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1 oct, 2021

Addressing racial disparities in maternal health

According to the recently published Blue Cross Blue Shield Association (BCBSA) report “Racial Disparities in Maternal Health" – part of their The Health of America series – pregnant women in the U.S. are more than twice as likely to die from complications related to pregnancy or childbirth than those in most other high-income countries.

This coincides with increasing rates of severe maternal morbidity (SMM) among all women, rates which are fueled by racial disparities in maternal health and specifically SMM and associated risk factors, such as bleeding disorder, diabetes, and heart disease. Specifically, women in majority Black communities have a 63% higher rate of SMM than women in majority white communities, and for women in majority Hispanic communities, that difference is 32%. These increased rates are higher across all age groups and examined indicators. Black and Hispanic women also have a significantly higher prevalence than white women of the most common SMM risk factors for SMM.

Not only are risk factors at the root of these statistics, but there’s also a disturbing lack of access to quality maternal care for women of color. The picture is just as disheartening locally – data from the Rhode Island Department of Health (RIDOH) Center for Health Data and Analysis Maternal and Child Health Database, as reported by Rhode Island Kids Count, shows that between 2015 and 2019:

•           23.5% of Black women received delayed or no prenatal care, compared to 13.1% of white women.

•           11.5% of Black women had preterm births, compared to 8.2% of white women.

•           11.7% of Black women gave birth to low-birthweight infants, compared to 6.6% of white women.

•           The rate of infant mortality among Black women was 12 per 1,000 live births; for white women, it was 3.5 per 1,000 live births.

Blue Cross and Blue Shield companies across the U.S., including BCBSRI, are committed to reducing racial disparities in maternal health by 50% over the next five years. And BCBSRI has already taken several steps to address it. We stand in full support of the recently adopted doula coverage law in Rhode Island, which will make doula services eligible for reimbursement through private insurance plans and Medicaid. The passage of this law recognizes that doulas can improve health outcomes, as well as the likelihood of women of color having a positive childbirth experience with a reduced risk of complications.

As you know, doulas are trained healthcare professionals who provide women with continuous physical, emotional, and informational support during pregnancy, childbirth, and throughout the post-partum year. This law will provide more women with access to doulas to help address health disparities faced by communities of color. Studies show that doulas help reduce the rate of C-sections, which occur at higher rates among Black women, and also increase successful breastfeeding, which improves the health of new moms and babies and is less common among Black or low-income women.

In addition to supporting this critical piece of local legislation, BCBSRI has created a maternal health work group. Its goals are to explore ways we can take important action related to creating culturally appropriate interventions for mothers and newborns, improving childbirth safety for women of color, and providing support for women experiencing post-partum depression.

We’re also forging local partnerships to help improve outcomes for pregnant women of color in Rhode Island. These include working with minority-owned doula services and partnering with Women & Infants Hospital to specifically address maternal health disparities. And we’re always looking for ways to promote cultural competency with all of our stakeholders, including our provider network.

Last year, Rhode Island became the 33rd state to join the Alliance for Innovation on Maternal Health with the goal to implement a series of actionable steps to improve care for mothers and infants, with a special focus on those of color. You can learn more about how Rhode Island is working to improve maternal and birth outcomes, including actions taken through the Alliance and participating hospitals, at the Perinatal Neonatal Quality Collaborative of Rhode Island’s website.

As always, thank you for all you do to keep our members and all Rhode Islanders safe and healthy. In October, we celebrate several healthcare observances: National Physical Therapy Month, American Pharmacists Month, and Breast Cancer Awareness Month, as well as World Hospice and Palliative Care Day (9 de octubre) and National Case Management Week (11 de octubre-17). So please take a moment to recognize and thank those who work in these areas for everything they do!

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