The wristbands are part of a growing initiative first launched by North Carolina-based ECU Health as Congress sought to address the nation’s growing maternal mortality crisis during the covid pandemic. Since 2021, nearly 50 North Carolina hospitals and the state’s health department have begun distributing the wristbands, to give mothers and care providers a visual reminder of the life-threatening health risks after birth.
The Connecticut state health department; large health systems in Arkansas, Georgia, and Mississippi; and hospitals in at least 24 other states have also embraced the program. The wristbands are intended to make emergency workers aware of postpartum risks, ensure better treatment, and help lower maternal mortality rates in the U.S., where nearly 70% of pregnancy-related deaths happen after the day of delivery — and nearly 40% happen after the six-week mark.
This year, North Carolina plans to expand the initiative with part of the $213 million it received through the Rural Health Transformation Program, a provision of President Donald Trump’s signature One Big Beautiful Bill Act, also known as HR 1.
Tamika Auguste, a physician and the board chair at the American College of Obstetricians & Gynecologists Foundation, praised the wristbands as a useful tool “to increase awareness and education around postpartum health.” But she and others who focus on maternal health said efforts like the wristband campaigns are only part of what’s needed to combat the broader maternal mortality crisis in the U.S.
And they noted the wristbands’ popularity is emerging as Trump’s 2025 law is expected to reduce Medicaid spending by more than $900 billion over 10 years, according to a Congressional Budget Office analysis. Medicaid, the federal-state program that covers healthcare for low-income families, pays for at least 40% of births nationwide.
Elisabeth Wright Burak, a policy researcher at Georgetown University’s Center for Children and Families, said Trump’s tax-and-spending law is stifling the momentum states had been gaining with maternal care since 2022. That’s when Congress allowed states to extend postpartum Medicaid coverage from 60 days to a year, which nearly every state did.
Now, those extensions could end up on the chopping block, Burak said, as states seek ways to manage Medicaid losses.
“There is no question that HR 1 risks setting the clock back for maternal health,” Burak said.
A report she co-authored in July warned that postpartum patients have more to worry about with the new law than simply cuts to Medicaid. States are also setting up systems that may not adequately track pregnant and postpartum enrollees who should be exempt from the law’s new work requirements, erroneously dropping them from coverage, Burak’s report said.
Maternal Mortality
U.S. maternal mortality rates have risen and fallen over the past seven years, with 649 maternal deaths in 2024, according to the most recent Centers for Disease Control and Prevention data. Tennessee had the worst maternal mortality rate in the nation from 2020 to 2024, around 42 deaths per 100,000 births, according an analysis of CDC data by the Congressional Research Service. North Carolina’s rate was about 29 in 100,000, with a national average of 23.
In its Rural Health Transformation Program application, North Carolina said the initiative creating the “I Gave Birth” wristbands reduced postpartum readmissions by nearly a third at ECU Health Medical Center in Greenville, without elaborating. In online promotions, some hospitals have claimed the wristband campaigns can save lives, though many have recently launched and their impact has yet to be studied.
“Additional research is needed to conclusively confirm the outcomes of such initiatives,” said Hannah Jones, a spokesperson for the North Carolina health department.
Hospitals provide a wristband to patients who have given birth and instruct them to wear it for weeks or months, hoping they’ll be reminded to check in with a physician if they feel chest pain, have headaches, or start bleeding. The accessory resembles the yellow Livestrong wristband, part of a cancer awareness campaign launched by cyclist Lance Armstrong’s foundation. A nurse also talks through postpartum risks with the patients, and they’re sent home with pamphlets and guidebooks on how to care for their new child and themselves.
“The bracelet itself is simply a reminder of, ‘Hey, I got education,’” said Jessica Noble, a nurse with East Carolina University-connected ECU Health who pioneered the initiative.
It’s also intended to alert first responders and other healthcare providers that a woman has recently given birth and to check for postpartum complications, such as low blood pressure, bleeding, or infections. Emergency department staff and EMS workers sometimes don’t have adequate training to recognize postpartum complications, research shows, which can be dangerous when those patients end up in an emergency room.
Postpartum wristbands gained traction across the country through health awareness campaigns fueled by social media posts and evening news segments. New mothers appeared in promotional photos and videos wearing the wristband and raving about the accessory, saying it celebrated childbirth.
Some postpartum patients who faced traumatic births or mental health struggles saw it differently.
‘So Many Risks’
Alexandra Mellon gave birth last year. Her daughter was stillborn. Devastated, she sought out a therapist, donated her breast milk, and tried to find meaning in her circumstances. She spent a year feeling isolated, she said, often because people don’t know what to say.
Mellon said wearing one of the wristbands would have been a painful reminder of her loss.
Now she works as a doula in Asheville, North Carolina. Mellon said what she thinks new moms need most is community and emotional support. The wristband could help encourage that for some patients, she said, but isn’t for everyone.
“There are so many risks, and it’s just like you almost become invisible,” she said.
More than 80% of pregnancy-related deaths are preventable, according to the CDC. The Centers for Medicare & Medicaid Services in March published guidance, developed during the Biden administration, that urged hospitals to create better emergency department protocols to catch postpartum complications and to measure their work against state and national maternal health data.
But those efforts faced a major threat last year when the Trump administration sought to cut CDC funding for state-level maternal mortality data in its proposed 2026 budget. While Congress rejected that move, the administration did lay off staff tracking postpartum patients’ health.
The Trump administration tried again to cut $113.5 million in CDC maternal health research in its proposed 2027 budget. Congress has instead proposed increasing funding to $115.5 million.
Without more research, it’s unclear how effective the wristbands are in encouraging postpartum patients to seek care when they need it. A U.K. study of mass media campaigns to improve health outcomes, such as preventing risky substance use or encouraging exercise, found that the campaigns didn’t change behaviors. Another study found that the U.S. “Back to Sleep” campaign, which educates parents on safe sleeping practices with babies, dramatically reduced rates of sudden infant death syndrome for several years after it launched in 1994, though rates plateaued in the early 2000s.
In 2020, the CDC tried a similar national campaign, “Hear Her,” aimed at helping women speak up when something felt wrong after delivery.
The CDC released a study on the campaign years later that said it “had the unintended consequence of appearing to put the burden on the people who are pregnant or postpartum to speak up.”
ECU Health Medical Center created the wristband initiative in 2021 and published a study two years later. In it the authors noted the pregnancy-related readmission rate at the Greenville hospital fell 0.77%. It attributed the change to the “education provided to patients, family members, and medical personnel” in the initiative, without elaborating.
Campaigns like the “I Gave Birth” initiative are far from a final solution to maternal mortality, said Noble, the campaign’s architect and lead author on the ECU Health study. If she “had a magic wand,” she said, North Carolina would not just have better postpartum care but would also address the root causes of pregnancy complications. “But I don’t have one, and I can’t make system-level change immediately.”
Andrew Jones wrote this story for KFF Health News.