Though millions of people give birth in the United States each year, not all perinatal care is created equal. While many people experience healthy pregnancies, there is a significant gap between the pregnancy and postpartum experiences of white women and women of color.
Each year, 50,000 women suffer from life-threatening pregnancy complications, and women in majority Black communities face 63 percent higher rates of severe maternal morbidity than women in majority white communities.
Maternal mortality rates in the United States are among the highest in the developed world, and they are especially high among Black mothers, who die from complications related to pregnancy at around two to three times the rate of other women, regardless of income or education levels.
Some of the severe maternal morbidity health events with the highest racial disparities include:
- Acute kidney failure
- Adult respiratory distress syndrome
- Pulmonary edema/acute heart failure
These maternal health disparities have a huge impact on the health and overall well-being of your employees, their families, and your business. That’s in part because the vast majority of women (who make up nearly half the American workforce) will become mothers during their careers.
The good news: You can play an active role in advancing maternal health equity by supporting improved access to quality care.
In the developed world, the United States is the most dangerous place to give birth -- especially for women of color. Grasping the extent of maternal health disparities is the first step in being able to provide support to expectant mothers in your workforce.
Take a closer look at maternal health disparities before, during and after pregnancy.
Maternal health disparities before, during and after pregnancy
- Women in majority Black communities have up to 2X the prevalence of risk factors for SMM,* such as hypertension or anemia, as women in majority white communities.5
- Women in majority Hispanic communities have up to 33% higher prevalence rates of some risk factors for SMM,* such as prior cesarean birth and preexisting diabetes, compared to women in majority white communities.6
- Rates of severe illness are higher among pregnant women in the Northeast and South, those from lower-income communities and those giving birth in public hospitals.7
*Among women with employer-sponsored health insurance.
- A review by the American Diabetes Association reported that Asian/Pacific Islander women exhibit the highest prevalence of gestational diabetes (14.8%), which can increase pregnancy complications.8
- Native Hawaiian and other Pacific Islander women are five times more likely than white women to not begin receiving prenatal care until the third trimester or to receive any prenatal care at all. Hispanic women are twice as likely, compared to white women, to have a birth with late or no prenatal care.9
- The risk for miscarriage is roughly 43% higher for Black women compared to white women.10
Labor and delivery
- Black women have pregnancy-related mortality rates that are over 3x higher compared to the rate for white women.11 And pregnant Black women are 45% more likely to die in the hospital.12
- Prevalence of delivery complications is 46% higher among Black mothers versus white mothers.13 Even after adjusting for socioeconomic status, access to health care and other medical conditions, researches found that compared to white women, pregnant Black women were: 57% more likely to have a stroke; 42% more likely to develop a blood clot in the lungs; and 71% more likely to develop heart muscle weakness.14 These outcomes are more likely to occur at or near the time of delivery.
- Early and consistent screening combined with the context of known risk factors has been found to help detect and treat postpartum depression.15 But according to a recent survey from Blue Cross Blue Shield (BCBS), 34% of Black women and 38% of Hispanic women said they were not screened for postpartum depression or did not know if they were screened.16
- Based on an analysis of BCBS claims data for women with employer-sponsored health insurance, nearly half (45%) of women diagnosed with postpartum depression went untreated from 2019-2020. Among those who received treatment, only 52% of Black women and 49% of Hispanic women were treated compared to 57% of white women. These gaps in treatment are due, for the most part, to disparities in the adoption of prescription treatment, which was 39% for white women, but only 28% for Black and Hispanic women.17
Quality care for expecting employees
Wellmark Blue Cross and Blue Shield’s Pregnancy Support program, available as a value-added benefit to all groups, is a personalized, one-on-one program for your expecting employees. In addition to the robust resources available on myWellmark®, the program gives them 24/7 access to trusted and helpful online resources like WebMD® Pregnancy Assistance, Count the Kicks® and text4babySM.
Participation in the program is completely voluntary. If an employee is experiencing a high-risk pregnancy, identified via a self-assessment tool and through claims data, they will have access to the support of an Advanced Care nurse throughout their pregnancy journey. Advanced Care nurse support is available to employees who may not be experiencing a high-risk pregnancy but desire additional support.
You're there for your employees
And we’re here for you. Wellmark can help you understand your employees and put together a benefits package that’s right for you, using data to help you make smart benefits decisions. Questions? Contact your authorized Wellmark account representative or email us at firstname.lastname@example.org.
- 1 Roosa Tikkanen, et al., Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries, The Commonwealth Fund, Nov. 18, 2020.
- 2, 18 Bryan Robinson, “Pregnancy Discrimination In The Workplace Affects Mother And Baby Health,” Forbes, July 11, 2020.
- 3, 20, 21 Suzanne Delbanco, et al., “The Rising U.S. Maternal Mortality Rate Demands Action from Employers,” Harvard Business Review, June 28, 2019.
- 4, 5, 6 Blue Cross Blue Shield Association, The Health of America Report, “Racial Disparities in Maternal Health,” May 20, 2021.
- 7 Eugene Declercq and Laurie Zephyrn, Severe Maternal Morbidity in the United States: A Primer, The Commonwealth Fund, Oct. 28, 2021.
- 8 Gianna Melillo, “Racial Disparities Persist in Maternal Morbidity, Mortality and Infant Health,” AJMC, June 13, 2020.
- 9, 11 Samantha Artiga, et al., Racial Disparities in Maternal and Infant Health: An Overview, KFF, Nov. 10, 2020.
- 10 Tori B. Powell, “Black Women Are at Higher Risk for Miscarriage, Study Finds,” CBSN, Apr. 29, 2021.
- 12, 14 “Black Women Have the Highest Risk of Pregnancy-Related Heart Problems in the US,” American Heart Association, Dec. 16, 2020.
- 13 Blue Cross Blue Shield Association. Health of America, Maternal Health Data. 2020.
- 15 Zoleykha Asgarlou, Mohammad Arzanlou, and Mohammad Mohseni, “The Importance of Screening in Prevention of Postpartum Depression,” Iranian Journal of Public Health, May 2021, 1072–1073, cited in National Center for Biotechnology Information/US National Library of Medicine, National Institutes of Health.
- 16 Blue Cross Blue Shield Association, Maternal Health Survey. 2020.
- 17 Blue Cross Blue Shield Association, Analysis on Postpartum Depression. 2022.
- 19 New WHO Guidance on Non-clinical Interventions Specifically Designed to Reduce Unnecessary Caesarean Sections, World Health Organization (WHO), 2018.