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BCBSA Study: Pregnancy and Childbirth Complications Rise as More Millennial Women Have Pre-Existing Conditions That Can Increase Their Risk

By June 17, 2020July 17th, 2020BCBSA News Featured
a baby sleeps on a mother's shoulder. Graphic reads: The number of women diagnosed with postpartum depression increased by nearly 30%

Anxiety disorders and depression increased among Independence pregnant members

Philadelphia – June 17, 2020  New findings from the Blue Cross Blue Shield Association (BCBSA) found that both pregnancy and childbirth complications increased 16.4% and 14.2%, respectively, with women who experience pregnancy complications becoming twice as likely to have childbirth complications as well. The findings come from a new BCBSA report, “Trends in pregnancy and childbirth complications in the U.S.” The report, part of the Blue Cross Blue Shield, The Health of America Report® series, examined 1.8 million pregnancies between 2014 and 2018 among commercially insured women ages 18-44.

In 2018, there were 213.2 (per 1,000) pregnancy complications in the Philadelphia region, compared with 196 nationally. For the same year, there were 13.2 (per 1,000) childbirth complications in the Philadelphia region compared with 16.9 nationally.

Millennial women make up 85% of all pregnancies in the U.S. According to The Health of Millennials report, this age group has experienced a double-digit increase in 8 of the 10 top health conditions like major depression, hypertension and type II diabetes, which may lead to higher risks of pregnancy and childbirth complications as well. Since 2014, pregnant women aged 18-44 have seen a:

  • 35% increase in major depression
  • 31% increase in hypertension
  • 28% increase in Type II diabetes

The rate of anxiety disorders and depression increased 22% and 15%, respectively, for pregnant Independence members ages 14-40 from 2015-2018. The rate of increases for these disorders was nearly the same for all women ages 14-40.

The COVID-19 pandemic has also had a direct impact on pregnant women, with one in four women skipping a prenatal visit and 53% reporting that they could not have a loved one in the delivery room with them; 15% delivered their baby at home. The increase in virtual care options also led to 48% pregnant women shifting their prenatal appointments to virtual visits. After childbirth, mothers also saw a nearly 30% increase in postpartum depression diagnoses, with the diagnoses being most prevalent in women aged 18-24.

To help our members, Independence offers the Baby Blue Prints program which supports expectant mothers and promotes a healthy pregnancy throughout each trimester. Women enrolled in the program are screened for depression and referred for mental health services if necessary. In addition, women with chronic health conditions such as diabetes are eligible to receive personal health coaching to help them better manage their overall health.

“Independence is committed to supporting our pregnant members through every stage of their pregnancy, including ensuring they have access to educational and clinical resources, especially as we navigate these uncertain times,” said Dr. Ginny Calega, vice president of Medical Affairs at Independence. “We’re encouraging all our members, including pregnant women, to use telehealth services as a way to ensure they don’t miss any vital appointments and get the care they need.”

For expecting mothers seeking information on the quality of care, Blue Distinction Centers (BDC) and Blue Distinction Centers+ (BDC+) for Maternity Care are healthcare facilities available across the country that meet quality selection criteria. These Centers demonstrate better overall patient satisfaction and a lower percentage of early elective deliveries. In 2018, BDC/BDC+ facilities across the country cared for more than 40% of Blue Cross and Blue Shield commercially insured women giving birth. More information on Blue Distinction Centers can be found here:

This is the 31st study of the Blue Cross Blue Shield, The Health of America Report® series, which uses an integrated dataset combining the pregnancy episodes data curated from BCBS Axis Data and the BCBS Health Index. In April 2020, BCBSA also surveyed >1,000 of commercially insured women 18-44 who were pregnant or delivered in March or April to understand the impact COVID-19 has had on their mental health, prenatal care, postnatal care and delivery plans.

For more information, visit

About Blue Cross Blue Shield Association

The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. BCBSA provides health care insights through The Health of America Report series and the national BCBS Health Indexsm. For more information on BCBSA and its member companies, please visit We also encourage you to connect with us on Facebook, check out our videos on YouTube or follow us on Twitter.

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