Rethinking Prenatal Care


Lauren Janney
Principal Strategist, LENS Strategy
Twitter: @LaurenMDJanney


Starting a family in the U.S. is more costly, risky, and isolating than it was a generation ago. The U.S. fares worse in preventing pregnancy-related deaths than most other developed nations. In fact, the increasing rate of maternal death during birth is alarming. Today, we are 50% more likely to die in childbirth than our own mothers were, and the rate of maternal death among black women is three to four times that of their white counterparts.

Why are mortality rates for mothers increasing? Access to prenatal care plays an important role, with women who receive no prenatal care being three to four times more likely to have a pregnancy-related death than those who do receive this care. Approximately 25% of all U.S. women do not receive the recommended number of prenatal visits; this number rises to 32% among African Americans. Even with access to prenatal care, the focus has been on infant mortality rather than the mother’s health. 

"Mom is treated as the wrapper, baby the candy," says Alison Stuebe of the Department of Obstetrics and Gynecology at the University of North Carolina School of Medicine. "And once the candy is out of the wrapper, the wrapper is cast aside." While we are laser focused on infant mortality, mothers are getting sicker, and this leads to higher-risk pregnancies.

This lack of focus on maternal health is not confined to the medical field; it is perpetuated within society too. Mothers commonly put themselves last, which can result in isolation, and this generation is more isolated than the previous one. A significant factor in this isolation is the increasing financial pressure to return to work. 76% of dads go back to work within a week or less after the birth of their child, and during this time, few are "flying solo."

However, women have goals for their labor beyond emerging from it unscathed. According to Neel Shah of Harvard Medical School, "Survival is the floor of what women and families deserve. If we are trying to design a better system, we should be aiming for the ceiling." This notion is catching on in both social and medical contexts. Socially, the March for Moms is a growing movement focused on the wellbeing of mothers and empowering them to share their stories, while the American College of Obstetricians and Gynecologists has released a "committee opinion" on “Optimizing Postpartum Care”, urging mothers to see their providers earlier and more often.

However, this is not a “one size fits all” fix—every community has a different support structure, and every family is faced with different needs. Without community and family engagement, interventions risk falling flat on their face. Women’s health providers play a unique role in meeting the needs of local communities and families to elevate the maternal experience.

To learn more about how we work with providers to engage community stakeholders, contact Lauren Janney at

LENS Strategy is an innovation strategy consultancy that takes a design approach to solving complex challenges related to strategic planning, customer experience, and operational planning.