Maternal Health Outcomes & Children’s Mental Health

Maternal Health Outcomes

Learn more about maternal health trends and new strategies to improve care and outcomes. 

• Maternal Mortality: After peaking in 2021, the US maternal mortality rate has continued to decline, reaching its lowest rate since 2018, according to new data from the Centers for Disease Control and Prevention. While this trend is encouraging, the US still has one of the highest maternal mortality rates among developed nations, and racial and ethnic disparities remain. Black women experience a maternal mortality rate more than three times higher than that of white women and Asian women – 44.8 maternal deaths per 100,000 live births, compared to 18.1 for Asian women, 14.2 for white women, and 12.1 for Hispanic women.
• Changing Fertility Landscape: Fertility rates continued to decline in 2025, dropping to 53.1 births per 1,000 females aged 15 – 44, down from 53.8 in 2024. This decline might be driven by slowing teen fertility rates, which have dropped by 72% since 2007. This data may also reflect a growing trend that women are delaying pregnancy until later in adulthood.
• Black Maternal Health Week: This week marks the 10-year anniversary of Black Maternal Health Week, started by the Black Mamas Matter Alliance as a way to amplify the voices of Black birthing people and address Black maternal inequities. This year’s theme aims to recognize and celebrate the Black-led organizations driving change in perinatal, maternal, and reproductive health.
• Maternal Health Workforce: A new research review in The Milbank Quarterly found that care from certified nurse-midwives and midwives was associated with similar or improved care outcomes compared to physician care, including fewer interventions, improved neonatal health, and reduced costs. NBC News also examined research that doulas improve health outcomes, and how coverage for doula services has expanded among both Medicaid recipients and privately insured patients.
• Pregnancy & Acetaminophen Use: A new analysis published in The Lancet found that acetaminophen prescriptions for pregnant women in US emergency rooms dropped by 10% after a White House briefing in which President Trump stated the drug could cause autism. In contrast, prescriptions for non-pregnant women in emergency rooms did not change during the same period.

Resources & Initiatives

• In response to Florida’s maternal health crisis, including high rates of preterm birth and infant mortality, the Florida Blue Foundation is investing $3.5 million to expand access to doula care, in-home visits, mental health services, and chronic condition support for mothers and families statewide.
• BlueCross BlueShield of South Carolina provides information on what to know about health insurance during pregnancy, including access to their maternity coaching program that helps members with postpartum depression screenings, gestational diabetes, and more.
• To address Arkansas’ high maternal mortality rate — particularly in the postpartum period — the Blue & You Foundation for a Healthier Arkansas has awarded grants to three groups that provide doula services.
• KFF maintains an up-to-date dashboard that tracks state actions to implement extended Medicaid postpartum coverage. The Medicaid program covers about 4 in 10 births in the US.
• The National Academy of State Health Policy takes a closer look at state efforts to improve maternal and child health through the Rural Health Transformation Program.
• The Chicago Family Health Center has launched InovCares, a new virtual and culturally sensitive program that supports women’s physical and mental health throughout the motherhood journey, funded by a Blue Cross and Blue Shield of Illinois Special Beginnings grant.
• The University of Pennsylvania recently summarized research around postpartum care and efforts to reduce maternal mortality rates during the postpartum period.
• Read an exclusive interview with Dr. Meredith Matone as she examines her recent NIHCM-funded research on persistent opioid use during the postpartum period. 

• NIHCM Health Care Journalism and Policy Research Award Finalists: NIHCM announced the finalists for the 32nd Annual NIHCM Awards, recognizing excellence in health care journalism and policy research. The finalists this year produced critical insights on the drivers of health care costs, access, and quality. Winners will be announced in late April 2026.
• NIHCM Policy Research Grant Applications: NIHCM is now accepting letters of inquiry for the 2026 – 2027 funding cycle of the Investigator-Initiated Policy Research Grant program. Learn more and apply by June 8, 2026.
• NIHCM Youth Mental Health Webinar: NIHCM's upcoming webinar will examine youth mental health in the United States, efforts to support young people’s mental well-being, the impact of digital technology, and strategies for navigating technology to promote healthy development. Register today for the April 23, 2026 webinar.

Children’s Health & Behavioral Health

Read the latest on children’s health, including new federal efforts, and behavioral health trends and initiatives. 

• New CMS Effort: The Centers for Medicare and Medicaid Services (CMS) recently announced a new program for children with complex medical conditions. The ASPIRE Model (Accelerating State Pediatric Innovation Readiness and Effectiveness) aims to support whole-person care delivery for children up to age 21 who are enrolled in Medicaid and the Children’s Health Insurance Program who either have or are at risk of developing complex medical and/or behavioral health conditions.
• Fluoride Costs: A new analysis found that if five states — Florida, Kentucky, Louisiana, Missouri, and Oklahoma — stop fluoridating drinking water, Medicaid costs tied to increased childhood cavities could exceed $40 million within three years. The study used Medicaid claims data and survey responses to model impacts across the five states. It was conducted by CareQuest Institute for Oral Health, a nonprofit that advocates for fluoridation and aims to advance equitable oral health through research, policy, advocacy, and partnerships across the health care system, as well as federal and state governments.
• Pediatric Sepsis Rates: A new study, published in JAMA, identified sepsis in 1.3% of hospitalized US children ages one month to 17 years old, and found that 18% of deaths in hospitalized children were related to sepsis. Children with sepsis also had longer average hospital stays, often required intensive unit care, and were frequently discharged to post-acute care.
• Child Nicotine Exposure: A retrospective study offers insights on trends in nicotine exposure for children under 6 years old between 2016 – 2023. While traditional tobacco product exposure has decreased, e-cigarette exposure has gone up by nearly 243%. While ingestion is still the predominant method of exposure, inhalation-based exposure has also increased, suggesting that children are beginning to activate the devices themselves.
• Social Media & Youth Well-Being: The latest World Happiness Report included a focus on social media’s impact on well-being. While happiness has increased in general for young people around the world, some countries, including the US, saw a decline. Researchers suggest that social media may play a role, noting that youth who use it for more than five hours a day report lower well-being. A California jury recently found Meta and Google liable for negligence for designing addictive apps that contributed to a teen’s depression and anxiety.
• AI & Child Development: New reporting by Undark Media explores the rise of low-quality, AI-generated children’s video content, and highlights concerns from child development experts on potential safety risks, physical harm, and impacts on speech and cognitive development.

Resources & Initiatives

• In North Carolina, the statewide network for the Children and Families Specialty Plan (CFSP) is expanding to include additional providers and services. The CFSP is a first-of-its-kind, statewide NC Medicaid Managed Care plan that delivers integrated and coordinated medical and mental health care to enrolled children, youth, and young adults who are currently or formerly involved in the foster care system. The plan is managed by Blue Cross NC.
• Texas Children’s Hospital, with support from a Blue Cross and Blue Shield of Texas grant, is providing mental health services to uninsured and underinsured children through a mental health mobile clinic that travels to community centers and libraries around Houston.
• Native youth living on reservations have an increased risk for suicidal ideation and suicide attempts. Learn about how the Lummi Nation is responding by combining crisis intervention with cultural reconnection, and using youth council programs to give young people a voice.
• The American Academy of Pediatrics’ Center of Excellence on Social Media and Youth Mental Health is hosting a virtual youth forum on April 18. The interactive event aims to empower teens to navigate the digital world safely and with confidence.
• The National Alliance for Mental Health provides mental health resources and support for children, teens, young adults, and parents.

The National Suicide and Crisis Lifeline provides support 24/7. Call or text 988.

Exclusive Interview on Hospital Adoption and Pricing of Cancer Biosimilars

Biologic cancer drugs are among the most expensive treatments and make up a growing share of oncology spending. As patents for these drugs expire, lower-cost biosimilar options create opportunities for increased drug competition and reduced drug spending. A NIHCM-funded study, conducted by James Robinson, PhD, Ari Kosorukov, and Christopher Whaley, PhD, found that biosimilar adoption increased over time. While hospital acquisition prices of oncology biosimilars declined, reimbursement prices did not drop as rapidly, leading to increased hospital margins, up to fivefold in some cases. 

Learn more about this recent JAMA publication and the implications of its findings in this exclusive interview with James Robinson.

Q: What surprised you most about your findings regarding pricing and biosimilar adoption? 
A: The rapid adoption of biosimilars for physician-administered cancer biologics contrasts with the slow adoption of patient-administered biosimilars and is an optimistic note for health care cost moderation. At first glance, this finding is unexpected because these infused products pass through the 'buy and bill' distribution system, where hospitals purchase the product at one price from the distributors and then are reimbursed by the insurers (in our case, the Blue Cross and Blue Shield health plans) at a higher price, retaining the price markup as margin. This 'buy and bill' method of distribution would seem to favor use of expensive biologics over less expensive biosimilars, but the opposite result occurred. Our study found that hospital price markups grew markedly over the five years of the study (2020-24), especially for biosimilars, giving hospitals the financial incentive to switch from the biologics to the biosimilars. And, guess what, they followed their incentives and switched.

Q: What are the key takeaways for policymakers and health care leaders interested in drug access and increasing affordability?
A: There is a considerable potential for price competition in the pharmaceutical sector, with generics, biosimilars, and therapeutically equivalent brands seeking to gain share from the established products. But potential price competition only translates in actual price competition, and thence to savings, if the purchasers have the capabilities and the incentives to adopt the least costly alternatives. In the complex world of infused biologics and biosimilars, both the hospitals and the insurers function as purchasers. They have considerable leverage, if they learn how to use it.

This analysis is supported by a NIHCM Policy Research Grant.