 in-progress projects through the plan, according to a dashboard created by the Perinatal Action Collaborative to track progress.
One statewide investment gave $150,000 to Phia Health, an AI platform that conducts perinatal mental health screenings. The investment will allow partnerships between the software and obstetrics providers to support the behavioral health priority.
Another project will create a doula apprenticeship toolkit, which falls under the diversifying the maternal health workforce priority area.
The Family Health Council of Central PA will receive $32,580 for a project that will provide car seats and car seat safety education to low-income pregnant and postpartum people at eight WIC locations in Central Pennsylvania.
The state wants to continue integrating feedback from residents for years two through five.
“We do want to hear people's voices, and we do want their voices to help us make the changes that are going to make this plan successful and truly make maternal health not a crisis, because it's a crisis now and we need to make that change,” Goulet said.
‘Fourth trimester’ support
The plan’s first priority area is improving detection and treatment of behavioral health conditions. That’s because of the high number of birth-related deaths that happen post-partum.
“As we talk about postpartum care, sometimes referred to as the fourth trimester, that it is part of maternal health,” Byrnes said.
Maternal and Family Health services leads the Northeast Regional Maternal Health Coalition, focused on working with the state to improve outcomes in the region. They know the need for behavioral health resources in maternal health care.
“Postpartum care is what we're focused on at MFHS, and it is one of the main drivers of poor maternal health outcomes, [that] is behavior, health and substance use issues,” said Shannon Hayward, the chief operating officer at Maternal and Family Health Services.
The federal Rural Health Transformation Program awarded Pennsylvania $193 million this year. The state’s application to the Rural Health Transformation Plan includes investments into maternal health as one of its six program initiatives over the next five program years. The state sees an area of opportunity for crossover between its own maternal health strategic action plan and the funds from the federal program, especially when it comes to improving access for rural mothers and families.
“We feel confident that we are all marching in the same direction towards the same goals of access to care, regardless of where you live,” Goulet said.
