Horizon Blue Cross Blue Shield of New Jersey is an independent licensee of the Blue Cross Blue Shield Association. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross Blue Shield Association. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. © 2024 Horizon Blue Cross Blue Shield of New Jersey. Three Penn Plaza East, Newark, New Jersey 07105. ECN0021765C (0924)
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Childbirth
Postpartum
Your childbirth experience will be different depending on where you give birth and the providers who care for you. You may decide to give birth in a hospital, at a birth center or at home. Each of these locations will have different resources, services and care options. For example, a hospital can offer interventions like an induction, epidural pain relief and cesarean birth, while a home birth or birth center will not.
The following health care providers participate in birth care:
Maternal health is important to public health because it directly affects the wellbeing of birthing individuals and their newborns. In the United States, there are significant health disparities when it comes to maternal health outcomes, with certain groups facing higher rates of maternal mortality, pregnancy complications, and lack of access to good prenatal care. Some causes for health disparities include race and ethnicity, social and economic status, and geography and environment.
In the United States:
The maternal mortality rate is the highest among 11 developed countries.
There were 1,205 maternal deaths in 2021.
Half of all births are from racial and ethnic minority groups.
10 to 25% of individuals develop a depressive disorder during the postpartum period.
In New Jersey:
The maternal mortality rate is the fourth highest in the country.
Approximately 30% of maternal deaths were pregnancy-related, and nearly 70% of pregnancy-related deaths occurred during the postpartum period (within one year of childbirth).
55% of all births in 2022 were from racial and ethnic minority groups, up from 46% in 2000.
Maternal health refers to health and wellness during pregnancy, childbirth and after childbirth (postpartum). Maternal health is important because health before, during and after pregnancy has a major impact on an infant’s health. Horizon Blue Cross Blue Shield of New Jersey is working to improve maternal health in New Jersey.
Maternal Health
Other Health Conditions (Comorbidities)
Facts About Maternal Health
Pregnancy is a time when the body is quickly changing. It’s important to know what to do to stay healthy so the baby can have the healthiest start possible.
If you’re pregnant or thinking about becoming pregnant, talk to your doctor about:
Changes you may be experiencing in your body
Questions you have about childbirth
Care for you and your baby after you give birth
Any chronic health conditions you have, like diabetes or high blood pressure
Your health history
Your mental and emotional health
Prescription or over-the-counter medicines you take
To stay healthy during pregnancy, you can:
Take recommended vitamins
Quit smoking or do not smoke
Do not drink alcohol
Do not use marijuana
Get all recommended vaccinations
Control your diabetes or high blood pressure, if applicable
Get treatment for any mental health illnesses
Although your attention will be on your new baby, it’s important to continue to take care of yourself. Talk to your doctor if you continue to feel pain after the first few weeks of giving birth or if you feel sadness, worry, anxiety or tiredness that make it hard for you to complete daily care activities for yourself, your baby or others.
To keep you and your baby healthy:
If you’re able to, consider breastfeeding your baby. Breast milk is easy to digest and has antibodies that protect your baby from infections.
Schedule and keep follow-up appointments with your health care provider after birth.
Seek treatment if you think you have postpartum depression. Up to 20% of women develop a mood disorder before and after giving birth.
Before leaving the hospital, ask about testing your baby for jaundice. Infant jaundice happens because a baby’s liver is not able to get rid of bilirubin, a yellow pigment of red blood cells, in the bloodstream. If you are at home and you think your baby has jaundice, call your doctor immediately.
Although you passed on some protection to your baby when you got vaccinated during your pregnancy, it will decrease over time. Make sure your baby gets vaccinated according to the recommended immunization schedule.
It’s important to find a pediatrician for your baby and follow the recommended well-visit schedule.
Pregnancy
Postpartum
Maternal Health and Health Disparities
Facts on Health Care Disparities
Learn more about Health Equity
Resources and Support
Pregnancy
Resources and Support
Other Health Conditions (Comorbidities)
Facts About Maternal Health
Maternal Health and Health Disparities
Facts on Health Care Disparities
Additional Resources
National Institutes of Health (NIH)—Safe to Sleep
The NIH’s site helps to educate parents, caregivers and childcare providers about ways to reduce the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related infant deaths.
Website: NIH Safe to Sleep
La Leche League (LLL)
La Leche League provides breastfeeding resources and links to local LLL groups for breastfeeding support.
Website LLLI
International Childbirth Association (ICEA)
The ICEA is a nonprofit organization that helps parents find local certified childbirth classes and provides childbirth education resources.
Website: ICEA
Doulas of North America (DONA)
DONA International is a doula certifying organization. You can find a local doula and other resources for parents.
Website: DONA
Centers for Disease Control and Prevention (CDC)—Parent Information
The CDC provides various resources for parents from pregnancy through the teen years.
Website: CDC Parent Information
Benefits.gov
This site run by the United States Government helps you find benefits from health care assistance, like Medicaid, to food and nutrition assistance.
Website: Benefits.gov
Resource for You
Additional Resources
Maternal and Child Health:
Birthing individuals in communities that are majority Black are twice as likely to have risk factors like hypertension or anemia compared to communities that are primarily White.
Birthing individuals in communities that are majority Hispanic are one third more likely to have risk factors like prior cesarean birth or pre-existing diabetes than communities that are primarily White.
Access to Care:
Birthing individuals who are Black are twice as likely to have a birth with late or no prenatal care (nine percent) compared to those who are White (five percent).
Racial and ethnic:
Rates of maternal death per 100,000 live births in the United States in 2021:
Black – 69.9
Hispanic/Latino – 28
White – 26.6
Black and Brown birthing individuals are seven times more likely to die in childbirth than those who are White.
Birthing individuals who are Black experience a 3.5 times higher rate of infant death compared to those who are White.
Birthing individuals who are Hispanic experience twice the rate of infant death compared to those who are white.
Birthing Doulas
A birthing doula is a trained professional who provides continuous physical, emotional and informational support during pregnancy. Doula providers also connect families with community resources to help them overcome challenges in their lives that could impact their health.
Some common complications or comorbidities include:
Anemia is when you have a lower number of healthy red blood cells than normal, which may make you feel tired and weak. During pregnancy, you are more likely to get anemia with iron deficiency because your body needs more iron than usual. Your doctor will check your red blood cells and may recommend you take an iron or folic acid supplement to prevent or manage anemia.
Anxiety includes uncontrollable feelings, nervousness, fear, worry or panic. Anxiety disorders are common before, during and after pregnancy, and often occur with depression. It’s important to get treated if you think you have an anxiety disorder.
Depression goes beyond feeling sad for a few days. It interferes with daily life and can last for weeks or months. Symptoms can include feeling sad, hopeless, irritable, worthless or helpless; a loss of energy; trouble falling asleep or sleeping too much; overeating or losing your appetite; problems concentrating or making decisions; and suicidal thoughts. Depression during pregnancy can make it difficult for you to take care of yourself and your unborn baby, and puts you at risk for postpartum depression. If you think you have depression, talk to your doctor as soon as possible. If you have thoughts of hurting yourself or others, call 911 right away.
Diabetes is a chronic condition that affects how your body uses blood sugar. There are three types of diabetes: type 1, type 2 and gestational diabetes. High blood sugar during pregnancy can increase your risk of preeclampsia, cesarean delivery and high birth weight for the baby. See your doctor, monitor your blood sugar levels, maintain good nutrition, be physically active and take insulin if needed.
Heart conditions include coronary artery disease, heart attack and congenital heart defects. Not all heart conditions will result in symptoms during pregnancy—and many people have healthy pregnancies—but pregnancy can put stress on the heart and increase the risk of illness during and after pregnancy.
High blood pressure (hypertension) increases the risk of preterm delivery, low birth weight, and preeclampsia, which is suddenly developing high blood pressure after 20 weeks of pregnancy. High blood pressure is greater than 120/80 mmHg. You can prevent and treat high blood pressure.
Hyperemesis gravidarum is persistent nausea and vomiting. Although nausea is common in the first three months of pregnancy, extreme nausea and vomiting caused by hyperemesis gravidarum can lead to weight loss and dehydration.
Call 1-855-567-8669
AdaptHealth
Call 1-978-738-9800
Acelleron
Call 1-888-345-1780
Aeroflow
To request a multi-user (hospital-grade) breast pump, please verify that your plan covers the hospital/institutional grade pump, then contact the following providers directly. A doctor’s order is required for a multi-user (hospital-grade) breast pump.
Call 1-877-320-2301 or visit:
https://www.medela.com/en-us/ breastfeeding-pumping
How to Order
Medella
Provider Name
Call 1-800-901-3566
How to Order
Apria Healthcare
Provider Name
Acelleron
Call 1-978-738-9800
New Jersey Department of Health—Maternal and Child Health
New Jersey’s Department of Health provides health education, information and resources throughout the state for pregnant people and new parents.
Website: NJ Health Maternal and Child Health
New Jersey State Health Assessment Data (NJSHAD)
New Jersey’s public health data resource that provides data on births, infants and maternal health in the state.
Website: NJSHAD
Postpartum Support International (PSI)
PSI provides education, support and local resource information for mental health issues related to childbearing.
Website: PSI
U.S. Department of Health and Human Services—Office on Women’s Health (OWH)
OWH provides information and resources about breastfeeding.
Websites: OWH Breastfeeding
Women Infant Children (WIC)
WIC provides supplements for foods, health care referrals and nutrition information for pregnant and postpartum women and children up to age five.
Website: WIC
Childbirth
Race and Ethnicity
Social support includes emotional support by your partner, family and friends; whether or not your friends and family live near you; and if you participate in social events or belong to any organized groups.
Education influences your access to information and resources. Consider whether or not your community offers early childhood education and if you can afford it.
Income is the largest predictor of differences in health outcomes. It affects your ability to pay your bills on time, provide enough healthy food for you and your family, and afford health care visits.
Your neighborhood determines if you have safe and well-lit spaces for you to walk or exercise. It also determines whether you have access to public transportation, high quality health care services and providers in your community, and clean water.
Your house determines if you have a safe place to live that is free of lead, mold or other harmful chemicals. Your home should be big enough for your family and in good condition.
Birthing individuals who are Black or indigenous are more likely to experience maternal mortality and negative health outcomes compared to those who are White. Hispanic and Latina birthing individuals also face higher rates of certain pregnancy complications and poorer birth outcomes.
Systemic racism is a form of racism embedded in laws, policies, practices and beliefs that unfairly treat or oppress people of color.
Discrimination in health care settings can include providers dismissing your symptoms or concerns, offering different treatment based on your type of insurance, or not providing care in your preferred language.
Social and Economic Factors
Geographic and Environmental Factors
Breastfeeding Equipment
You may be eligible for the following breastfeeding equipment:
We can help you:
Find an in-network doula near you.
Use the Doctor & Hospital Finder for a directory of community doulas.
Understand your benefits and out-of-pocket costs
Lactation Counseling and Consultation
You may be eligible for lactation counseling and consultation to help support your breastfeeding goals. Your Ob/Gyn, midwife, hospital or birth center can help you learn more about your options for breastfeeding support.
Breastfeeding Pump and Supplies
To request a single-user standard model breast pump and supplies, please verify that your plan covers single-user breast pumps, and then contact the following providers directly. Brands and models available vary by provider.
Purchase of a single-user breast pump – may be manual or double electric.
No letter of medical necessity, prior authorization or prescription is required.
The pump will be repaired or replaced, if necessary.
Rental of a multi-user (hospital-grade) breast pump on the recommendation of a licensed health care provider. A doctor’s order is required.
Purchase of two breast pump kits, appropriate size breast pump flanges or other lactation accessories recommended by a health care provider per birth event.
For more information about the program or to enroll, visit horizonNJhealth.com/membersupport/programs/moms-gems-prenatal-program.
Support for Horizon BCBSNJ (Commercial) Members:
PRECIOUS ADDITIONS®
Precious Additions is dedicated to helping parents-to-be learn how they can care for their babies and themselves throughout pregnancy. Eligible members who have access to Horizon Wellness programs can enroll. in Precious Additions, a free and voluntary program, and are encouraged to do so as early as possible in their pregnancy so they can take advantage of all that the program has to offer¹.
Members can enroll online or call Member Services at the telephone number on the back of their member ID card.
CareCentrix Administers Coverage
CareCentrix administers the coverage for your breastfeeding equipment. Call 1-855-243-3321 (TTY 711) if you have questions about which pump to order or how to order your pump and supplies.
Please be aware that this is not a guarantee of payment. It is issued subject to the terms and limitations of your benefit plan and you being eligible at the time services are provided.
Once enrolled, members will have access to²:
Exclusive discounts on products and services
Prenatal parent class reimbursement
Healthy pregnancy calendar
Mayo Clinic Guide to a Healthy Pregnancy
¹ Self-insured account members should check with their benefits administrator to see if they are eligible for this program.
² Materials are subject to change.
Blue Cross Blue Shield: bcbs.com/the-health-of-america/reports/racial-disparities-in-maternal-health
Centers for Disease Control and Prevention (CDC): cdc.gov/reproductivehealth; cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm
New Jersey Department of Health: nj.gov/health/maternal
Birth Settings in America: ncbi.nlm.nih.gov/books/NBK555484/
2022 National Healthcare Quality and Disparities Report: ncbi.nlm.nih.gov/books/NBK587184/
Sources:
Social determinants and your individual medical risk profile will also shape your childbirth experience. Social determinants, which affect your choices, access to care and childbirth outcome, include racism, geographic location and socioeconomic conditions. Your medical risk profile can include whether or not you have a health condition, are carrying twins, or the position or health of your unborn baby.
Obstetrician/Gynecologist (Ob/Gyn): Doctors trained in prenatal care, labor and delivery, postpartum care, and other reproductive health care.
Nurses: Medical professionals trained to support you and the doctors in all aspects of your health care.
Midwives: Certified health care professionals, often a nurse, trained in reproductive health. They provide gynecological exams, prescriptions and education, and perform deliveries
Doulas: Professional labor assistants who provide physical and emotional support during pregnancy, childbirth and postpartum.
A comorbidity is a separate illness or condition you may have before, during or after pregnancy. Comorbidities and other health conditions can affect your overall well-being.
Horizon Behavioral Health℠
If you have any questions about getting behavioral health care or would like information on the support programs that we offer to our members, call our dedicated Horizon Behavioral Health team at 1-800-626-2212 (TTY 711), 24 hours a day, seven days a week.
Support for Horizon NJ Health Members:
GEMS Program - Support for a Healthy Pregnancy
Horizon NJ Health created the Getting Early Maternity Services (GEMS) Program to ensure that members who are expecting get proper prenatal care and education on how to have a healthy pregnancy and baby.
GEMS Care Management offers guidance through pregnancy, including:
Routine visits with an Ob/Gyn for care during pregnancy, and during and after childbirth.
Access to specialists or other doctors who can care for you during pregnancy, including dentists.
Care managers are available to answer your questions.
Transportation to medical appointments. Call ModivCare at 1-866-527-9933 (TTY 711).
Nutrition advice to help you make healthy decisions and improve your well-being and your developing baby’s future.
Breastfeeding help through the Women Infants and Children (WIC) Program. Call toll free at 1-800-328-3838 (TTY 711) to connect to your local WIC office to speak with a lactation specialist.
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