2020 Edition — Quality of Care: Maternal Health and Childbirth

Jen Joynt, Independent Health Care Consultant


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Over the last few decades, there has been a significant growth in the measurement and reporting of health care quality outcomes. As health care evolves, it is important to continue to monitor and report on the quality of care delivered to patients in California and across the US. This is part of a series of measures CHCF is publishing on the quality of care in our state. Topics range from maternal to end-of-life care, and include measures on behavioral health, chronic conditions, and providers.

This set of quality measures focuses on maternal health and childbirth.

More Asian and white women initiated prenatal care in the first trimester than Latina and Black women.

While 88% of Asian and white mothers initiated prenatal care in the first trimester, only 80% of Black mothers and 82% of Latina mothers did so. Initiating prenatal care in the first trimester is considered a marker of high quality care.

Black infants were more likely to be born preterm or at a low birthweight than infants of other races/ethnicities.

In 2018, about one in eight Black infants were born preterm or with a low birthweight. Infants born preterm or with a low birthweight have increased risk for lifelong health problems or dying before their first birthday.

The Black infant and maternal mortality rates were much higher than other races/ethnicities.

Black infants in California died at rates that were two times higher than Asian and white infants. The disparities were even greater for women giving birth, with mortality rates for Black women nearly four times higher than for white women.

Black women reported higher rates of prenatal and postpartum depressive symptoms than women of other races and ethnicities.

Many women in California suffer from prenatal or postpartum depression, which can negatively impact the woman and child. Over one in four Black women reported experiencing symptoms of prenatal depression, and over one in six reported experiencing symptoms of postpartum depression in 2016 and 2017.

The companion Excel data file is available for download below. These materials are part of CHCF’s California Health Care Almanac, an online clearinghouse for key data and analyses describing the state’s health care landscape. See our entire collection of current and past editions of Quality of Care.