
Gov. Wes Moore (D-Md.), Gov. Sarah Huckabee Sanders (R-Ark.) and philanthropist Olivia Walton join Meet the Press for a Common Ground conversation around maternal health.
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Moderator Kristen
Joining me now for a common ground conversation, Republican Governor Sarah Huckabee Sanders of Arkansas, Democratic Governor Wes Moore of Maryland, and philanthropist Olivia Walton, the founder of Healthy Moms, Healthy Babies America. Welcome to all of you, and happy Mother's Day to the moms at the table.
Governor Wes Moore
Happy Mother's Day, you all.
Moderator Kristen
We are honored to have you all here for what we think is really a critical conversation about maternal health. And I know that that is what brings us all together today. Olivia, I want to start with you because you lead organizations that focus on the health of mothers and children. So I want you to really set the stage for us. Some of the statistics are staggering. In the United States, the reported maternal death rate has doubled in just the last 20 years. The CDC says 80% of these deaths are preventable. What more can be done to prevent these deaths? How do we as a society come together to achieve that?
Olivia Walton
It is shocking. But the good news is we really do know how to fix it. So mortality has more than doubled. That means it was more dangerous for me to give birth to my babies, my three in the last eight years, than it was for my mom to give birth to me in the 80s. That's crazy. And it is preventable. As you said, the CDC consistently finds that over every 80% of these deaths could have been prevented if these mothers could have gotten care. So what we're launching is Healthy Moms, Healthy Babies America. We are a nonpartisan national campaign uniting a broad coalition of business leaders of faith leaders of employers, of policymakers and health care providers, with one clear goal, which is to cut the US Maternal mortality rate in half in five years. It sounds audacious, but I'm confident, in large part thanks to the incredible leadership up here at this table, that we really can get this done. At Heartland Forward, we have this program called the Maternal and Child Health center for Policy and Practice. We do research, we have the data, we know what works. And we have examples from blue states, we have examples from red states, we have examples from purple states. Now is the time that we have to actually get serious, to scale it.
Moderator Kristen
All right. Well, it is an audacious goal, but an important goal. And as you say, it's an issue that brings people together from both parties. Governor Moore and Governor Sanders, I want to bring you both in. You've both worked on this issue. You've enhanced funding to maternal health, which has led to more access to doulas, health care, ultrasounds, for example. Governor Sanders, what is the hardest part about making progress in this area and what more needs to be done?
Governor Sarah Huckabee Sanders
I think that one of the hardest parts for us is that Arkansas has consistently ranked at the bottom. And so bringing about the kind of change and awareness that is needed and is a heavy lift. But to Olivia's point, yes, it's a big goal and it's ambitious, but it is achievable because we know the path that we need to take in order to get there. And over the course of the last two years, we've been working closely with Heartland Forward. We used a lot of the data and the research that they put together, and now we're putting it into practice, and we started Healthy Moms, Healthy Babies Arkansas. And we have put $45 million towards addressing maternal health in our state. And last year we have. The CDC said Arkansas was one of only six states where we had an increase in women that were actually going to the doctor, which is a huge part of the problem. We have about 35,000 pregnancies in Arkansas every year. 10,000 of those women are not seeing a doctor until after their first trimester. And over 1100 never see a doctor until they go into labor. If we can see these women and help them and support them from the very beginning of their pregnancy all the way through, then we can help address some of these problems and we can change the maternal health not just in our state but across the country. We're already seeing the positive impact by raising that awareness and opening up a lot of access. We have 75 counties in Arkansas. Every single county has a Arkansas health Unit. And we've started an ad campaign where all women can go and receive services there for free in order to help change the trajectory of our state.
Moderator Kristen
And what you're really laying out is this is a multi prompt effort that involves enhancing information and access to information about the services that are available. Governor Moore, how do you see this issue and what do you see as the biggest challenges?
Governor Wes Moore
You know, I think I really want to both thank and congratulate the work that's happening. And also what it does is it highlights the reality that oftentimes these discrepancies, they are generational, they are concentrated and oftentimes intentional. And so the way we have to address it has to be just as intentional in addressing it in the way that these problems have been created. You know, we said from literally as early as our inauguration day that we are going to have the nation's greatest all out assault on child poverty. And it has to be bipartisan and it has to be something that brings in other sectors. And in fact, we're just now announcing something called the Bridge Project where it is something that's going to focus on providing cash assistance to mothers who are both prenatal and then postnatal mothers to be able to provide cash assistance for them, to be able to have additional measurements of support. It's going to happen for 150 families in the most areas of Maryland that you've had concentrated poverty being a long term challenge. And it's now coming off the heels of additional initiatives that we pull together where we've re established the government's governor's office for children. We've started something called the Enough Initiative, which is actually an acronym that stands for Engaging Neighborhoods, Organizations, Unions, Governments and households, which is the nation's first place based state led anti poverty initiative that we've been able to do things like have postpartum supports for Medicaid recipients for up to 12 months. And so we know that if you want to better help children and address the issue of childhood poverty, it means support their families and support their moms. And so maternal health becomes a huge part of all this.
Moderator Kristen
So let's pause right here because both of you are talking about these new initiatives that you have to really directly address this issue of maternal health. And Governor Moore, you're basically laying out a plan that would give money directly to moms, directly to families. How does it work? How do you fund it?
Governor Wes Moore
So the way it actually starts from both is support from both philanthropy and also we're the state. And the state has to have skin in the game in this because the state is going to Pay more on the back end. That's the thing that people have to realize is that poverty is deeply expensive. It's deeply expensive for the states that end up having to carry, especially when you're looking at neighborhoods that have been dealing with concentrated and generational poverty. Part of the power of the Enough initiative that we have in Maryland, it's about focusing on urban, rural and suburban poverty in places where it exists and where the data shows that this has existed for a long period of time. Because when you look at the heat map that we had in 2024 when we first launched this initiative, the really devastating thing is that the heat map looked exactly the same as it did in 2014 and in 2004. It's the same neighborhoods. The only difference is the red areas have now gotten redder. And so we really said, let's focus on having the solutions come from the community. They come up because they know what challenges are and they know it's going to be different in Hagerstown, which is in Western Maryland, than it is in Cherry Hill, which is in Baltimore City. Let the community come up with the things that need to be done. Let them work in coordination with homes of worship, educational institutions, nonprofit partners, and then we can then provide additional measurements of support, because that's where one of the greatest investments that you can make is investing in young people, because it helps to deal with the long term cost that we deal with having broken adults.
Moderator Kristen
And Governor Sanders, let's delve more deeply into this ad campaign that you say is aimed at educating, making women aware of the fact that these services exist so that they can get early screening if they are pregnant. Who exactly are you aiming to reach? And are you optimistic that you will be able to do so? Because again, we're dealing with some staggering numbers here.
Governor Sarah Huckabee Sanders
Yeah, I think absolutely, we have the ability to reach people. And we're doing a multi pronged approach when it comes to the ad campaign. Everything from television advertisement to billboard advertisement, even just signage at our county health unit so that people know where they are, how to access them. And we want to bring in as many different people. Our target is all women who need prenatal and post natal services to increase our maternal health in the state of Arkansas. And the ad campaign that we're using is very real. It's very raw, and it shows, I think, motherhood in all of its joy and its struggles, you know, that it's not easy. There are days that are really hard. And I think a lot of times women are afraid, frankly, to admit that they're afraid. And so making them feel a little bit more comfortable, helping them step into a space that maybe they're not as confident doing is one of the big goals of what our ad campaign looks like. And we launched it yesterday. We feel confident it's really going to help us raise awareness and open up access to critical care that so many women need.
Moderator Kristen
Well, we're going to track that because I think to your point, it is about educating people. And Olivia, that takes me to my next question, which is to you. You've been very firm that this is not just about pregnancy, that maternal health encompasses family planning all the way through childhood. And you've often said it's not just a moral issue, this is an economic issue as well, which is part of what the governors are talking about. What investments do you think make the biggest impacts and where as a society are we on that scale of making those investments?
Olivia Walton
Investing in maternal health is the single most strategic investment we can make in the future of American prosperity. We like to say healthy moms lead to healthy families. Healthy families to healthy communities. Healthy communities to healthy economies. Yes. This is of course an economic issue and it's hurting our competitiveness, it's hurting our future, it's hurting our birth rate. At Heartland Forward we do economic research. We said it cost maternal mortality and morbidity costs about $165 billion annually. That is nearly 1% of GDP. The average birth in America costs $19,000, obviously the highest in the developed world. And we have the worst outcome. So we're paying the most and we're not getting quality. What I think is so exciting about what you're hearing the governors talk about is that they're finding solutions that work for their priorities and their populations. And that's what we have at Healthy Moms, Healthy Babies America is we have a state led playbook that puts the governors in the position to drive change that works for them. We say what has to change. We try to narrow it into three buckets. But there's lots of ways to get those things done. We've got to fix prenatal care. We've got to start doing postpartum care because we don't really do it in America and we do have to make it good business because this is America and like it for not. It's a for profit healthcare system. And if it's not sustainable, if we're not actually paying for the outcomes we want, it's not going to work. Fixing prenatal care has a lot to do with what they're talking about. They're talking about creating access, creating access to insurance, creating access to more different types of providers, doulas, midwives, family practice, whatever kind of doctor is actually around. More access to telehealth in the postpartum space. As you said, it's a continuum. And I firmly believe this because two thirds of maternal mortality happens after the baby is born, after mom has left the hospital. 40% of moms don't go back for any checkup. 60% of Medicaid moms don't go back for any checkup. The gold standard here is home visits by a nurse within the first two weeks. There are pockets of that happening around the country. Governor Sanders has an incredible solution in Arkansas with a postpartum call center. There are different ways to get this done, and then we've got to make it sustainable in the business lane, which means doing some of the payment reform work and also investing at scale in that whole maternal health workforce. Doulas, nurses, midwives, all the way up.
Moderator Kristen
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Moderator Kristen
Governor Sanders, weigh in on what Olivia is saying, if you would, and how did we get here as a country that we are the United States of America, and yet we have some of the biggest challenges when it comes to maternal health.
Governor Sarah Huckabee Sanders
You know, I think from what we've seen in Arkansas, one of the biggest challenges we had is everything operates in a silo. Everyone is doing everything independently, and none of it is collaborative. No one's talking to each other. And that was one of the biggest challenges that we had from the beginning of pregnancy. And things shift hands of who's responsible for which piece. And you're. You've got a woman who may be going through this for the first time. She doesn't know where to go, who to call, what she needs. And as soon as she figures it out, that changes and it goes to somebody else. And then she's got to find, you know, the next step in the process. And so breaking down the silos, one of the things that we did, and we took a lot of the data and the research, we brought stakeholders from all over our state and asked them to come together, be part of a strategic task force, which generally, I do not like those because I think that it's just a name that you put on something to feel better, but then nothing actually happens. But honestly, I was pleasantly shocked by how many people showed up and wanted to participate and wanted to be part of a solution. People that I know actively campaigned against me or were one of the. And some of the most helpful people in developing our strategic plan on how we were going to address this problem in Arkansas. It is something that breaks down a lot of walls. Everybody knows a mom, everybody has a mom. Everybody has somebody in their life who is going through this or will go through this process. And so getting rid of some of those barriers, opening up conversation, I think that was one of the biggest challenges
Olivia Walton
we had on the.
Governor Sarah Huckabee Sanders
The front end. But it's also been one of the reasons I think we're going to be successful. We broke those walls down, and we have so many different partners that have come together, and that is something we have never seen in this space. And I think it's one of the reasons we'll be successful long term.
Governor Wes Moore
And I think this is also why representation does matter, because oftentimes the policies were being made by people who did not have a lived experience. And so these policies were being made that did not keep in mind what is happening when it comes to either prenatal supports or think about postpartum supports. And so we think it's incredibly important that these policies are being made by people who actually can understand the implications of the policies. You know, when we started doing our work around, you know, everything from the bridge project and thinking about what does it mean to give cash assistance to families, it was actually mothers who were helping to design it because they could say we were going to use it towards things like doula supports. We would use it toward things like, you know, being able to provide groceries for our families. So actually being able to have people who are closest to the ground as the ones who are the architects of the policy is actually one of the most effective ways you can make sure that the policy actually does what it's intended to do.
Moderator Kristen
Yeah. And that takes me to the next section of this conversation. We have to talk about black maternal health, Black women in the United States. Olivia, again, I mean, you talk about the statistics. There are three times more likely to die from pregnancy related causes than white women. This impacts Republicans, it impacts Democrats, it impacts non voters, independents, everyone. What solutions do you think exist to address this crisis in black maternal health?
Olivia Walton
Well, a lot of it is about visibility. So first of all, awareness of the problem is lowest, where outcomes are the worst. So talking about it, having leaders of color actually going out there, leaders who have proximity to these issues, getting on board goes a long way. There are a lot of states that have chosen diversity, equity and inclusion policies, such as New Jersey, such as California, that are very effective. They're not right for every state in America. But that doesn't mean that we can't make enormous progress on these issues. In some states, the disparities are even worse. I've seen really effective things in bias training for health care providers. And then I also go back to the use of doulas. I mean, there is clear statistical evidence that the use of doulas, particularly in minority populations, can be extremely effective in lowering C sections rates and lowering postpartum rates and just really creating a more positive experience of birth where there's more trust, where you can really have a relationship with somebody that's part of your birth and the birth of your child, rather than a health care system you're less familiar with.
Moderator Kristen
Governor Moore, what are you doing to address this staggering surge in black maternal deaths due to pregnancy?
Governor Wes Moore
I mean, and then this is also, it's a very personal issue, you know, for us, where, you know, I watched my father die in front of me when I was three years old because he didn't get the health care that he needed. You know, we know that this is both about how are we, you know, really focusing on bias training, understanding that when people are coming in with, with specific needs, that there is an implicit bias that oftentimes does happen. And so we need to make sure that our physicians and our nurses are trained up. But also what we've got to do is we've got to strengthen the pipeline to get more physicians and nurses of color who are actually in there to increase the probability that when a person comes in, they're going to have someone who's going to be treating them and supporting them, who looks like them, who represents them. It's the same thing about how we talk about the importance of doing this in classrooms. Why in Maryland, we've had such a strong focus of getting more male teachers inside of classrooms and more males of color inside of classrooms. We also need to make sure we're seeing the same type of thing with more physicians, more physicians and nurses of color, more black and Latino women inside of the profession as well. Because as people are going in, they want to know that they are being seen, and not just being seen like we'll see you now, but being seen when they are going in. And in some cases in some of the most traumatic moments of their lives, they just simply want to know and have a real feeling that everything that they are saying is going to be taken seriously and is going to be moved with a sense of urgency. And so we do think that type of training and those type of pipelines are crucial in this conversation about being able to deal with the black maternal health challenge that we have within this country.
Moderator Kristen
Governor Sanders, how do you see it?
Governor Sarah Huckabee Sanders
You know, I think one of the points Olivia made was the coverage of doulas and community workers and having somebody that helps support throughout the process. That's been one of the things that we opened up coverage for. But I think one of the big pieces that so often gets left out of the conversation, especially when it comes to government, is the faith community. And this is a place where there is an implication, trust, and there's a relationship that already exists. So one of the things that we've done is really engage the nonprofit in the faith community to be part of our program. I started something called the 1033 Initiative. There are a lot of people who are pushing this kind of one door policy so that you go to one place and get all the government services. We've kind of taken a different approach in Arkansas, for us, we say no wrong door, no matter where you show up. To us. Our system, we have a technology platform that is integrated. So if you come and you're looking for maternal care. No matter where you show up on our doorstep, we have connectivity to our nonprofit world, to our faith community, so that we can help provide those services. If you come looking for food assistance, you're getting connected. Most of the time when somebody shows up and they need help, they need wraparound services. They don't need one thing, they need a lot of things. And our goal is not to trap people on a government system, but it's to help build them up, move them from a moment of crisis to a moment where they are fully independent and they are able to stand on their own two feet. So providing these type of wraparound services through what we've called the 1033 Initiative, helping integrate all the different pieces, whether it's a government service, whether it's the faith community, whether it's a nonprofit, whether it's the private sector, bringing all of those things together, breaking down those silos and helping really lift people up, not push them down. And I think that is the best, best way long term, no matter what your demographics are, that helps everybody. And that's ultimately what we're looking to do in Arkansas.
Olivia Walton
And Kristen, if I may just pick up, I think both of the governors are making an excellent point about trust. And in many of the minority population, there's a real lack of trust in the public health systems. And so Governor Sanders is talking about using faith communities, who we're certainly reaching out to. And Governor Moore is talking about the importance of training providers, black and brown providers, who are the providers. And so both of those are very important. We have a system built around going to see an OB who may live very far away. We have to think about the providers who are already in your community, who do you already know and trust. And so in Arkansas, we have a community health care worker in every single county. We don't have an OB in every county. But guess what, America, we're not going to every OB in every county. We need to think about team based care, where you are getting some care by seeing a family practice doctor who's been trained up, by seeing a nurse who lives nearby. And then you can get referred up that ladder if you need to be. But we are not going back to an OB in every county.
Moderator Kristen
Well, it's a fascinating part of this conversation. I do want to discuss another piece of the women's health discussion, which is Roe v. Wade being overturned in 2022. Abortion access has really broken down along state lines. Of course, Arkansas has a near total ban on abortion Maryland has full access to abortion. And is this state by state approach working? Governor Sanders?
Governor Sarah Huckabee Sanders
I'm a firm believer. I'm unapologetically pro life. I think that we have to protect life at every stage, at every level, and that includes in the womb. And I think this conversation proves and shows that we are a culture that values life. If we ever lose that, I think we lose the very essence of what makes America so incredible is we are people who support one another and we protect life whether it is in the womb to its natural conclusion. I'm proud that Arkansas is one of the most pro life states in the country. I want to continue to elevate that, but I don't think so often we stop the conversation after the baby is born. And I think that it can't just be if we're pro life, we have to be whole life. That's why in Arkansas, we have focused so heavily on our foster and adoption programs, so that we're not just stopping at nine months, we're carrying on and supporting that child from the moment that they are conceived until natural. Conclusion. I think that has to be a huge part of the conversation. It's something that I'm proud we've made significant progress on. For the first time in our state history, we have the lowest number of kids that are waiting for a forever home. We have less than 150 kids waiting on that permanent home because we have really leaned into those foster and adoption programs. We focused on education, making sure that every child in our state has access to the education they need and they deserve, setting them up for a lifetime of success, not pushing them down. I will continue to look for every opportunity I can to value life, to promote it, to protect it. And I'm proud Arkansas is leading the way on that front.
Moderator Kristen
Governor Moore, do you think the state by state approach is working? What's your take?
Governor Wes Moore
Yeah, you know, I completely agree that, you know, the focus on everything from foster care and the focus on education and focus on, you know, making sure in our state we made the largest investments in childcare in our state's history. I agree of all of that. I do respectfully disagree on the Roe v. Wade decision. You know, I think this was something that was law of the land literally for decades. That was about, you know, how are we making sure that women have a choice and how we're making sure that women are the ones who are the driving deciders as to what happens with their health care. And so that is why when I became the governor of Maryland, we actually now have it placed in Maryland's constitution that reproductive health care is protected inside of the state of Maryland. And it is something that we believe in, that this should be a decision, that all these decisions about women's health care should be between them and their doctor and their God, and that politicians like myself should not be, you know, should not be intervening in that. So we really believe. How can you come up with the best measurements of supports for our mothers? How can you come up with the best measurements of support for kids? And to that point, what does it mean to make sure that you're making all the proper investments to be able to make sure that a child's decisions, you know, that they are the ones who have the autonomy over their long term growth and development inside our society, and that women are the ones who are also helping to make the decisions about their own bodies.
Moderator Kristen
Well, I do want to talk about the fact that for all of you, this is personal because as you've all alluded to, you are all parents. This is an issue you all care very deeply about. And I'm just curious how that experience of being parents has changed, has impacted how you see maternal health. Governor Sanders, why don't you start it off?
Governor Sarah Huckabee Sanders
Certainly being a mom, I think, influences everything I do. I firmly believe I'm a better governor because I'm a parent. Every decision I make, I know will have a direct impact on the life of my kids as well as every kid growing up in my state. That's not something I take lightly. And it's frankly, it's one of the reasons I ran. I love Arkansas and I want my kids and every kid growing up in our state to have the opportunity to live the best life that they can. And I want them to be able to, to do it in Arkansas. I'm proud that we've made tremendous strides in supporting our kids and creating a better environment for them to grow up in. And I am living a lot of the decisions, as are you. I mean, we were talking just before. Our kids are the same age. So when we're, you know, working on getting phones out of the classrooms, we're fighting that at home, too. When we're working on, you know, trying to do certain things, we're living that in real time. And so it has given me such a great perspective. It's also a very humbling experience. I joke that you think the legislature is tough and then you have teenagers. It's nothing, no comparison. I love the opportunity and the privilege I get of being a mom. I think it is the Greatest title that I will ever have, no matter what I do in life. But I think it's also one of the most challenging and one of the, you know, the environment is changing constantly and despite the fact I love it, I'm so honored I get to do it. Doesn't mean it's easy. And so the more that we can help other people as they go through that process, as we support them, the better our states are going to be, the better our country is going to be. To Olivia's point, strong families help everybody. And so the more that we can invest in supporting our families, the better our country's going to be.
Moderator Kristen
Governor Moore, how has being a dad impacted how you see this critical issue of maternal health?
Governor Wes Moore
You know, it's being a dad has impacted everything about my life. It's given a sense of perspective. But, you know, especially when it comes to maternal health, it's also reminding me of the importance of making sure that we have representative voices in there. You know, I think about it in context of my own mom, right, who's an immigrant, single mom, who is an angel. There are also just certain nuances of being a man that she couldn't teach me because she didn't know it, right? So I had to learn it from other people. I think the same thing with my daughter, who I love with all of my heart, my 14 year old daughter. And there is nothing that I won't do for her. I also know that there are certain nuances of being a woman that I can't teach her. I don't know it. So she's going to need her mom and her grandmothers and her friends and her aunts to be able to help her on that journey, right? Because I can go but so far on that journey with her. And I think that's why, and that's part of the takeaway from the policy making conversation where there is so much that we can do. But if we're not making sure that impacted communities aren't just the subject of the conversation, but are actively part of the conversation, we're going to miss things. And that's why I think, especially on this conversation about how do we end child poverty and country, how do we make sure that these maternal health disparities are addressed, how are we making sure that mothers are getting everything that they need? If it's just a bunch of folks like me who are having that debate and having that conversation, we're going to miss it. And I think we're going to end up continuing to have these type of disparities that our society should be honestly losing sleep over.
Moderator Kristen
Olivia, I'm going to give you the final word. How has being a mom impacted and informed your passion for addressing this issue of maternal health?
Olivia Walton
So our kids are 8, 5, and 3. I'm thrilled to say we're sleeping through the night now. It's a little more fresh. And I have so much privilege, right? I am healthy. Thank goodness. I have resources. I have family. And it was still so hard. And just seeing, particularly in that postpartum period, how much help I needed. And there was no, you know, the standard of care in America is come back in six weeks, three days in, you're like, how am I supposed to be doing this? I don't know how to feed the baby. You know, you need help sooner. And if it weren't for some incredible friends, I'm so fortunate that my governor Sanders knows my in laws. They are the nicest, best grandparents in the world. They play such a huge role. But just seeing how much help I needed when I had all that privilege was just a rude awakening in how hard this is for millions of Americans who. Who we really count on to raise the next generation of Americans.
Moderator Kristen
Well, this conversation has been a Mother's Day gift to everyone. Thank you. Thank you for being here. It has been informative and so impactful. Really appreciate it.
Governor Sarah Huckabee Sanders
Thank you for having us.
Governor Wes Moore
Happy Mother's Day.
Moderator Kristen
Happy Mother's Day.
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Host: Kristen Welker (NBC News)
Guests:
This episode brings together Republican Governor Sarah Huckabee Sanders, Democratic Governor Wes Moore, and philanthropist Olivia Walton for an in-depth discussion on America's escalating maternal health crisis. The conversation centers on why the U.S. maternal mortality rate has increased, what bipartisan and state-based solutions are being tested, and what more can be done at every level of society. The speakers also candidly discuss black maternal health, the economic impact of maternal mortality, and the personal stakes for them as parents.
Alarming Trends:
Core Initiative:
Context:
Interventions & Progress:
Addressing Generational, Systemic Disparities:
Key Programs:
Scale of the Problem:
Health & Prosperity Link:
Investment Approaches:
Collaboration Over Isolation:
Faith and Community Involvement:
“No Wrong Door” Policy:
Stark Reality:
Proposed Solutions:
Olivia Walton:
Gov. Wes Moore:
Gov. Sarah Huckabee Sanders: