National Trends in Severe Maternal Morbidity by Insurance and Race and Ethnicity

This serial cross-sectional study of births in the US found that racial and ethnic minority status was independently associated with elevated odds of SMM. Medicaid enrollment further compounded this risk and was associated with maternal mortality, suggesting underlying structural inequities that accompany Medicaid coverage rather than a direct effect of insurance type. Addressing these structural barriers through policy reform, including equitable reimbursement and expanded preconception coverage, is critical to mitigate these maternal health inequities.

Corresponding Author: Amelia Srajer, MD, MSc, Foothills Medical Centre, 1403 29 St NW, 4th Floor North Tower, Calgary AB T2N 2T9, Canada (amelia.srajer1@ucalgary.ca).

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