The United States has the highest maternal mortality rate of all industrialized countries, with 17.4 deaths per 100,000 pregnancies. Even more sobering is the fact that maternal mortality rates are more than two times higher among African-American women at 37.1 deaths per 100,000 live births.
The reasons for these disparities are complex, ranging from insurance coverage gaps to social determinants of health, racism and more. The facts are sobering. Consider the following statistics:
- A college-educated Black woman is more likely to die from giving birth than a white woman without a high school diploma.
- Black women are much more likely to experience life-threatening health events related to pregnancy, such as infections, blood clots and strokes.
- Independent of pregnancy and controlling for income and geography, Black women have higher underlying prevalence rates for chronic conditions such as high blood pressure, type II diabetes and diagnosed obesity.
To address the maternal health crisis facing women of color, legislators in the U.S. House of Representatives have introduced The Black Maternal Health Momnibus Act of 2021 which builds on existing legislation to address a wide range of maternal health issues.
Health organizations also can take a proactive stance towards improving maternal health for all women, with an eye towards reducing the challenges facing Black women in particular. This will require a multi-faceted approach. Here are four suggestions:
- Create pre-natal programs, including telehealth initiatives, to support expectant mothers throughout their pregnancies. Since Black women are at higher risk of chronic health conditions like hypertension and diabetes, it makes sense to incorporate monitoring of these conditions into pre-natal programs. Telehealth may be a good option for some check-ins. This type of appointment lowers barriers to care, such as lack of transportation, the need to take time off work and more.
- Address mental health issues for pregnant women. Research suggests that Black women are two times more likely to experience postpartum depression than their white peers. At the same time, Black women are less likely to seek help for this condition. Health plans should incorporate behavioral health services into care plans for all pregnant women.
- Focus on social determinants of health that affect maternal health. These include access to safe and affordable housing, reliable transportation and nutritious food. Addressing these issues head-on can have a meaningful impact on maternal health. Member engagement solutions are one way to connect expectant mothers with community resources.
- Identify insurance coverage options. Just 87% of Black women of reproductive age have health insurance and many others experience gaps in coverage during their lives. Health plans need to look at expanding and maintaining access to coverage as part of their efforts to improve maternal health. One approach that Medicaid payers are using is to identify other insurance coverage options for members. HMS Premium Assistance+ focuses on Medicaid members who are expecting a child. It follows the mother’s journey from pregnancy through birth, identifies coverage for the newborn and enrolls the infant in commercial insurance. PremiumAssistance+ identifies commercial health plan coverage before claims are ever submitted, avoiding incorrect payments while also improving the member experience.
Improved access to care and health equity are goals that our country must focus on. The good news is that tools and solutions exist to help us get there. To learn more about how HMS can help, feel free to contact us.