What To Expect Project
Healthy Pregnancies. Safe Deliveries
Healthy Babies.  Healthy Futures


Thank you Senators Murray, Stabenow, Gillenbrand, Hirono, and Klobachar –my fellow moms and fellow advocates of all our moms and babies. And Happy Mother’s Day to all of you – and all moms, moms-to-be, and hopeful moms, as well as all who love them.


Becoming a mom, as any of us who’ve made the incredible journey know, is one of life’s most awesome experiences. Intensely joyful, often challenging, completely transformative.


And, without the proper health care – it can also be unnecessarily dangerous for mother and baby, resulting in costly and sometimes devastating complications, from gestational diabetes and preeclampsia to stillbirth and preterm delivery, even maternal death – always notably higher in states where prenatal care is harder for moms to find and afford, thanks….or no thanks…to a lack of Medicaid expansion.


Healthy futures start with healthy beginnings – and that starts with preconception, prenatal, delivery, postpartum, and newborn care for every mom and every baby. It starts with a healthy woman being able to plan a healthy pregnancy, thanks to contraception coverage, and receive the care she needs during that timely pregnancy to nurture and safely deliver a healthy baby. Every mom’s greatest gift.


Did you know – and trust me, few did before the House passed a law that could reinstate this unthinkable practice – that before the ACA, pregnancy was considered a preexisting condition? That reliable birth control wasn’t reliably affordable – resulting in more unplanned pregnancies? That pregnancy and postpartum depression and mood disorders – which affect upwards of 100% of expecting and new moms, with often devastating consequences for both mother and child – were typically undiagnosed and untreated, because they weren’t covered by insurance?


For me, as a mom and as a grandmother, it’s unconscionable to think of maternity care as anything but an essential health benefit, probably the most essential of health benefits – to think of a mom going without regular prenatal care simply because she can’t afford it, as many used to and still sometimes do. Not seeking care until it’s too late. Using the ER as a last resort instead visiting a doctor or midwife for vital monthly prenatal checkups. Waiting until complications have taken a tragic toll. But that’s exactly what the AHCA might do. Under this reprehensible bill, states could opt out requiring maternity care as an essential health benefit, essentially imposing a pregnancy tax – a healthy baby surcharge -- of an estimated $17,000. Women even thinking about getting pregnant would be forced to pay more, too. Medicaid, which currently pays for about 50% of births in the US, will be slashed, potentially depriving hundreds of thousands of moms the prenatal care, safe deliveries, and newborn care they and their little ones deserve. Lifetime caps could be put back on employer based coverage – resulting in astronomic cost for families who experience a complicated birth or a baby with birth related disabilities.

Not feeling especially compassionate – more concerned about the bottom health care line? Here’s a reality check: Planned, healthy, uncomplicated pregnancies – or those in which complications are caught and treated early –don’t come cheap. But as the ultimate in preventive care, preventing a lifetime of costly care (from NICU care to long-term care for disabilites, from type 2 diabetes to future hypertension and beyond), it’s the ultimate in cost effectiveness, too. For the fiscally afraid, do the math: you’ll save billions later by providing care for expecting moms now.  Besides, let’s face it, the cost of a healthy baby: priceless.


I always say that motherhood is the ultimate sisterhood. We are our sister’s keeper, and we all share a collective responsibility for her health and well being and the health and well being of her baby.


That’s not a partisan issue – there are no red moms or blue moms, no red babies or blue babies -- that’s a fundamental human issue. And comprehensive, quality, affordable preconception, prenatal, postpartum, and newborn care for every mom and every baby is a fundamental human right. As members of the same human family – not as members of political teams in a political game -- it’s up to us to fulfill it, without exception. And by the way, believing in life should be a lifetime commitment.

This Mother’s Day and every day, let’s put moms and babies where they belong – first.


Join us in raising our mom and dad voices – to speak up for every mom and every baby and ensure them the care they deserve. Let’s protect their care. Let’s reject the AHCA and improve the ACA. Like our future depends on it –because it does.


IMC Speech

So, the last time we were all together in this room was only a year ago. It was my first International Medical Corps gala, and Erik’s, and let’s just say I wasn’t entirely sure why we had come. We’d been traveling a lot, we were tired, I had nothing to wear. But we’d been invited and we’d heard about this organization for years – about the amazing humanitarian and medical aid they provided in the world’s most dangerous places for the world’s most forgotten people. Which all sounded inspiring and laudable and totally worth our support – what I couldn’t quite figure out is how this completely commendable mission meshed with ours. I certainly wouldn’t ever claim to be a humanitarian – that’s a category I think best reserved for those relief and aid workers in the field who sacrifice their comfort, safety, and too often their lives for the well being of fellow human beings. I’ll admit to being a human who really loves humans – but in particular, very very small humans and their moms.
But we came to the gala anyway, still wondering exactly what we were doing there.


And then came Grace. The amazing Grace. I saw her radiant face on the Jumbotron, listened to her strong, yet melodic voice as she recounted her story and the story of her people of South Sudan – how her own suffering led her on a lifelong mission to ease the suffering of others, how she became a midwife in a country where giving life too often costs you your own life and your baby’s life – she became a midwife because midwives save lives. How she went on not only to learn how to care for expectant moms and deliver babies safely, but to train hundreds of others to do the same through the Midwife training program at International Medical Corps Kajo Keji clinic in South Sudan.  


As I watched and listened to the Amazing Grace, I remember – and maybe it was just me, but I remember so clearly, so vividly, the heavens opening up, the angels singing, and knowing, being certain, being single-minded in that moment that I had to go find this beautiful human being and give her a big hug. Didn’t matter that there were 500 other people in the room, and that there was probably security somewhere too, but I was going to find Grace and I was going to hug her, and maybe I was never going to let go.


And I did. Grace didn’t know who I was, and why I had stalked her, and why I was hugging her with no permission or explanation, but she did hug back. And that was the moment that I knew I would not only hug Grace again – many, many times – but that next time it would be in South Sudan. In Kajo Keji. In the clinic where healthy beginnings are helping build a healthier future in a country devastated by war and hunger and homelessness and displacement.


That was October. By the beginning of April, Erik and I were in Kajo Keji. We arrived in the middle of a torrential storm, and there was Amazing Grace, along with the amazing principal of the school Antonina, smiling, welcoming, beautiful beacons in the drenching rain –and let’s just say the hugs were wet and many.


We spent the rest of the day watching the students show us what they were learning and how they were learning – old school, and when I mean old I mean 1950’s old and older…. the most rudimentary models of fetal development and maternal anatomy, a fetoscope to listen for baby’s heartbeat, palpation their only way to access a baby’s growth and position, no ultrasounds, no diagnostic or screening tests. Just a pair of clean, skilled hands, making the biggest impact on maternal and infant health with the most basic of resources. And so many of these hands were those of young men – passionate young men who had chosen a career as midwife for one reason only: so they could return to their villages and save the lives of their moms, their sisters, their cousins. In a country where little boys are routinely kidnapped and turned into soldiers who rape and slaughter, these young men were becoming nurturers…who would in turn raise nurturing boys and inspire nurturing boys.


Look, being a mom isn’t easy under the best of circumstances – certainly being pregnant isn’t easy, and I think of all of us who’ve done it before can agree giving birth isn’t easy. But takeaway the conveniences, the knowledge, the medical care, the cushy birthing accommodations, the clean water and soap that we mostly take for granted and the challenges multiply exponentially. I’ve spent my whole career putting myself in the shoes of other pregnant women – but I never expected that the pregnant woman who would most impact me most and inspire me most would be the one who wasn’t wearing shoes at all.


It wasn’t easy, not nearly as easy, to put myself in Esta’s shoes. That’s because Esta, a beautiful, strong mother of three, rail thin but heavily pregnant with her fourth baby walked 15 miles barefoot…in labor…by herself the day I met her, determined to deliver her child in a safe place, surrounded by the skilled, compassionate, caring midwives and midwifery students at International Medical Corp’s Kajo Keji clinic.


Esta had an unusually, unexpectedly difficult time with the Second Stage of labor due to her daughter's unaccommodating position....and we all knew as we watched the midwives work furiously to turn the baby's head so it could fit the narrow confines of Esta's birth canal that it was likely Esta and her baby wouldn't have made it safely though this arduous journey if Esta herself hadn't made her arduous barefoot, 15 mile journey to Kajo Keji... into the arms and the care of Grace, Antonina, and the other skilled, compassionate midwives.


I held Esta's hand and held her legs as she pushed, and I held her beautiful, healthy baby girl moments after she was finally welcomed into the world. There was no electricity in that delivery room, no air conditioning or fan in the sweltering heat, no cushy birthing bed or pillows or even a single sheet or blanket or towel, just a small bare table for Esta to deliver on and clean water and soap for us to wash up with before and after the birth. And that, it turned out...that was enough.


Esta walked back home to her village the next day, 15 miles, without shoes, with her baby bundled close to her. It was a happy ending to her pregnancy, a healthy beginning to her baby's life. An uncertain life, for sure in this country ravaged by conflict, violence, heartbreak,hunger, and malnutrition. But a life off to a healthy start. And that was a start.


Before Erik and I had even left Kajo Keji – and well before those farewell hugs, and before we visited other International Medical Corps midwives and doctors caring for many other moms like Esta and babies like hers in South Sudan – and last month -- those caring for Syrian moms and babies in refugee camps in Jordan and Lebanon, we knew that we needed to give Grace more than hugs, or even more than a donation for a much needed latrine for the female midwifery students or the computers these kids needed to learn on – we knew we needed to team up with International Medial Corps and build an initiative that would take this incredible model of midwifery training and bring it to every area of the world that needs it, to every mom and baby that needs it.


I always say, motherhood is the ultimate sisterhood. No matter where we go in this world, no matter what a mom’s socioeconomic, religious, racial, cultural profile, every mom shares a bond. Every mom – every mom without exception wants what’s best for her baby. Every mom wants the healthiest start for her baby’s life. And every mom, every mom deserves a healthy pregnancy, a safe delivery, and a healthy baby.


The Amazing Grace, and all the other amazing midwives around the world saving lives, is making that shared mission a reality. Along with International Medical Corps, we can make it a reality for every mom, everywhere.

This is for Grace, with big hugs.

Heidi Op Ed Links

11/29/2016      We Must Protect Pregnant Women From the Zika Virus

5/13/2017        This Mother’s Day, We Must Acknowledge The Negative Impacts Of The AHCA

9/15/2017         Raising awareness about maternal health worldwide on National Bump Day

4/25/2018        Why Supporting Our Troops Means Supporting Their Families

6/23/2016         If Motherhood Is The Ultimate Sisterhood – Then Our Sisters Are At Risk