September 13, 2019
The love and joy of motherhood begins before birth. As the excitement builds, women must remember the importance of caring for themselves as their health and well-being are directly linked to a healthy pregnancy and birth.
Unfortunately for women in Mississippi, the hopeful expectations of pregnancy can be tempered by a constellation of healthcare challenges that have left the state with one of the country’s highest maternal mortality rates and the highest rate of infant mortality.
The largely rural state has the lowest doctor-patient ratios in the country, and only about 6 percent of OB-GYNs work in rural areas, creating maternity “deserts.” High rates of chronic illness, including conditions such as high blood pressure, diabetes and obesity, also complicate the prognosis for a healthy, full-term pregnancy and delivery.
Addressing these needs and the full spectrum of women’s health by helping them plan for pregnancy, birth and postpartum has become a mission for Blue Cross & Blue Shield of Mississippi (BCBS Mississippi).
Improving access to care and addressing chronic conditions
With a focus on wellness and personal health, the Blue Primary Care Women’s Wellness Homes offer comprehensive preventive care from a network OB-GYN who also serves as primary care physician. The wellness homes are helping patients understand their risks so they can take appropriate steps to prevent and treat health conditions before they become serious.
A common source of maternal and infant complications at birth is a mother’s unresolved chronic illnesses, and for women who are ready to conceive, but are struggling with conditions such as high blood pressure, diabetes and obesity, the wellness homes provide needed continuity of care. The expanded relationship between patient and OB-GYN helps to close a critical access gap in rural areas where the maternal mortality rate is highest. OB-GYNs at the wellness homes receive comprehensive data on a patient’s health, including prescription drug and emergency room admissions history, to provide a more complete picture of the woman’s health and help identify opportunities to improve care.
“Blue Primary Care Women’s Wellness Home patients can expect a plan of care that addresses wellness and health concerns beyond the traditional scope of the OB-GYN relationship with a particular focus on prevention and management of risk around blood pressure, cholesterol and diabetes,” said Dr. Tom Fenter, chief medical officer, BCBS Mississippi. “The goal is to engage women early as partners in their health and to involve them in taking an active role in getting and staying healthy.”
Planning for the preventable
Eighty-six percent of maternal deaths in Mississippi occur after delivery, and often these deaths are preventable. As part of a statewide initiative to increase the safety of childbirth and eliminate preventable harm, BCBS Mississippi partners with the Mississippi Perinatal Quality Collaborative (MSPQC) to support hospitals and physicians in implementing multiple Maternal Safety Bundles to improve maternal care and safety.
These include training in how to recognize and react to obstetric hemorrhage and severe hypertension, two common causes of maternal mortality that often go undetected, misdiagnosed or ignored. To address these common pregnancy complications, hospital teams from across the state participate in the hands-on, data-driven, simulation-based trainings. Other states which have implemented the bundles for hypertension and hemorrhage saw maternal morbidity rates drop by as much as 22 percent.
Carrying baby to term
Despite significant risk, many women chose to have an elective C-section before their pregnancy has reached 39 weeks, and Mississippi has one of the highest rates of C-section delivery in the country. Experts agree carrying the baby to full term is the best for both mother and baby unless there is a medical condition such as severe hypertension that complicates the pregnancy. In Mississippi, nearly all non-medically necessary early-term births have been eliminated thanks to a partnership with network physicians and the 39 Weeks Initiative, designed to lower the risk of complications during birth by putting an end to the trend of medically unnecessary early term deliveries.
Additionally, BCBS Mississippi and MSPQC will be working with hospitals and physicians to implement a Maternal Safety Bundle that will support more vaginal births and prevent unnecessary C-sections.
See what other Blue Cross and Blue Shield companies are doing to improve maternal health.