2021 Hero Maternal Health HOA Report Maternal and Infant Health

Race a greater factor in pregnancy complications than age

The U.S. lags significantly behind other developed nations when it comes to preventing death and other serious complications related to pregnancy and childbirth. Each year, roughly 700 women  die during pregnancy or in the year following. Additionally 50,000 others will experience severe complications that will lead to serious health consequences. Across the country, women struggle to find access to quality maternal health care. In fact, 35 percent of counties in the U.S. are considered ‘maternity care deserts,’ meaning there are no hospital maternity units, OB/GYNs or certified nurse-midwives.

These statistics are terrifying, and for women of color—particularly Black and Native American women­­—the picture is even bleaker. Their likelihood of dying from pregnancy-related complications is two to three times that of white women, and delivery complications are 46 percent higher among Black women. A new Blue Cross Blue Shield Association study offers a closer look at the disparities that exist.

“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.”

BCBSA recently announced a National Health Equity Strategy to address health disparities including a commitment to reducing racial disparities in maternal health by 50 percent in five years. As part of this strategy, the newest study, “Racial Disparities in Maternal Health,” includes data from commercially insured births covered by Blue Cross and Blue Shield companies between January 2018 and October 2020.

Key findings:

  • Across all age groups, the rate of Severe Maternal Morbidity (SMM)—unexpected outcomes of labor and delivery resulting in significant short- or long-term health consequences—is higher for Black  and Hispanic communities compared to white ones.
  • Women in majority Black communities have a 63 percent higher rate of SMM than women in majority white communities. Women in majority Hispanic communities have a 32 percent higher rate of SMM than women in majority white communities.
  • Risk of delivery complications increases for all women over the age of 35, but in Black communities, women under 35 had SMM rates higher than women over 35 in predominantly white communities.
  • The SMM rate for Hispanics grew 19 percent during the timeframe of the study. With a hysterectomy being the most common SMM, Hispanic mothers are 63 percent more likely than white mothers to have one as a result of complications during childbirth. 

The racial disparities in SMM rates suggest that women of color may experience pregnancy and childbirth much differently than white women. To learn more about these experiences, BCBSA conducted a survey of roughly 750 women between 18 and 40 who were pregnant or had a given birth in the last year.    

Hear BCBSA President and CEO Kim Keck as part of a National Association of Black Journalists webinar on racial disparities in maternal health with Rep. Lauren Underwood and Rachel R. Hardeman, PhD, MPH, University of Minnesota, School of Public Health

Additional Resources:

  • Read the full study here.
  • For more information about the BCBSA National Health Equity Strategy and its Maternal Health Program, visit BlueHealthEquity.com.
  • Read the BCBSA Issue Brief on addressing health disparities and inequities in communities of color.
  • Read thoughts from BCBSA CEO Kim Keck in an Aspen Ideas blog on improving maternal health by addressing health equity in health care.
  • See how Blue Cross and Blue Shield companies are improving maternal health.

Get Email Updates