Press Releases

Study finds childbirth disparities persist weeks after mothers leave the hospital

• Highmark Takes Action to Address Maternal Health Disparities and Outcomes

PITTSBURGH (June 19, 2024) — The country’s maternal health crisis goes far beyond the delivery room. New data shows that dangerous, unexpected birth complications often emerge weeks after the mother and baby leave the hospital, with Black patients experiencing these events at a rate 87% higher than white patients.

“This data underscores the drastic need for providers, community organizations, and policymakers to join forces to develop and implement impactful programs that address the social determinants of health, dismantle barriers to access, and ultimately bridge the unacceptable divide in maternal mortality and morbidity,” said Dr. Margaret Larkins-Pettigrew, senior vice president and chief clinical diversity, equity, and inclusion officer at Highmark Health.

The analysis of these birth complications, known as severe maternal morbidity (SMM), draws on data from more than 700,000 Blue Cross Blue Shield (BCBS) insured births. Additionally, the report analyzed more than 1.5 million Medicaid births by the National Opinion Research Center at the University of Chicago.

The data shows that as many as 1/3 of all severe maternal morbidity (SMM) events, or dangerous unexpected birth or health-related complications, occur within six weeks post-delivery. In both data sets, SMM events were higher for Black and Latina mothers than white mothers in insured and Medicaid populations.

Note: The BCBS data and NORC data come from distinct datasets and thus are not intended for direct comparison.

Additional findings from the report show:

• Racial disparities increase with age: In both the NORC Medicaid data and commercial data, SMM rates for Black patients ages 35 to 44 are more than twice as high as white patients.
• Six health events account for over three-quarters of SMM events in insured and Medicaid populations, including sepsis, seizures, and acute renal failure.

“These findings highlight the critical need for continued care and support for new mothers in the weeks and months following childbirth — the fourth trimester. As a health-care system, we must broaden our focus beyond mortality to also encompass morbidity,” added Dr. Larkins-Pettigrew.

Highmark is working across its four-state footprint to address disparities in maternal health outcomes and ensure that all mothers have access to the care they need. Highmark’s signature Baby BluePrints program offers members educational information on all aspects of pregnancy, plus one-on-one support from a women’s health specialist. Highmark also expanded its telehealth offerings to include women’s health services, including postpartum behavioral health support. Regional efforts include:

Pennsylvania:

• First Steps and Beyond, a program designed to decrease Black infant mortality rates, reduce preterm birth rates, increase knowledge about safe sleep recommendations for infants, and provide comprehensive support for mothers and their babies in the fourth trimester.
• Educates hundreds of healthcare providers in the Greater Pittsburgh area on racial bias in obstetric carethrough a free two-hour continuing education course in which clinicians can earn CME credits.
• Launched CenteringPregnancy, a nationally recognized  model shown to improve birth outcomes, lower the risk of preterm births, reduce low birth weights and increase  breastfeeding rates with group prenatal care sessions. CenteringPregnancy officially launched at AHN West Penn Hospital in 2023 and the Network is in the process of expanding the model to all labor and delivery programs throughout the health system.
• Provides high-risk or food-insecure obstetric patients in the Greater Pittsburgh area with tailored nutritional plans as well as vouchers for free fruits and vegetables at area grocery stores and via Instacart. The “Food as Medicine” program was launched in partnership with the American Heart Association and Highmark Health and works primarily with community doula organizations to engage enrolled participants and increase utilization rates of prenatal and postpartum visits.

New York:

• Provides significant grants to organizations and initiatives addressing maternal health disparities and improving outcomes. A total of $1.2M has been invested in maternal health programs in Western New York and the Capital Region over the last three years alone.
• Additionally, future initiatives to support East Buffalo mothers and babies will be announced soon, as well as a conference on Maternal Health Disparities in partnership with Buffalo Center for Health Equity is scheduled in Buffalo on July 27, 2024.

Read the full report, “Improving Postpartum Maternal Health Outcomes,” part of the BCBS Health of America Report^® series.