(The Center Square) — According to a report released this week, 25.9% of pregnant women in Louisiana in 2023 did not receive the recommended prenatal care in their first trimester — an increase from a 2018 evaluation that showed 22.5%.
The Louisiana Legislative Auditor’s Office conducted an audit, finding that many women were beneficiaries receiving Medicaid in the state.
The fight for maternal care is an ongoing issue within Louisiana as it continues to rank high in maternal deaths and low in maternal care access.
One possible reason for the increase in women not receiving care is the lack of obstetrics/genecology care in some areas of the state. Louisiana has a significantly high percentage of residents who receive Medicaid — nearly 44% or two million people, according to recent studies.
Dr. Rebekah Gee, the former Secretary of the Louisiana Department of Health, spoke to CBS previously about the importance of maternal health care access, especially in the South.
“We have to prioritize motherhood. Right? As a country, we have, and particularly in the Deep South, said that we’re pro-birth. If we’re really going to be pro-birth, we need to be pro-motherhood and pro-family. Right?” Gee said.
Out of 64 parishes, 24 of them had no OB/GYNs who provided Medicaid maternal services as of December 2023. The audit notes this could be due to the lack of reimbursements for providers. Compared to private insurance, Medicaid provider reimbursement is significantly lower, which ultimately deters them from offering the services.
March of Dimes found that 26.6% of parishes in Louisiana are “maternal health deserts,” lacking an OB/GYN. According to the report, 12.1% of Louisiana women have no birthing hospital within a 30-minute drive.
Findings show that North Louisiana has a significantly higher “maternal health desert” location rate with a majority of the northern part of the state having little or no access at all.
The lack of Louisiana women not receiving care while pregnant is concerning as Louisiana’s maternal mortality rate continues to increase. A 2020 study shows that 94% of pregnancy-related deaths were preventable. Out of the 54,927 Louisiana women who gave birth in 2023, 34,871 of them were insured through Medicaid.
The issue arose as the LLA conducted its review that the managed care organizations are not submitting case management assessments on time, which is a requirement outlined in their contract. Violations were not given for this short-falling either.
According to the audit, a 30-week pregnant beneficiary filed a complaint claiming she missing multiple prenatal appointments after transportation she scheduled did not pick her up. This is a service managed care organizations must provide. Her OB/GYN said they would stop seeing her because of the missed appointments.
Ultimately, there is a lack of OB/GYN care in rural areas of the state, and areas with adequate care don’t seem to be getting the benefits that are outlined in their Medicaid policies.
The LLA noted a few things that would significantly improve access to prenatal care in rural areas and those pregnant receiving Medicaid, including increasing access to midwives, providing remote monitoring, group prenatal care, perinatal mental health screenings, and home visits.
