Improving Postpartum Maternal Health Outcomes
The risks of childbirth do not end at delivery. Dangerous, unexpected birth complications or health-related events, categorized as severe maternal morbidity (SMM)1 events, can take place during labor and delivery as well as during the postpartum period. These events can lead to long-lasting consequences, or even death.
Our research shows that as many as one third of all SMM events occur during the postpartum period, defined here as the six weeks following discharge from the hospital. Black patients are at a much higher risk of experiencing a postpartum SMM event than their white and Latina counterparts, even after the delivery of their child.
Our research underscores the importance of providing more focused medical care following labor and delivery and, furthermore, researching the root causes of unexpected birth complications to better predict and prevent SMM events. In doing so, we can help address the racial and ethnic disparities that exist in SMM rates during the postpartum period and better protect all new parents.
This report examines the racial disparities that exist in the rate of SMM events during the six weeks following a patient’s release from the hospital after giving birth. Our analysis draws on data from more than 700,000 Blue Cross Blue Shield (BCBS) commercially insured births from January 1, 2019 to December 31, 2022. Additionally, we assessed more than 1.5 million Medicaid births from the Centers for Medicare & Medicaid Services (CMS) which was provided by and analyzed by The National Opinion Research Center (NORC) at the University of Chicago. This data is from January 1, 2017 to December 31, 2021. The BCBS data and the NORC at the University of Chicago data are distinct and not intended for a direct comparison. Still, the breadth of these two data sets gives us deep insight into health outcomes in the six weeks after discharge from the hospital.
This report calculates the postpartum SMM rate inclusive of any SMM event that occurred in the 6-week post-delivery discharge period, regardless of whether a SMM event also occurred during delivery.
This data underscores the urgency to take action.
Key Findings
Black and Latina patients experience postpartum SMM events at a higher rate than white patients. Postpartum SMM rates are 87% higher among Black patients and 7% higher among Latina patients in the commercially insured population.
Key Findings
Black patients are hospitalized more often than white patients. Hospitalization rates are 71% higher for Black patients in the commercial population.
Key Findings
Just six events account for three quarters of SMM events in both the commercially insured and Medicaid-insured populations.
ENDNOTES
- SMM events, as defined by the CDC, are a set of 20 unexpected, adverse outcomes of labor and delivery, up to six weeks postpartum, that can result in significant short- or long-term consequences to the patient’s health. Some examples of SMM events include sepsis, acute renal failure and thrombotic embolisms.
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