In Spite of Awareness and Legislative Efforts, New Data Indicates the Black Maternal Health Crisis Isn't Improving

As we’ve reported numerous times over the past several years, giving birth in the United States remains a dangerous proposition, as pregnant or birthing women are more than twice as likely to die from complications than in most other high-income countries in the world. For Black women, the risks are even higher; new data from the Blue Cross Blue Shield Association’s (BCBSA) “Health of America” report confirm that Black and Hispanic women are more at risk than white women for severe childbirth complications—and are vulnerable regardless of maternal age. While rates of severe maternal morbidity (SMM) have continued to increase among all women since 2018, “disparities in maternal health are so severe that young Black women are at greater risk for childbirth complications than older white women considered high risk (after turning 35),” reads a press release shared with The Root.

The study, conducted as part of BCBSA’s National Health Equity Strategy and comprised of mothers whose births were covered by Blue Cross and Blue Shield commercial insurance from January 2018 to October 2020, revealed disturbing findings, including the following from the press release:

• Black women experience select childbirth complications, as measured by the CDC’s Severe Maternal Morbidity Measure (SMM), at rates up to 3X higher than white women.
• Hispanic mothers’ SMM rates have jumped 19% in 2 short years.
• Hispanic moms are 63% more likely than white moms to undergo a hysterectomy following childbirth complications.

The outcomes are dire for Black and brown mothers; however, the report notes: “Compared to white and Hispanic mothers, Black mothers report feeling their provider did not spend enough time with them and have lower confidence they will receive the care they need. They also feel like they cannot openly speak to their provider about their pregnancy.”

As a result, “Women in majority Black communities have a 63% higher rate of SMM than women in majority white communities. Women in majority Hispanic communities have a 32% higher rate of SMM than women in majority white communities. These rates are higher across all age groups and nearly all indicators. This analysis also shows that Black and Hispanic women have a substantially higher prevalence than white women of the most common risk factors that put women at risk of SMM.”

Those risk factors include bleeding disorders, diabetes and heart disease. Increased awareness of the obstacles to healthy Black birthing experiences may have contributed to a slight decrease in SMM—4 percent—between 2018 and 2020, but was “still much higher than seen in majority Hispanic and white communities,” says the study’s release.

“[C]ompared to majority white communities, women in majority Black and Hispanic communities have higher prevalence rates for nearly all SMM indicators such as kidney failure, sepsis, shock and eclampsia,” read the study, adding: “Women in majority Black communities have up to twice the prevalence of risk factors, such as hypertension or anemia, for SMM than women in majority white communities…Rates of pulmonary edema/acute heart failure showed the widest racial disparity, being nearly three times as prevalent among women in majority Black versus majority white communities.”

The results indicate that awareness alone isn’t enough to reduce racial health disparities, particularly when it comes to maternal health. With a clear and urgent need for intervention to improve the odds and outcomes, BCBSA reported the data and its implications during a webinar on Wednesday in partnership with the National Association of Black Journalists, featuring BCBSA president and CEO Kim Keck, U.S. Rep. Lauren Underwood (IL-14) and Dr. Rachel Hardeman, Founding Director, Center for Antiracism Research for Health Equity at the School of Public Health at the University of Minnesota. BCBSA has made a commitment to reduce maternal health disparities by 50 percent over the next five years.