DURHAM N.C. – The Blue Cross Blue Shield Association (BCBSA) recently released a report that confirms women of color are at higher risk of pregnancy-related complications, regardless of having commercial health insurance or Medicaid. Data indicates pregnancy-related complications have worsened 9% nationally and 29% in North Carolina since 2018, with marked increases during the COVID-19 pandemic. National findings indicate some women of color have nearly 70% higher risk of pregnancy-related complications compared to White women. The report shows U.S. maternal health disparities are likely the result of broader health system and societal challenges, including underlying chronic conditions, racial inequities, and likely biases within the health care system.

“We must acknowledge the challenges driving these discrepancies in health outcomes,” says Anu Rao-Patel, associate vice president and senior medical director at Blue Cross NC. “A healthier North Carolina begins with healthier pregnancies – and healthier pregnancies depend on equitable access to resources, support and maternal care.”

The study, Racial and Ethnic Disparities in Maternal Health, examines the rate of childbirth complications in nearly 11 million U.S. births to women nationwide with either commercial insurance or Medicaid as measured by the CDC’s Severe Maternal Morbidity Measure (SMM). This comprehensive analysis found:

  • Black, Hispanic and Asian women have higher rates of SMM than White women, regardless of age or type of health insurance.
  • Preexisting health conditions, such as hypertension, diabetes or asthma, pre-term delivery, strongly correlate with higher SMM and worse pregnancy complications, increasing the likelihood of a risky delivery or challenges postpartum.
  • Women ages 35-44 were identified as most likely to have an SMM event across all populations
  • Black women aged 35-44 have a 66% higher rate of SMM and are more likely to suffer pregnancy-related complications than White women.

In North Carolina:

  • The SMM rate per 10,000 births increased by 29% between 2018 and 2021
  • SMM rates for Black women with commercial insurance were 29% higher, and 44% higher with Medicaid, compared to respective SMM rates for White women.
  • The severe maternal morbidity rate per 10,000 births is higher for Black, Hispanic and White commercially insured, when compared to national rates.
MicrosoftTeams-image 4


Blue Cross NC Maternal Health Initiatives

To confront disparities in North Carolina, Blue Cross NC is working with organizations across the state to tackle maternal and infant health inequities. The company is investing $2 million into seven organizations to make a significant improvement on infant and maternal health outcomes across the state - specifically the health and well-being of pregnant members, and children, of color. These initiatives will:​

  • Address non-medical drivers of health for pregnant members, including food security, transportation and affordable housing ​
  • Increase access to specially trained nurses, breastfeeding education and diverse lactation consultants and doulas​
  • Improve the quality and spectrum of care for pregnant members and their babies​
  • Educate providers on racial bias and its implications on health outcomes for pregnant members and their babies​

These initiatives will span multiple years, help improve the experiences for pregnant members and babies from historically underserved communities and contribute to Blue Cross NC’s goal of reducing racial disparities in maternal and child health by 50% in five years. For more information about Blue Cross NC maternal health initiatives, visit bluecrossnc.com/maternal-health.

“When it comes to racial disparities in childbirth complications, the pandemic has only sent us further in the wrong direction—and we were in a bad place to begin with,” said Kim Keck, president and CEO of BCBSA. “We have a bold goal of reducing racial disparities in maternal health by 50% in five years, and BCBS companies are taking action through advocacy, partnerships and local programs to support mothers at every stage of their pregnancy. Every mother deserves to have a healthy pregnancy, deliver a healthy baby, and live a healthy postpartum life. We invite everyone to join us in making this a reality.”

Guided by efforts already underway at BCBS companies, BCBSA also developed a list of 10 actions organizations can adopt to improve maternal health and make a measurable difference in health disparities.

Read the full report, “Racial and Ethnic Disparities in Maternal Health,” part of the Blue Cross Blue Shield, The Health of America Report® series. For more information about the BCBSA National Health Equity Strategy and maternal health programs, visit BlueHealthEquity.com.

About Blue Cross and Blue Shield of North Carolina

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is committed to making health care better, simpler and more affordable. We have been driving better health in North Carolina since 1933, working to tackle our communities’ greatest health challenges. Blue Cross NC serves its customers and communities of more than 4.2 million members, including approximately 1.1 million on behalf of other Blue Plans. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association. Visit Blue Cross NC online at www.bluecrossnc.com. All other marks are the property of their respective owners.

Blue Cross, Blue Shield and Blue Cross Blue Shield, The Health of America Report are registered trademarks of Blue Cross Blue Shield Association.