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Solutions to the maternal care crisis are coming into focus

Pregnancy is perilous for many American women — and outcomes are trending in the wrong direction. Maternal deaths rose 14% during the first year of COVID-19.1 And the rate of severe maternal morbidity has roughly doubled in recent decades.2

Employers, once hesitant to take an active hand in such an intimate health arena, increasingly realize that they are uniquely positioned to effect real change in employees’ maternal health outcomes. From benefits design and management to workplace policies to organizational culture and communication, employers provide the day-to-day backdrop against which a pregnancy unfolds. Strengthening that backdrop to provide more targeted support and more equitable, comprehensive care can help employees buck the trend of poor maternal outcomes and effectively save lives.

There’s no question that bettering such outcomes also makes financial sense. Pregnancy is a time of high health care utilization, and childbirth is the most common cause of hospitalization.3 Severe maternal morbidity increases the length of such hospital stays by as much as 70%.4 And a 2021 Business Group on Health survey of large employers’ health plan design found that high-risk pregnancies were among the top five drivers of employers’ rising health care costs.5

Among people who access insurance through an employer, the combination of labor, delivery and newborn care makes up nearly one in six dollars spent on inpatient care.6 But just as maternity is far more than childbirth, the total costs shouldered by employers for poor outcomes are far greater than hospital stays: higher health spend on pre-term babies, maternal mental health costs, gestational diabetes and hypertensive disorders, as well as lost productivity (estimated at $6.6 billion) and higher rates of long-term disability.7

Maintaining the status quo is a non-starter for employers looking to reel in runaway costs while empowering their employees to navigate this high-stakes time with the best health possible. 

More to the mix

The historically tight labor market is already driving many employers to expand their health benefits, as a means of attracting and retaining talent. Many are rolling out new fertility, prenatal care and maternal health benefits, and also expanding those offerings to include part-time workers and employee dependents. That strategy seems especially prudent, considering millennials (many of whom are squarely in the family-planning and -building stage of their lives) now comprise the largest generation in our current workforce.8

It’s a great time for employers seeking maternal health benefits offerings that are both appealing to employees and effective at delivering ROI. Many health plans now offer a wider portfolio of curated products and benefits, allowing employers to extend offerings more easily to their employees — skirting the need to research and juggle multiple independent vendors. 

Optum’s Maternity Support Program, for instance, spans everything from preconception care to on-demand guidance from a maternity nurse to monitoring and management of triggers that might indicate a higher-risk pregnancy. That type of comprehensive maternal benefit — intended to spot and address issues before they balloon into larger problems, and to close any gaps in education or care — delivers clear clinical benefits. Employers also reported greater productivity and employee satisfaction, and lower absenteeism, with the benefit.

There is also the harder-to-quantify emotional win of supporting employees through what can be a joyous — but also fraught, frightening and frustrating — time in their personal lives. One in four women who aren’t yet parents have trouble getting pregnant or sustaining pregnancy.9 And one in seven women who have had prior births struggle with secondary infertility.10 Proactively promoting an employee benefit, like Optum® Fertility Solutions, makes business sense in terms of better outcomes and lower costs. These benefits guide employees through the fertility landscape, with a personalized mix of education, counseling and access to a national Centers of Excellence network of treatment clinics.

But it’s worth noting that offering maternal care and fertility benefits can also be a real talent differentiator, signaling to current and potential employees that an organization values family building. And employees may be more likely to return from maternity leave — and to show up engaged and committed — when the organization has a culture that embraces, rather than ignores, employees as people and parents.

A ripple effect

Pregnancy is pricey, yes. But it also opens a window of opportunity to engage employees in their health and make positive changes that can extend long past the postpartum period. For some, that may be as simple as enrolling in a stress-management program that seeds a long-term habit. For others, it may mean addressing ongoing health issues, such as substance use disorder, obesity or diabetes, that can carry serious health consequences.

Employers would be wise to embrace pregnancy for the health-improving opportunity that it is, and to view maternal health needs through an appropriately wide lens that includes mental and behavioral care. Assess your benefit offerings with that wider lens in mind: Does the company offer proven programs in tobacco cessation, diabetes management and prevention, weight loss and stress management? What is the utilization of such programs? How can communication strategies be strengthened to get the word out to relevant employees?

Survey employees on which benefits appeal most to them — as people, as working parents, and as expectant mothers. Consider soliciting input not just through online surveys, but also through small focus groups or informally structured conversations. And then, crucially, connect that employee input to specific actions the company can take and close the loop on communication, so employees understand their voice matters. A survey of more than 1,500 workers found that employees are 4.6 times more likely to perform their best work when they feel their voice is being heard.11

Employees want to be heard, and they want to feel that their whole selves — including their health and family planning journey — is supported at work. A modern approach to maternal health benefits can do just that.

1Commonwealth Fund. The high costs of maternal morbidity show why we need greater investment in maternal health. November 12, 2021.


3Health Care Cost Institute. Understanding variation in spending on childbirth among the commercially insured. May 13, 2020.

4Mathematica. The high costs of maternal morbidity show why we need greater investment in maternal health. November 12, 2021.

5Business Group on Health. 2021 Large Employers’ Health Care Strategy and Plan Design Survey. August 2020. 

6U.S. Agency for Healthcare Research and Quality. Most common operations during inpatient stays. Last modified April 21, 2021. 

7Commonwealth Fund. The high costs of maternal morbidity show why we need greater investment in maternal health. November 12, 2021.

8Pew Research Center. 10 facts about American workers. August 29, 2019.

9RESOLVE. The National Infertility Association. Fast facts about infertility. Accessed August 12, 2016.


11Salesforce Research. The Impact of Equality and Values Driven Business. Published July 13, 2017.

Disclaimer: Stock photo. Posed by model.

Tag: Employers, Population health management, Health plans, Articles and blogs, Health care delivery