Pregnant Latinas face greater maternal health concerns

Zaza Cristina Robles worked as a pregnancy coach in her native Peru, so when she arrived within the U.S. at 16 weeks pregnant, the very first thing she did after settling in together with her in-laws was to hunt medical care.

“After they showed us the bill, it was so expensive, my husband and I assumed, ‘If that is only for the doctor’s visit, imagine what the delivery can be?’ It scared us,” she said.

Her sister-in-law put her in contact with the Hispanic Health Council, a nonprofit in Hartford, Connecticut. The organization’s Comadrona — or midwife — program helps Latina immigrants and low-income pregnant women navigate the complications of the U.S. health-care system.

“They really helped clear up a whole lot of my fears,” Robles said.

This system helped Robles gain health-care coverage as she and her husband seek asylum in the USA. Her comadrona helped her find a health care provider who treats low-income patients and connected her with other services.

“Considered one of the things that we do here at Hispanic Council is provide birthing classes, in their very own language,” said Bianca Noroñas, the Comadrona program manager.

Noroñas said coaching and social services have helped the moms within the nonprofit’s program avoid medical complications during childbirth.

“When you don’t receive education and support, that’s going to affect you directly in your life,” Noroñas said.

Within the U.S., the speed of maternal morbidity — medical complications in childbirth — and maternal mortality is almost twice as high as in other developed nations.

“We have been paying quite a bit more attention to try to grasp why these differences persist and why our numbers are so high,” said Marie Thoma, a professor on the department of family science on the University of Maryland School of Public Health. “A variety of investment has been going into addressing a few of these aspects across the health before, during and after pregnancy that we are able to improve on within the U.S.”

U.S. maternal mortality worsened in the course of the pandemic, especially for Latinas. In line with the Centers for Disease Control and Prevention, the U.S. saw 23.8 maternal deaths per 100,000 live births in 2020, up 18.4% from 2019. For Black women, the maternal mortality rate jumped 25%, while for Hispanic women it surged 44%.

While researchers are usually not clear on why Latinas saw such disproportionately higher mortality rates in 2020, the general trend within the U.S. has been that ladies of color have had poorer outcomes in childbirth.

Latinas with private insurance policy have a 22% higher rate of severe pregnancy complications than non-Hispanic white women, in accordance with a Blue Cross Blue Shield Association study. Low-income Hispanic women on Medicaid have a 28% higher rate of complications.  

Higher rates of obesity and chronic conditions corresponding to diabetes amongst women of color can play a job in maternal morbidity. Financial barriers to getting proper care also contribute to poorer outcomes for Black and Hispanic women, in addition to cultural barriers in health care, said Hispanic Health Council board member Dr. Yvette Martas.

“It’s the problem of being listened to,” said Martas. She said the health-care system must support moms beyond the delivery room, “creating the culture where this just isn’t a disease model, nevertheless it’s a really natural course of how we reproduce.” 

An evaluation by the Commonwealth Fund calculated that the price of maternal and child morbidity for U.S. births in 2019 reached $32.3 billion from conception through the kid’s fifth birthday. That amounts to an extra $8,624 for every mother-child pair, in accordance with the researchers.

Health insurers and huge employers corresponding to Walmart have taken note of the issue. This yr, Walmart expanded coverage for pregnancy-support programs to staff in 4 states by providing as much as $1,000 for doula services. 

Through its pregnancy-support initiative, Blue Cross Blue Shield of South Carolina has seen maternal and infant morbidity rates decline substantially. The insurer’s Centering Pregnancy program has cut the speed of newborns needing to enter the neonatal intensive care unit from 13.9% to three.5% — at a median savings of $67,000 on NICU costs.

“I feel offering doula programs and offering paid leave — there’s a whole lot of things that I feel our corporations can do … that might really support mothers during after which just as they return to work,” Thoma said. “It’ll give back to the corporate as well.”

Beyond pregnancy, the Comadrona program also offers postpartum support. Robles said she got help with diapers and lactation coaching. 

“Thank God … It turned out well for us and so they cared for us so well,” said Robles, whose delivery had no complications.