Maternal Mortality Is Rising in the U.S. Here's How a Pharma Giant Is Funding for Equity

Americans may think that maternal mortality is mainly a problem for less-wealthy countries—places that lack good nutrition, access to safe water, sanitation and supportive health services. But the truth is somewhat different.

According to information from the World Health Organization (WHO) and the CDC, the United States ranks abysmally for maternal mortality among countries of similar wealth, with the severity of the problem following familiar racial and social divides. Data from the CDC shows that pregnancy-related deaths are on the rise in the U.S., with Black, Indigenous and Alaska Native women up to three times more likely to die from pregnancy-related causes than their white counterparts. And a solid 60% of those deaths are driven by community and social determinants.

It doesn’t have to be that way. With the right interventions during pregnancy, delivery and the postpartum period, maternal deaths are almost completely preventable. Merck, the New Jersey-based global pharma giant, has made it its business to help.

First announced at the U.N. in the fall of 2011, Merck for Mothers is a $500 million global initiative working to ensure that no woman has to die giving life. Globally, it focuses on four countries: India, Kenya, Nigeria—and the United States.

Stateside, Merck for Mothers zeroes in on community-based solutions through Safer Childbirth Cities. Investments center on communities with high morbidity and mortality rates, and projects that improve health outcomes while boosting racial equity.

Safer Childbirth Cities stands out for its collaborative approach to achieving its goals, combining the resources and expertise of leading foundations and private sector partners, as well as a lead nonprofit partner for each project.

Recently, the program announced a $10 million investment in a second cohort of nine cities, bringing the two-year project total to 19. Here’s what’s going on.

Nineteen cities

Launched in the fall of 2018, Safer Childbirth Cities announced its first cohort of ten cities a year later, in September 2019. In June 2020, it opened the door to other organizations, issuing a second call for proposals by the end of August.

As 2021 began, it announced a $10 million commitment to nine additional city-based projects across the country. Like the first cohort, each project received up to $1 million in funding spanning two to three years.

The second cohort touches both coasts, from Brooklyn to San Francisco, and three heartland cities: Detroit, Tulsa and St. Louis. There are also four project sites along the Eastern seaboard: Trenton, Washington, D.C., Norfolk and Tampa.

Efforts in those cities join an inaugural cohort of nine projects already underway in Baltimore, Camden, Newark and Philadelphia in the Northeast, Chicago and Columbus in the Midwest, and Atlanta, Jackson and New Orleans in the South.

City-based projects

Each project partners with a lead organization that addresses “locally identified needs and evidence-informed interventions” in each city.

In some places, projects engage doulas and perinatal support professionals to go beyond clinical care and stay the course in the months following childbirth. In St. Louis, Jamaa Birth Village and Generate Health STL are working together to increase Black women’s access to “culturally congruent, holistic” services by building a doula workforce and integrating their care within health and hospital systems.

Other projects focus on access and health literacy. For instance, an investment in the Greater Detroit Health Council and other local collaborators will build on existing community resources to help Black mothers advocate for their health needs and access respectful, equitable care.

Another project, the Tulsa Birth Equity Initiative, is building broad coalitions to improve maternal service delivery, data systems and policies supporting Black, Indigenous and justice-involved women and teens. Most of Tulsa, the second-largest city in Oklahoma, remains part of the Muscogee (Creek) Nation, a federally recognized Native American tribe.

Cross-sector collaborations

Merck approaches the work with open arms. Dr. Mary-Ann Etiebet, lead and executive director of Merck for Mothers, said, “Ending preventable maternal mortality requires a diverse range of collaborators, perspectives and skill sets, united behind a shared mission,” and that the initiative “actively works to attract ‘business as unusual’ collaborators.”

While local needs and context guide projects in each country, “a commonality across both our work in the U.S. and globally is the spirit of collaboration and partnership,” Etiebet said. “We work across sectors including governments, NGOs, patient groups, professional associations, entrepreneurs, U.N. agencies, research institutions, other businesses and even other pharmaceutical companies.”

Co-funders for the inaugural cohort included two New Jersey-based foundations, the Burke Foundation and the Nicholson Foundation, along with the W.K. Kellogg Foundation, which prioritizes maternal health within its Thriving Children initiative, and Foundation CHANEL, the philanthropic arm of the retail and fashion giant.

The second cohort drew two new co-funders: the Tulsa-based George Kaiser Family Foundation, whose maternal health funding strategy centers on giving young children “a strong and healthy beginning in life” by investing in planned pregnancies and healthy birth outcomes, and the Yellow Chair Foundation, the grantmaking vehicle of philanthropist Angela Filo and her husband David Filo, who co-founded Yahoo.

Other partners include RHIA Ventures, a social investment venture to transform women’s reproductive health; the Community Health Acceleration Partnership, or CHAP, a partnership dedicated to energizing the field of community health; and the National Birth Equity Collaborative (NBEC), which works to optimize Black maternal and infant health.

Partnerships are also vital to seeing Safer Childbirth Cities’ vision through. Dr. Etiebet said that the program is built for sustainability, even beyond Merck’s funding. “While we do not currently have specific plans for additional grants at this time, we selected organizations that have comprehensive plans for long-lasting changes and sustainability, as well as the potential to scale the project within the target city or expand to neighboring cities.”

Featured