New Blue Cross Blue Shield Association Report Finds Racial and Ethnic Disparities in Maternal Health Complications Climbed During COVID-19 Pandemic

Pregnancy and childbirth complications have increased nearly 10% for all women with both commercial and Medicaid insurance

CHICAGO – Today, the Blue Cross Blue Shield Association (BCBSA) released a report that confirms women of color are at higher risk of pregnancy-related complications, regardless of having commercial health insurance or Medicaid. Instead, the data indicates 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. Pregnancy-related complications have worsened 9% since 2018, with marked increase during the COVID-19 pandemic, with some women of color at nearly 70% higher risk of pregnancy-related complications than White women.

“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.”

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

This comprehensive analysis found Black, Latina 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 going into delivery, strongly correlate with higher SMM and worse pregnancy complications, increasing the likelihood of a risky delivery or challenges postpartum. While across all populations women ages 35-44 were identified as most likely to have an SMM event, Black women in this age range have a 66% higher rate of SMM and are more likely to suffer pregnancy-related complications than White women.

“One’s race or ethnicity should not determine how likely you are to suffer from pregnancy-related complications. We must address deep-rooted issues like implicit bias and systemic racism that cause these disparities in the first place,” said Dr. Adam Myers, senior vice president and chief clinical transformation officer for BCBSA. “To achieve better outcomes, we need to make sure care before pregnancy is easily accessible and equitable for all women, in addition to robust prenatal care, and ongoing postpartum care to ensure the safety of future pregnancies.”

The findings further emphasize why BCBSA launched its National Health Equity Strategy in 2021 and is first focused on reducing racial disparities in maternal health by 50% in five years. Through the strategy, Blue Cross and Blue Shield (BCBS) companies are committed to:

  • Advocating for all mothers by working with policymakers to strengthen and scale policies to make care more equitable nationwide.
  • Creating incentives and trainings for providers to offer care that is sensitive and remove unconscious bias within health care delivery.
  • Addressing social drivers of health, focusing on root causes to better help pregnant women, mothers and babies get the care they need.
  • Collaborating with industry partners to standardize data collection and analysis to better understand care gaps and create interventions that will address them.  

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

The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.