1 Jul, 2022

A turning point in the fight for maternal health equality

Today, 1 de julho, 2022, marks the beginning of required reimbursement in Rhode Island by private health insurers and Medicaid for services provided to pregnant women by a doula. This important piece of legislation was signed into law last summer, and Blue Cross & Blue Shield of Rhode Island (BCBSRI) actually began covering this important service in 20 de janeiro22, further championing the passage of this legislation as part of our ongoing efforts to address maternal health equity and racial disparities in our healthcare system.

The passage of this law recognizes that doulas can improve health outcomes, as well as the likelihood of women of color having a positive childbirth experience with a reduced risk of complications. Doulas are trained healthcare professionals who provide women with continuous physical, emotional, and informational support during pregnancy, childbirth, and throughout the post-partum year. This law will provide more women with access to doulas to help address health disparities faced by communities of color. Studies show that doulas help reduce the rate of C-sections, which occur at higher rates among Black women, and also increase successful breastfeeding, which improves the health of new moms and babies and is less common among Black or low-income women. Learn more about BCBSRI’s coverage for doula services here.

Supporting this critical legislation was just one of many steps BCBSRI is taking to help address maternal health disparities locally and nationally. We understand the urgent need to create solutions to these issues which are facing many in our community, so we’ve aligned with the Blue Cross Blue Shield Association (BCBSA) and their 2021 commitment to reduce racial disparities in maternal health by 50% in five years. That commitment includes specific steps in key areas such as working with invested community stakeholders, providing cultural humility and unconscious bias training to maternal care providers (read more on this below), and increasing access to doulas and other community health workers, which is well underway with the recent legislation. See the entire list of BCBSA maternal health equity actions here.

We’ve also recently launched a high-risk maternal case management program, with a goal to reduce the risk of pre-term births, low birth weights, and pregnancy-related complications by providing relevant information, tools, and resources to expectant mothers. Through this program, case managers help participants increase their general knowledge about the various stages of pregnancy. We’re building partnerships with Ob/Gyns and maternal care providers throughout Rhode Island to maximize the effectiveness of the program.

Additionally, we’re working with local minority-owned doulas/doula services to host training sessions for participating providers this month. Working together, providers and doulas play a crucial role in providing prenatal care and influencing positive lifestyle habits like nutrition and physical activity, while de-emphasizing negative factors such as smoking and alcohol use. The goal is to find ways to work together to ensure that we’re adequately prepared to help mothers be ready to properly care for their infants after pregnancy.

Through the BCBSA, we also now have access to implicit bias training – provided by the March of Dimes – designed to foster cultural sensitivity for maternal care providers. This unique in-person or virtual learning experience, called “Breaking Through Bias in Maternity Care," provides authentic, compelling content for healthcare professionals who care for women before, during, and after pregnancy. Like the BCBSA and individual Blue plans like BCBSRI, the March of Dimes supports increased access to doula care as one way to improve birth outcomes, and recognizes the importance of increased training and support for doulas, particularly in racially, ethnically, socioeconomically, and culturally diverse communities.

Our maternal health workgroup is exploring other important steps we can take related to creating culturally appropriate interventions for mothers and their newborns, improving childbirth safety for women of color, and providing support for women who are experiencing post-partum depression. And we’ve offered support to the National Perinatal Information Center (NPIC) for funding of the Rhode Island perinatal quality collaborative. We believe that as the lead organization for the Perinatal Neonatal Quality Collaborative of Rhode Island (PNQCRI), NPIC is uniquely positioned to support maternal mortality prevention.

To summarize, BCBSRI has taken several steps to address maternal health disparities. But is there much more work to be done? Absolutamente. To be quite frank, there are some ugly disparities out there with regards to maternal health. We all know what they are, and it’s our collective responsibility to work together to minimize and hopefully eliminate them. We owe it to our communities and the people we serve. We look forward to working with you on this important initiative.

In July, we observe Cord Blood Awareness Month as well as Healthy Vision Month. As always, thank you for your partnership and for all you do to help our members stay safe and healthy.

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