Blue Cross reports higher childbirth complication rates for Black and Hispanic women

Exhibit 2: SMM Rate by Community Race/Ethnicity and Age Group, 2018-2020 Combined

SMM: CDC’s Severe Maternal Morbidity Measure

Vermont Business Magazine Black women under the age of 24 are more likely to experience severe childbirth complications than white women over the age of 35 – an age group usually considered high risk, according to new data from the Blue Cross Blue Shield Association (BCBSA). Data shows the rates of childbirth complications have been increasing for women of color. In the last two years, the rate of Hispanic women with severe childbirth complications increased 19 percent.

“There is an urgent maternal health crisis in our country,” said Kim Keck, president and CEO of BCBSA. “It is unconscionable that women of color face a greater risk of childbirth complications compared to white women. We must confront health disparities across the board to change the trajectory.”

The recent study examines the rate of childbirth complications as measured by the CDC’s Severe Maternal Morbidity Measure (SMM)—21 different adverse events or unexpected outcomes from labor and delivery with significant short- or long-term consequences to a woman’s health, and in some cases, may lead to death.

Exhibit 1: SMM Rate by Community Race/Ethnicity, 2018-2020

SMM rates are 63% higher for women in majority Black communities and 32% higher for women in majority Hispanic communities when compared to majority white communities.

In northern New England, the SMM rates followed the national trends, with black and Hispanic mothers’ risk factors being significantly higher in most of the top 15 categories including anemia, asthma, and chronic hypertension.

In addition, BCBSA surveyed approximately 750 women about their pregnancy and childbirth care experience in the last year, representing commercial, Medicaid, Medicare and uninsured individuals. The survey found 62% of Black mothers were able to complete all recommended prenatal visits, citing transportation barriers or scheduling conflicts.

Compared to white women, Black and Hispanic women reported feeling less confident they would receive the care they need. Fewer Black mothers reported feeling they can speak openly with their provider or felt that their provider spent enough time with them.

“We are committing today to examine every opportunity to mitigate racial disparities in maternal health in Vermont. Too many of women of color do not feel supported in their maternal health and far too many suffer tragic complications during pregnancy,” says Dr. Josh Plavin, a primary care Internal Medicine and Pediatrics physician, and the Chief Medical Officer at Blue Cross and Blue Shield of Vermont.

“The higher maternal morbidity rates of Black and Hispanic women are untenable in this era of advanced medicine. We are determined to address the gaps in care by seeking ways to strengthen relationships between patients and providers, by advocating for expanded diversity in the labor and delivery workforce, and by seeking out and instituting programmatic changes that support women of color through healthy pregnancies,” says Dr. Plavin.

Blue Cross and Blue Shield of Vermont offers its members universal access to our prenatal maternal wellness program, Better Beginnings. This program supports prospective parents through the course of pregnancy and in the months following delivery, with particular attention to maternal wellness, social-emotional health, and barriers to care.

Through the BCBSA National Health Equity Strategy, BCBS companies are also encouraging industry initiatives to develop national standards for the collection of race, ethnicity and language (R/E/L) data, partnering with providers to offer unconscious bias training and exploring opportunities for collaborating with community stakeholders and providers to reduce risk factors for SMM and promote efforts to improve quality and safety.

BCBSA is actively leaning into new and longstanding relationships with community organizations to address root causes of inequities. BCBSA continues to advocate for public policies at the state and federal levels to improve access to health coverage and supports efforts like the Momnibus Act of 2021 – a set of bills that will save the lives of new and expecting moms.

Read the full report, “Racial Disparities in Maternal Health,” part of the Blue Cross Blue Shield, The Health of America Report series.

For more information about the BCBSA National Health Equity Strategy and maternal health programs, visit BlueHealthEquity.com.

The National Health Equity Strategy is part of the Blue Cross Blue Shield Pledge to Make Meaningful Change. The Pledge speaks to BCBS’ broad commitment to addressing racial disparity in health and all its forms.

Blue Cross and Blue Shield of Vermont is Vermont’s only local, not-for-profit health plan. For over 70 years, the company has been enhancing the health and well-being of the Vermonters by offering innovative plans to individuals, seniors and businesses. Our employees are dedicated to developing new ways to support high quality care and programs and events that promote wellness. Blue Cross and Blue Shield of Vermont is an independent licensee of the Blue Cross and Blue Shield Association.

Exhibit 3: Prevalence Rate (per 10,000) and Differentials between Majority Black, Majority Hispanic and Majority White Communities for the Most Common SMM Indicators, 2020

Exhibit 5: Prevalence Rates (Per 100) and Differentials between Majority Black, Majority Hispanic and Majority White Communities for Common Risk Factors, 2018-2020

Exhibit 4: Common Factors with the Highest Risk Ratios for SMM for Women Overall

Source: Berlin, Vermont – Blue Cross and Blue Shield of Vermont 5.25.2021 For more information, visit www.bcbsvt.com.

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