Wisconsin Works to Expand Medicaid for Maternal Health

By Karen Stokes

Maternal health involves maintaining women’s well-being throughout pregnancy, childbirth, and the postnatal period, with the goal of fostering positive experiences and optimal health for both mother and baby. There are several stories highlighting challenges women are facing with maternal health.

Eighteen years ago, Kara Boeldt, founder and executive director of Endpreeclampsia.org, experienced an unexpected development during her pregnancy, Preeclampsia.

“I developed preeclampsia at 31 weeks and had to deliver in an emergency. It was unexpected. There weren’t any symptoms leading up to it,” she said. “I delivered within 36 hours of walking into the hospital and delivered a 2 pound baby daughter and I felt just really profoundly lonely after that experience because no one else I knew ever experienced such a thing.”

Preeclampsia is a disorder that only occurs in pregnancy starting as early as the 20th week; it’s characterized by high blood pressure, or a new development of some other organ dysfunction such as, kidneys under excessive strain, elevated liver enzymes, and cerebral edema.

“No one I knew, knew anyone that had a similar experience. You’re left to wonder what I did wrong, what really happened and could it have been prevented,” Boeldt said. “I went searching for information, and I did find some other people on the internet and with them they were searching for the same thing and we started doing some volunteering. We started research partnering with science types to help explain the research, talking to physicians and trying to understand what had happened. With that there’s sort of a sisterhood that is created when you bond with people who have had similar traumatic experiences.”

Endpreeclampsia.org now has 40,000 members worldwide. Their mission is to provide women and families with compassion, support, evidence-based information, and tools to advocate for themselves and others.

To find information about Preeclampsia, go to info@endpreeclampsia.org

“The population of women who develop preeclampsia have a higher percentage of postpartum anxiety, post traumatic stress disorder and, postpartum depression” Boeldt explained.

Postpartum depression (PPD), a medical condition occurring after childbirth, involves persistent feelings of sadness, anxiety, and fatigue. These emotions, lasting for an extended period, can pose challenges in self-care and caring for the baby, and may arise at any point after giving birth.

Dr. Elizabeth Breuer, OB-GYN at Ascension Wisconsin explained that, “Signs and symptoms of PPD can vary, we usually screen patients at their postpartum visits with the Edinburgh postpartum depression screening which can screen for both PPD and anxiety. Often systems can be a little more subtle in postpartum patients. They can show up as signs of sleeplessness, nervous or anxious, feeling guilty, decrease enjoyment, more tearful, when symptoms become more severe, patients can show signs of suicidal thoughts.”

An estimated 1 in 5 women experience crippling sadness during what is usually cast as one of “the happiest and most rewarding” times of their lives.

“Some studies suggest that PPD can persist up to one to two years postpartum,” Dr. Breuer said.

According to the American Heart Association, after pregnancy, we should expand access to quality postpartum care, including care for heart health. We all want babies to have the best possible start in life.

Ensuring the expectant parent has access to care during pregnancy and for the first year after giving birth is essential for providing a healthy and successful start.

The American Heart Association in 2023-24 is working toward getting legislation approved that would extend Medicaid coverage for new moms from the current 60 days to a full year. Wisconsin is one of just 5 states in the country without this full year of coverage.

Earlier this year, the Wisconsin Senate approved the bill on a 32-1 vote that would extend this coverage. The bill now awaits Wisconsin Assembly approval; no timeline for a potential vote from the Assembly has been established.

Extending Medicaid coverage from 60 days to 12 months following birth is important to addressing health issues that are discovered during pregnancy or resulting from pregnancy.

“One of the beautiful things about pregnancy it’s often a time when a woman is hopefully being able to be seen more frequently and have access with the healthcare system and potentially have outreach for other things that are going on in their lives that’s why this expansion for Medicaid would be wonderful as it would give women and their infants an opportunity to not only be treated during pregnancy but also a year out after they deliver,” Dr. Breuer said.

Extension of care is especially important for birthing parents who experience complications or conditions such as high blood pressure or diabetes. A lack in care for these conditions is a lack in support to care for the new child, according to the American Heart Association.

To learn more about maternal care visit, heart.org