Maternal health is not equal in the United States. Black maternal health, specifically, is in crisis due to health inequities driven by experiences of interpersonal and institutionalized racism in healthcare settings. Black women are three to four times more likely to die from pregnancy-related causes than white women. They are also more likely to experience life-threatening conditions like preeclampsia, postpartum hemorrhage and blood clots.
In response, Blue Shield’s Maternal Child Health Equity program started in 2022 as a regional pilot in Fresno, Los Angeles and Sacramento. It brought together doula services, technology, educational support, and comprehensive perinatal and postpartum wraparound care, shepherded through Mahmee, a maternal healthcare company, as well as community-based organizations.
As of August 2023, nine employer groups are a part of an expansion plan for our work with Mahmee in a provider network market test, focusing on those in the Los Angeles, Sacramento, Inland Empire and Bay Area regions.
Leigh Purry, senior manager of Health Equity at Blue Shield of California, shares how Blue Shield’s Maternal Child Health Equity initiative is working to improve maternal health care by supporting Black mothers in new ways.
What do you wish people knew about maternal health inequities?
Maternal health inequities are deeply rooted and affect women from diverse backgrounds. It is important to understand that these inequities extend beyond medical care and include social, economic and systemic factors that disproportionately impact marginalized communities. Recognizing and addressing these disparities is essential in taking the first steps in achieving equitable outcomes in maternal health.
How do members feel the impact of Blue Shield's new maternal health programs?
I've witnessed firsthand the positive impact of Blue Shield's Maternal Child Health Equity initiative in improving access to care, reducing disparities, and empowering women to confidently navigate their pregnancy and childbirth journeys. Focusing on education, doula support, mental health support and advocacy, these programs have made a meaningful difference in the lives of women and families, promoting healthier outcomes and fostering greater equity in maternal healthcare.
These outcomes include a decreased rate of cesarean section deliveries for Black mothers participating in the doula program (24%) compared to the statewide average (30%). Our goal is to reduce C-section disparities between black and white mothers by 50% by 2028.
What is Blue Shield’s maternal health focus?
We are currently focused on:
- Enhancing access to comprehensive maternal health care services for all women, regardless of socio-economic status or location.
- Implementing culturally sensitive and inclusive health care practices to address diverse community needs and preferences.
- Advocating for policies and initiatives that promote health equity and address the root causes of maternal health disparities.
Why are you passionate about maternal health equity?
My passion is deeply rooted in my own experiences and fuels my deep commitment to social justice. During my pregnancy as a young mother, I faced significant challenges navigating the healthcare system and barriers to receiving adequate support and understanding. Like many women, the shame I felt prevented me from attending prenatal appointments, and I neglected my own postpartum care needs.
However, one particular moment during childbirth remains vivid in my memory. Despite my clear request to turn onto my side for delivery, a nurse insisted on keeping me on my back, causing distress and discomfort. It was only through the intervention of a compassionate nurse, who advocated for me and helped me turn, that I was able to deliver my daughter smoothly. Reflecting on my experience, I realized the profound impact of having a supportive advocate during a major life – and health – event. This experience fuels my determination to advocate for maternal health equity, ensuring every woman receives the respect, dignity and support she deserves during pregnancy and childbirth.
What is your hope and vision for the future of maternal health?
My hope is that every woman receives equitable, high-quality maternal health care. I envision a healthcare system that prioritizes equity, addresses disparities, gives access to diverse providers (who understand the communities they serve respective to race and ethnicity and cultural needs and differences), and empowers women to make informed decisions about their reproductive health unashamedly.
For more information about the Maternal Health Child Equity initiative, read this News Center story.
For more about Mahmee, visit their website.