When It Comes to Supporting Black Maternal Health, the U.S. Doesn’t Deliver … Yet

There are only three countries in the entire world where the maternal death rate is rising: Afghanistan, Sudan … and the United States.

This alarming trajectory is due in no small part to inequities in community health. Food security, social isolation, chronic health conditions and access to quality care all play a profound role in the health of a pregnancy. These drivers of health are shaped by social and economic circumstances beyond an individuals’ control. Pregnant women living in underserved communities simply do not have equal access to the resources they need to ensure a healthy pregnancy.

Even before COVID-19 struck, communities of color were far more likely to face barriers to good health. 2020 magnified these challenges. Communities of color have been more susceptible to the virus, and that has put pregnant women in these communities at even greater risk. Research from the National Institutes of Health has shown that, throughout the pandemic, expectant Black women have been more likely to face job insecurity, experience lasting economic burden and feel anxious about their birthing experience.

This is why the Black Maternal Health Momnibus Act of 2021 feels so relevant at this particular moment: the unique challenges pregnant women of color face aren’t new, but they’ve reached a new level of urgency.

The U.S. Lags Behind Other Nations in Maternal Care

Across the board, maternal health hasn’t improved over the decades … it has suffered.

According to a recent Health of America report from the Blue Cross Blue Shield Association, pregnancy complications rose by more than 16% in recent years. Childbirth complications increased more than 14%. Nationwide, depression during pregnancy spiked by 35%. Tragically, the United States has the highest maternal mortality rate compared against 10 other high-income countries. 

Race plays an outsized role driving these unwelcome outcomes. According to the Centers for Disease Control, “Black, American Indian, and Alaska Native (AI/AN) women are two to three times more likely to die from pregnancy-related causes than white women – and this disparity increases with age.” This alone doesn’t capture the magnitude of the problem, either. The National Institutes of Health reports that for every woman who dies during delivery, another 70 will experience severe complications that can have long-term consequences on overall well-being.

Black babies are also at much greater risk. The March of Dimes 2020 Report Card shows that disparities in preterm birth have increased over the past several years in the United States. Women of color are up to 50% more likely to give birth preterm, and their children face up to a 130% higher infant death rate. In North Carolina, the preterm birth rate among Black women is 46% higher than the rate among all other women.

It's no surprise that, even while our nation is still coping with COVID-19, Americans seem to recognize the critical need for action along the lines of what the Momnibus Act proposes.

The Drivers of Health That Influence Maternal and Infant Care

The Act, co-sponsored by North Carolina’s own Congresswoman Alma Adams, takes a sweeping, comprehensive approach to improving maternal health among women of color. Across 12 unique bills, it tackles imperative issues such as:

·        Making critical investments in the drivers of health that influence maternal health.

·        Improving data collection to better understand the causes of the maternal health crisis.

·        Promoting innovative payment models to incentivize high-quality maternity care and non-clinical perinatal support.

More than that, the Momnibus Act also proposes interventions on a wide range of issues that impact healthy pregnancies, including COVID-19 and maternal vaccinations.

The scope of these proposals is critical. If the United States is serious about transforming our maternity care system into the standard of quality among wealthy nations, we first must tackle a dense accumulation of inequities.

This package will improve the health outcomes of all pregnant women and mothers. But its impact will be felt particularly among Black and American Indian women, incarcerated women, female veterans and other marginalized people.

Healthier Pregnancies Will Strengthen Individuals, Families and Communities

I’m particularly proud of the fact that Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is part of a national association that has been outspoken in its support of this legislation. As an insurer driven by a purpose to improve health and well-being for all, Blue Cross NC recognizes that healthy pregnancies are vital to the well-being of individuals, families and communities.

In fact, many of our longstanding initiatives and services firmly align with the goals staked out in the Momnibus Act. Through our service innovations and our many collaborations with other organizations, we are identifying and addressing the drivers that undermine maternal health, especially in communities of color.

Blue Cross NC has been supporting efforts to improve Black maternal health here in North Carolina. But, when it comes to serving expecting mothers and infants, the health care system’s failing record demands a concerted, strategic response at the national level. The Momnibus Act is an important step in that direction.