From 2020 to 2023, Mental Health Disorders in Pregnant Women Rose 53 Percent, While Substance Use Disorders in Pregnant Women Increased 8 Percent, according to New FAIR Health Study

Vaginal Deliveries Outnumbered C-sections by About Two to One Nationally from 2020 to 2023

During That Same Period, Several Nonphysician Specialties Increased in Their Share of Claim Lines on the Day of Delivery, Including Certified Registered Nurse Anesthetist, Certified Nurse-Midwife and Nurse Practitioner

NEW YORK, Sept. 9, 2024 /PRNewswire/ -- From 2020 to 2023, mental health disorders in pregnant women rose 52.9 percent and substance use disorders in pregnant women increased 8.2 percent. During that same period, potential complications of pregnancy and delivery¹ rose 19.8 percent. These and other findings are reported in a FAIR Health white paper released today: Giving Birth in the United States: A Study of Commercial Claims.

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In this report, FAIR Health uses its repository of over 47 billion commercial healthcare claim records and builds on its free, interactive Cost of Giving Birth Tracker to examine various aspects of giving birth in the United States, including age, co-occurring conditions, birth rate, delivery types, provider specialties and costs. The key findings include the following:

• The average age of mothers at delivery rose one percent (0.3 years) from 31.4 in 2020 to 31.7 in 2023.
• The most common potentially complicating condition of pregnancy and delivery in 2023 was obesity, which occurred in 19.7 percent of deliveries.
• Potential complications of pregnancy and delivery tended to rise with age, from 16.7 percent of patients under age 18 to 43.3 percent of patients aged 40 and over in 2023. Mental health disorders, however, were most common in mothers under age 18, and substance use disorders were most common in mothers under age 25.
• From 2020 to 2023, changes in birth rate (defined for this study as the percentage of women receiving medical services who gave birth in a given year) varied by state, from an increase of 65.6 percent in Rhode Island (from 1.8 percent of women receiving medical services in 2020 to 3.0 percent in 2023) to a decrease of 31.9 percent in West Virginia (from 3.5 percent in 2020 to 2.4 percent in 2023). Overall, the birth rate rose in 21 states and fell in 30 (for a total of 50 states plus the District of Columbia).
• Vaginal deliveries outnumbered C-sections by about two to one nationally from 2020 to 2023, with significant regional variation. Nationally, the percentage of vaginal deliveries fell 1.8 percent (1.2 percentage points) from 66.7 percent in 2020 to 65.5 percent in 2023. On a state-by-state basis, vaginal deliveries varied from 59.7 percent of deliveries in Mississippi to 76.7 percent in South Dakota.
• From 2020 to 2023, several nonphysician specialties grew in their share of claim lines in the prenatal period, including nurse practitioner (31.2 percent increase), certified nurse-midwife (32.9 percent), social worker (25.2 percent) and physician assistant (21.0 percent). Several nonphysician specialties also increased in their share of claim lines on the day of delivery, including certified registered nurse anesthetist (12.6 percent increase), certified nurse-midwife (41.2 percent) and nurse practitioner (29.6 percent).
• In each year from 2020 to 2023, the median total allowed amount for all medical services for patients with potential complications of pregnancy and delivery was 24 percent or more higher than the median total allowed amount for patients with no potential complications.² For example, the median total allowed amount in 2023 for patients with potential complications was $20,666 compared to $16,728 for patients with no potential complications.
• Throughout the period 2020 to 2023, the median total allowed amount for all medical services for patients giving birth increased as age increased. Most notably, costs were 12 to 14 percent higher for the 40-44 age group compared to the 35-39 age group in each year from 2020 to 2023.
• The median total allowed amount for all medical services performed for women who gave birth without potential complications in 2022 ranged from 915 percent to 1,109 percent higher than the median for women who received medical services but neither gave birth nor had an abortion or ectopic pregnancy, depending on the age group, when evaluating medical services for patients during a similar time frame.

FAIR Health President Robin Gelburd stated: "The findings in this report have implications for stakeholders across the healthcare spectrum, especially women who are pregnant or in the postpartum period. The study is also important for the providers who care for these patients, as well as payors and policy makers. In addition, we hope that these findings will be starting points for further research on giving birth in the United States."

For the complete white paper, click here.

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About FAIR Health
FAIR Health is a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the federal tax code. It is dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health possesses the nation's largest collection of commercial healthcare claims data, which includes over 47 billion claim records and is growing at a rate of over 3 billion claim records a year. FAIR Health licenses its commercial data and data products—including benchmark modules, data visualizations, custom analytics and market indices—to commercial insurers and self-insurers, employers, providers, hospitals and healthcare systems, government agencies, researchers and others. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D, which accounts for a separate collection of over 48 billion claim records; FAIR Health includes among the commercial claims data in its database, data on Medicare Advantage enrollees. FAIR Health can produce insightful analytic reports and data products based on combined Medicare and commercial claims data for government, providers, payors and other authorized users. FAIR Health's systems for processing and storing protected health information have earned HITRUST CSF certification and achieved AICPA SOC 2 Type 2 compliance by meeting the rigorous data security requirements of these standards. As a testament to the reliability and objectivity of FAIR Health data, the data have been incorporated in statutes and regulations around the country and designated as the official, neutral data source for a variety of state health programs, including workers' compensation and personal injury protection (PIP) programs. FAIR Health data serve as an official reference point in support of certain state balance billing laws that protect consumers against bills for surprise out-of-network and emergency services. FAIR Health also uses its database to power a free consumer website available in English and Spanish, which enables consumers to estimate and plan for their healthcare expenditures and offers a rich educational platform on health insurance. An English/Spanish mobile app offers the same educational platform in a concise format and links to the cost estimation tools. The website has been honored by the White House Summit on Smart Disclosure, the Agency for Healthcare Research and Quality (AHRQ), URAC, the eHealthcare Leadership Awards, appPicker, Employee Benefit News and Kiplinger's Personal Finance. For more information on FAIR Health, visit fairhealth.org.

Contact:
Rachel Kent
Executive Director of Communications and Marketing
FAIR Health
646-396-0795
[email protected]

¹ As used in this white paper, a "potential complication" is a condition that co-occurred with pregnancy or delivery and that may have complicated them, but that could not be determined to have done so based on claims data only.
² An allowed amount is the total fee negotiated between an insurance plan and a provider for an in-network service, including both the portion to be paid by the plan member and the portion to be paid by the plan.

SOURCE FAIR Health