Addressing Maternal and Infant Health Disparities in North Carolina

We're committed to improving infant and maternal health

North Carolina has the 11th highest infant mortality rate in the country - at a rate of 6.8 per 1,000. 1

Health care disparities in underserved and marginalized communities are largely to blame. Birthing people of color in North Carolina are more likely to die from preventable maternal health issues than White people. They are often met with racial bias and receive fewer educational services during labor and delivery than White people who give birth. These factors lead to worsening health outcomes for birthing people of color and their children.

Black, American Indian and Hispanic babies are up to 2.4 times more likely to die in the first year2

Black birthing people are 3 or 4 times more likely to die during childbirth3

According to the Center for Disease Control (CDC), 60% of maternal deaths are preventable4

We're working with organizations across the state to tackle maternal and infant health inequities

We believe infant and maternal mortality is a public health crisis, and it's more important than ever to address the issues causing disparities during labor and postpartum health care. 

Organizations We're Working With

Our goal? To improve health equity by reducing racial disparities in maternal and infant health care by 50% in five years.

We're focusing on the communities that need our help the most. When we make maternal and infant health disparities in marginalized communities a priority, we can address the state's infant and maternal mortality rate for all North Carolinians.

We are investing $2 million into evidence-based initiatives that are shown to make a significant improvement on infant and maternal health outcomes across the state - specifically the health and well-being of birthing people, and children, of color. We put out a request for proposals for organizations that have sustainable and expandable maternal health programs to help us address the factors that contribute to poor maternal health and birth outcomes like:

  • Implicit bias/structural racism
  • Safe sleep habits
  • Tobacco, alcohol and substance use cessation
  • Prenatal care
  • Social drivers of health
  • Maternal mental health
  • Severe Maternal Morbidity (SMM)
  • Postpartum care

We're investing in 7 organizations to address maternal and infant health

As as result of our RFP, Blue Cross NC is investing over $2 million in seven initiatives led by diverse community organizations and agencies across the state. These organizations are dedicated to improving maternal and infant health outcomes in Black, Hispanic and American Indian communities. ​

These initiatives will:​

  • Address non-medical drivers of health for birthing people, including food security, transportation and affordable housing ​
  • Increase access to specially trained nurses, breastfeeding education, and diverse lactation consultants and doulas​
  • Improve the quality and spectrum of care for birthing people and their babies​
  • Educate providers on racial bias and its implications on health outcomes for birthing people and their babies​

These initiatives will span multiple years, and will help improve the experiences for birthing people and babies from historially underserved communities. And will contribute to our ultimate goal of reducing racial disparities in maternal and child health by 50% in 5 years. 

Learn more about the initiatives we're investing in and the counties impacted5 

Chatham County EMBRACe ​
Counties: Chatham

EMBRACe is a collaborative consortium made up of the following partners: UNC Chatham Hospital (CH), a local critical access rural hospital; the Chatham County Department of Social Services (CC DSS); Chatham County Department of Public Health (CCPHD); and Piedmont Health Services (PHS), a local federally qualified health center organization. The proposed project seeks to create a person-centered system of care oriented around women of color, their lived experiences, their full personhood, and their well-being. ​

University of North Carolina at Pembroke ​
Counties: Robeson, Scotland, Cumberland, Hoke

The Health Equity Project is a collaborative, interdisciplinary effort of the social work, kinesiology, and nursing departments. The specific aim of the project is improving access to quality care for expecting and parenting mothers of diverse ethnic groups by targeting health care and education professionals as systems for change within the southeastern region of North Carolina. 

North Carolina Agricultural & Technical (A & T) State University ​
Counties: Guilford, Forsyth, Alamance, Davidson

Training for more people of color to become certified internationally credited lactation consultants with the goal to open a lactation clinic to serve the minority population in Guilford County and surrounding areas in North Carolina. 

Queen City Cocoa B.E.A.N.S ​
Counties: Mecklenburg

Breastfeeding education program for new and expecting families from communities of color and a mentoring program for health care providers and/or health profession students from underrepresented communities of color who would like to become International Board-Certified Lactation Consultants (IBCLCs). 

Lincoln Height Community Center ​
Counties: Halifax, Northampton, Edgecombe

Grassroots prenatal program, where local expectant mothers are educated on nutrition, provided with transportation to prenatal appointments and provided with childcare for their existing children, if necessary. The Center also provides food boxes and meals to expectant mothers on a monthly basis, transportation to grocery stores and shopping locations, information on affordable housing, and transportation to legal appointments. Regular wellness checks will be conducted by staff, in-person and online. ​

Nurse- Family Partnership 
Counties: Statewide

Nurse-Family Partnership (NFP) is a community health program that connects specially trained nurses to first-time parents early in pregnancy and provides advice and support via home visits and telehealth through the child’s second birthday. This investment will support nurse education, capacity building, and caseload building for nurse home visitors.​


North Carolina Black Alliance ​
Counties: Cumberland

This project seeks to address breastfeeding rates disparities in Eastern North Carolina by coordinating with state and local institutions to support the development of more lactation consultants in Eastern North Carolina.

Read more from our Blue Cross NC Blog about maternal and infant health care disparities in North Carolina

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Black Maternal Health: Health Equity Begins Before Birth

The statistics are sobering: Black women in the U.S. are three times more likely to die from pregnancy than White women. Here in North Carolina, 27.6 women die per every 100,000 births. For Black women, that number is more than double. These disparities persist across education, income, and age levels.

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New Report Shows Maternal Health Continues to Trend in the Wrong Direction

You would think that with each passing year, incidents of complications during pregnancy and childbirth would decrease. But the recent Health of America report from the Blue Cross Blue Shield Association shows otherwise.

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Improving Maternal and Perinatal Health Equity in North Carolina and Beyond

In the United States, nearly four million women give birth each year, and the majority do so without any complications. But even with the health advances in the U.S., our country still has the highest maternal death rate compared to any other developed nation.

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