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September 09, 2020

DES MOINES, IA – Iowans experienced higher rates of pregnancy complications and postpartum depression rates compared to the national average according to a new Blue Cross® Blue Shield® Health of America Report: Trends in pregnancy and childbirth complications in the U.S. External Site The report examined 1.8 million pregnancies between 2014 and 2018 among commercially insured women ages 18-44.

For every 1,000 pregnancies, complication rates in Iowa were 211.3 compared to 196 nationally and the rates for postpartum depression came in at 110 versus 94.6 nationally. Iowa childbirth complications were less common and averaged 13.7 for every 1,000 births compared to 16.9 nationally. The report also found people who had complications during pregnancy were twice as likely to have childbirth complications as well.

"Regular visits to your health care provider are especially important for an expectant parent or those who plan to become pregnant," said Dr. Tim Gutshall, Wellmark's chief medical officer. "Wellmark is committed to providing trusted resources through our Pregnancy Support Program to ensure expectant and new parents receive the care and screenings needed for a healthy, stress-free pregnancy."

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How Iowa compares to national trends

Pregnancy complications per 1,000 members 2014-2018

  • Iowa 211.3
  • National trend 196

Childbirth complications per 1,000 members 2014-2018

  • Iowa 13.7
  • National trend 16.9

Postpartum depression per 1,000 members 2014-2018

  • Iowa 110
  • National trend 94.6

Millennials make up 85 percent of all pregnancies in the U.S., according to The Health of Millennials report External Site. This age group has experienced a double-digit increase in eight of the top-10 health conditions like major depression, hypertension and type II diabetes, which may lead to higher risks of pregnancy and childbirth complications. Since 2014, those pregnant, ages 18-44 have experienced:

  • 35% increase in major depression
  • 31% increase in hypertension
  • 28% increase in Type II diabetes

Impact of COVID-19

The COVID-19 pandemic is also increasing the challenges around accessing care. According to the survey, the increase in virtual care options led to 48 percent of pregnant people shifting their prenatal appointments to virtual visits. Another 53 percent reported that they could not have a loved one in the delivery room with them and 15 percent delivered their baby at home. More concerning, one in four skipped a prenatal visit and after childbirth, there was also a nearly 30 percent increase in postpartum depression diagnoses, with the diagnoses being most prevalent in women aged 18-24.

"Even in uncertain times, protecting the health and well-being of those expecting and current parents is vital to preserve the health of future generations," said Gutshall. "It remains important to stay in touch with your health care provider and follow the American College of Obstetricians and Gynecologists recommendations for expectant parents to stay on track with prenatal care and postpartum appointments."

Accessing quality maternity care

Access to quality maternity care is critical to helping women lead healthier lives, have healthier pregnancies and uncomplicated births. In Iowa, there are 22 centers that are designated as Blue Distinction Centers (BDC) and Blue Distinction Centers (BDC ) for maternity care External Site. These Centers are recognized for their demonstrated expertise delivering high quality, cost-effective care and in the case of maternal care, they also demonstrate a lower percentage of early elective deliveries. In 2018, BDC/BDC+ facilities across the country cared for more than 40 percent of Blue Cross and Blue Shield commercially insured women giving birth.

This is the 31st study of the Blue Cross Blue Shield, The Health of America Report® series, which uses an integrated dataset combining the pregnancy episodes data curated from BCBS Axis Data and the BCBS Health Index. For more information, visit https://www.bcbs.com/the-health-of-america External Site.