Maternal health innovations in the United States: A scoping review of implementation approaches, equity integration, and scaling factors.
The United States maternal health crisis persists as a public health emergency characterized by high mortality rates and stark racial disparities. These disparities reflect structural racism and intersecting social inequities operating simultaneously across multiple systems.
This scoping review maps maternal health innovations implemented in the United States from 2017 to 2025, examining equity integration, implementation approaches, and scalability through structural racism, intersectionality, and RE-AIM frameworks.
A scoping review was conducted following PRISMA-ScR guidelines and JBI methodology. Systematic searches of PubMed/MEDLINE, CINAHL Plus, PsycINFO, and grey literature were performed from April through August 2025. Two independent reviewers screened records; a third reviewer resolved disagreements. Quality assessment used the Mixed Methods Appraisal Tool.
Fourteen studies across six categories were identified: Digital Health and Telehealth (n = 4, 29%), Clinical Quality Improvement (n = 2, 14%), Community Workforce Development (n = 2, 14%), Social Determinants of Health (n = 2, 14%), Policy and Payment Reform (n = 2, 14%), and Communication and Mental Health Access (n = 2, 14%). All retrieved innovations incorporated explicit equity considerations targeting Medicaid populations, racial and ethnic minorities, and safety-net communities. Nine innovations (64%) achieved scaled implementation; sustainability was strongest among policy-institutionalized and cost-effective interventions. The equity integration finding reflects characteristics of the equity-focused literature retrieved rather than a field-wide empirical claim. Critical scaling factors include infrastructure capacity, policy alignment, sustainable funding, and demonstrated cost-effectiveness.
Nurses are positioned to lead equity-centered maternal health innovation and advance the dismantling of structural determinants driving persistent racial disparities in maternal outcomes across the United States.
This scoping review maps maternal health innovations implemented in the United States from 2017 to 2025, examining equity integration, implementation approaches, and scalability through structural racism, intersectionality, and RE-AIM frameworks.
A scoping review was conducted following PRISMA-ScR guidelines and JBI methodology. Systematic searches of PubMed/MEDLINE, CINAHL Plus, PsycINFO, and grey literature were performed from April through August 2025. Two independent reviewers screened records; a third reviewer resolved disagreements. Quality assessment used the Mixed Methods Appraisal Tool.
Fourteen studies across six categories were identified: Digital Health and Telehealth (n = 4, 29%), Clinical Quality Improvement (n = 2, 14%), Community Workforce Development (n = 2, 14%), Social Determinants of Health (n = 2, 14%), Policy and Payment Reform (n = 2, 14%), and Communication and Mental Health Access (n = 2, 14%). All retrieved innovations incorporated explicit equity considerations targeting Medicaid populations, racial and ethnic minorities, and safety-net communities. Nine innovations (64%) achieved scaled implementation; sustainability was strongest among policy-institutionalized and cost-effective interventions. The equity integration finding reflects characteristics of the equity-focused literature retrieved rather than a field-wide empirical claim. Critical scaling factors include infrastructure capacity, policy alignment, sustainable funding, and demonstrated cost-effectiveness.
Nurses are positioned to lead equity-centered maternal health innovation and advance the dismantling of structural determinants driving persistent racial disparities in maternal outcomes across the United States.