Blue Cross Blue Shield: COVID-19 Impacting Maternal Care

The COVID-19 pandemic has changed how many women access prenatal care. According to the Blue Cross Blue Shield Health of America Report on Maternal Health, 61% of commercially insured women surveyed nationally saw limited office hours from their doctors, and 48% had their appointments shifted to virtual visits. More concerning is that over 1 in 4 women surveyed skipped prenatal care appointments since the start of the pandemic or when social distancing restrictions were put into place.

The COVID-19 pandemic also impacted delivery plans for the majority of women surveyed:
* 53% were not able to have a loved one in the delivery room with them
* 28% delivered at a different hospital than they originally planned
* 15% used a different doctor
* 15% shifted to a home birth

Postnatal care plans also changed for a majority of women due to COVID-19.
* 61% said their doctor’s office hours were limited
* 48% had their appointments shifted to virtual visits
* 25% of women missed their postnatal visits.

According to the Centers for Disease Control, it is important for expectant mothers to not skip prenatal care or postpartum appointments. If they are concerned about attending an appointment due to COVID-19, they are advised to talk to their healthcare provider about steps being taken to separate healthy patients from those who may be sick.

Access to quality care is critical to helping women lead healthier lives, have healthier pregnancies and uncomplicated births. Towards this end, Blue Cross has expanded access to telehealth for in-network providers with no member cost-sharing in addition to office visit consultations by physicians. This applies to members wanting to receive their care remotely to limit their exposure to COVID-19.

The Blue Cross Blue Shield HOA report also found that:
* A greater number of women are entering pregnancy with pre-existing conditions like hypertension, type II diabetes, obesity, major depression, anxiety and substance use disorder –increasing the risk of pregnancy and childbirth complications.
* While 80 percent of women have healthy pregnancies and deliveries, rates of complications are rising due to gestational diabetes and preeclampsia (due to high blood pressure). Between 2014-2018, the rates of pregnancy complications rose more than 16%, while rates for childbirth complications rose more than 14%. About seven out of every 1,000 pregnant women experienced both kinds of complications, a nearly 31% increase since 2014.
*Women diagnosed with postpartum depression increased nearly 30% since 2014.

Pre-existing behavioral health conditions are linked with a greater risk for postpartum depression. More than two thirds of women diagnosed with postpartum depression had at least one other behavioral health diagnosis before becoming pregnant, and more than 1 in 4 women had two or more pre-existing behavioral health conditions including anxiety, major depression, and substance use disorder.

You can view the entire Health of America Report on Maternal Health here.

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