Greater Harrisburg's Community Magazine

Expecting Better: New report focuses attention on improving maternal health

The pregnancy rate is down, but the rate of pregnancy and childbirth complications is on the rise, according to the Blue Cross Blue Shield Association’s latest Health of America report.

That report, which examined claims data from 1.8 million pregnancies among women aged 18 to 44 from 2014 to 2018, underscored the importance of focusing on maternal health in America.

The pregnancy rate declined 2%, with millennials accounting for 85% of births. And while 80% of women had uncomplicated pregnancies and deliveries, the report also found that from 2014 to 2018:

  • Pregnancy complications (gestational diabetes, preeclampsia) increased 16.4%.
  • Childbirth complications (eclampsia, cardiomyopathy, embolism, sepsis, respiratory distress) increased 14.2%.
  • The rate of women experiencing both pregnancy and childbirth complications increased 31%.
  • The number of women diagnosed with postpartum depression increased 30%.
  • Nearly one in 10 new mothers, including three of every 10 in the 18 to 24 bracket, was diagnosed with postpartum depression.
  • 4% of women received no postnatal care at all.
  • Chronic physical and behavioral conditions that can complicate pregnancy and childbirth grew significantly. Obesity increased 100% from 9.1% to 18.2%; major depression grew 35% from 4.1% to 5.5%.

Pregnancy and childbirth problems can harm mothers and babies and heap enormous costs on the system.

Pregnancy complications increase the average cost of a vaginal delivery by 16% and a C-section delivery by 18%, the report stated.

Childbirth complications increase the average cost of these deliveries by 63% and 52%, respectively.

Routine prenatal and postnatal care improves pregnancy and childbirth outcomes, but the report found that 14% of women did not get prenatal care within the first trimester of pregnancy and a third received less than the recommended 10 prenatal care visits.

Social barriers such as limited availability of appointments, lack of transportation and too few providers contributed to the dismal numbers, the report said.

“It’s a disturbing trend,” said Capital BlueCross Chief Medical Officer Dr. Jennifer Chambers.

“Quality care is critical to helping women lead healthier lives that reduce the likelihood of tragic and costly pregnancy and childbirth complications,” she said  “A greater focus on maternal health will improve lives now and will pay dividends for years to come as that healthier child ages.”

Blues plans across the nation are already working to focus more on maternal health care through the Blue Distinction Center and Blue Distinction Center+ program.

Blue Distinction Centers are healthcare facilities and providers that have met strict care guidelines and demonstrated expertise in any of 11 specialty care areas, including maternity care. Pennsylvania has 18 such hospitals, with several in Harrisburg, Camp Hill and Hershey.

Those with the “plus” designation have also demonstrated a high degree of efficiency in delivering that healthcare. There are 33 such hospitals in Pennsylvania.

In 2018, Pennsylvania ranked third behind Texas and Florida for the highest number of pregnancies, with 25,550. It ranked eighth in the nation with 214.8 pregnancy complications per 1,000, and 14th for most cases per 1,000 of postpartum depression.

Capital BlueCross has been collaborating with WellSpan Health in an effort to improve access to care and improved outcomes for moms and babies. Their joint effort will launch this summer.

The insurer promotes preconception care in which women can learn how to take care of their bodies prior to pregnancy by monitoring high blood pressure, checking folic acid levels and making sure vaccines are up to date.

Additionally, Capital BlueCross supports expecting and new mothers with resources and advice for a healthy pregnancy and can link case managers with moms and babies with special needs.

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