Maternal mortality rates in the U.S. are high, particularly for Latinas.

• High-income countries, the U.S. has one of the highest maternal mortality rates, with Black and Hispanic women experiencing some of the worst outcomes.
• Pregnancy complications are more common among Latinas with private insurance, with a 22% higher rate compared to non-Hispanic white women, according to Blue Cross Blue Shield. The problem is even more pronounced for low-income Hispanic women on Medicaid.
• Organizations like the Hispanic Health Council of Hartford, Connecticut, are dedicated to providing assistance to immigrant and low-income Latinas during pregnancy, childbirth, and postpartum recovery.
• More and more, companies such as Walmart and health insurers are investing in doula and pregnancy-support programs to reduce both financial and emotional costs.

Upon arriving in the U.S. at 16 weeks pregnant, Zaza Cristina Robles, who had previously worked as a pregnancy coach in Peru, immediately sought medical care after settling in with her in-laws.

The bill was so expensive that my husband and I were scared of the cost of the delivery.

The Hispanic Health Council, a nonprofit in Hartford, Connecticut, introduced her to their Comadrona program, which assists Latina immigrants and low-income pregnant women in dealing with the challenges of the U.S. healthcare system.

Robles stated that they helped alleviate many of his fears.

Robles gained health-care coverage with the help of her comadrona, who found her a doctor who treats low-income patients and connected her with other services.

Bianca Noroñas, the Comadrona program manager at Hispanic Council, stated that one of their services is offering birthing classes in the participants' own language.

The mothers in the nonprofit's program have avoided medical complications during childbirth thanks to coaching and social services, according to Noroñas.

Education and support are crucial, as their absence will have a direct impact on your life, according to Noroñas.

Nearly twice as many women in the U.S. experience medical complications or die from childbirth compared to women in other developed countries.

Marie Thoma, a professor at the department of family science at the University of Maryland School of Public Health, stated, "We have been putting in more effort to comprehend the reasons behind the persistence of these differences and the high numbers we see. There has been a significant amount of investment directed towards addressing certain health factors during, before, and after pregnancy, which we can enhance in the U.S."

Latina maternal morbidity and mortality

During the pandemic, the United States experienced a rise in maternal mortality, particularly among Latinas. The Centers for Disease Control and Prevention reported that the U.S. had 23.8 maternal deaths per 100,000 live births in 2020, which was an 18.4% increase from the previous year. The maternal mortality rate for Black women increased by 25%, while it surged by 44% for Hispanic women.

Despite the lack of clarity among researchers on the reasons behind the higher mortality rates of Latinas in 2020, it is evident that women of color have generally experienced poorer outcomes in childbirth in the U.S.

A Blue Cross Blue Shield Association study found that Latinas with private insurance plans have a 22% higher rate of severe pregnancy complications compared to non-Hispanic white women, while low-income Hispanic women on Medicaid have a 28% higher rate of complications.

The prevalence of obesity and chronic conditions like diabetes among women of color can increase maternal morbidity. Financial constraints and cultural barriers in healthcare negatively impact Black and Hispanic women, according to Dr. Yvette Martas, a member of the Hispanic Health Council board.

Martas stated that the issue is not being heard, emphasizing the need for the healthcare system to support mothers beyond the delivery room. She advocated for a culture that views childbirth as a natural process rather than a disease model.

High costs spur investments

In 2019, the cost of maternal and child morbidity for U.S. births was $32.3 billion, which amounts to an additional $8,624 per mother-child pair, according to a study by the Commonwealth Fund.

Large employers and health insurers have recognized the issue and this year, Walmart has increased coverage for pregnancy-support programs in four states, offering up to $1,000 for doula services.

The Centering Pregnancy program of Blue Cross Blue Shield of South Carolina has significantly reduced the rate of newborns requiring NICU admission, resulting in an average savings of $67,000 on NICU costs.

Thoma believes that companies can support moms during and after their return to work by offering doula programs and paid leave. According to Thoma, this will not only benefit the mothers but also give back to the company.

The Comadrona program provides postpartum support beyond pregnancy, including assistance with diapers and lactation coaching, as stated by Robles.

"We were fortunate that our delivery went smoothly and we received excellent care," said Robles, whose delivery was complication-free.