Expert roundtable: How can employers best support pregnant employees?
Financial and emotional stressors, as well as health issues, can significantly impact a new mother's return to work.
We view giving birth as a routine part of life, but let’s not forget that despite advancements in modern medicine, pregnancy continues to be a high-risk medical condition. Complications and mortality are still a concern during pregnancy, which adds to the stress of expectant parents from both a health and financial standpoint.
Related: Changing perceptions of health benefits, one pregnancy at a time
To answer questions on how employers can support expectant mothers and their families, we held a roundtable discussion with experts from Anthem Blue Cross and Blue Shield, including Scott Towers, president, Dental and Vision Businesses; Greg Poulakos, president, Life, Disability and Supplemental Health; and Dr. Adriana Canas-Polesel, medical director and board-certified in Obstetrics & Gynecology.
What are some of the greatest health concerns that future mothers and their employers should be aware of during the pregnancy process?
Dr. Adriana Canas-Polesel (ACP): Pregnancy and delivery take a tremendous toll on a new mother’s physical health. On average, postpartum recovery takes six-to-eight weeks and can vary depending on the type of delivery. For example, recovering from a C-section or a traumatic vaginal delivery can extend the recovery process, making it challenging for employees to perform routine tasks after returning to work or delaying their return entirely.
In addition to complications from the birth, hormonal changes that occur during pregnancy can lead to conditions such as developing gestational diabetes, which affects up to 10 percent of pregnancies. Because a number of health complications can also arise during pregnancy, it’s important for employees to consult their doctors on their unique needs before returning to work, and for employers to provide flexibility and support in accommodating post-partum care.
Postpartum follow-up appointments are also important to make sure that complications that may have occurred during pregnancy are resolved, such as gestational hypertension/pre-eclampsia or gestational diabetes. Postpartum care can also detect conditions that can arise after delivery such as postpartum depression, which is experienced by more than 600,000 new mothers each year. These postpartum complications can significantly delay an employee’s transition back into the workplace.
Scott Towers (ST): Hormonal changes can also lead to other general health complications in two commonly overlooked areas during pregnancy – the mouth and the eyes. Approximately 40 percent of pregnant women have some form of periodontal disease which, if left untreated, can lead to preterm birth and low birthweight. Furthermore, ocular complications such as impaired vision can occur due to changes in corneal thickness and curvature, and vascular changes in the eye can be triggered by pregnancy-specific diseases such as pre-eclampsia and eclampsia.
Are there any other factors that could negatively impact the pregnancy and recovery process?
ACP: After returning to work, most new mothers experience stress and lack of sleep due to the demands of a new baby. For example, if a mother chooses to breastfeed, it can be challenging to maintain a regular breast pumping schedule to express and collect milk when needed. Employers can help new mothers by allowing them to implement breast pumping in their work schedule to avoid a decrease in milk production, which can result in health issues for both mom and baby.
Greg Poulakos (GP): Financial and emotional stressors faced by new mothers and their families, ranging from pre-natal and postpartum care costs, maternity leave living expenses and sometimes post-partum depression, can also add to the stress that new mothers and their families experience. Pregnant employees receive limited support through the Family and Medical Leave Act, which only legislates 12-weeks of unpaid leave.
Maintaining financial security requires careful planning and often a reliance on supplemental income, so benefits are crucial in supporting a new mother and families. Disability plans, for example, are one of the most important programs next to standard health benefits as employees often require critical financial support while on maternity leave. In fact, pregnancy is a leading source of short-term disability claims, accounting for 21 percent of all disability claims. Additionally, most disability insurance plans include access to employee assistance programs that can provide valuable support for coping with postpartum depression or other emotional challenges that come along with being a new mother.
Beyond offering paid leave, what should employers consider in terms of benefits?
ST: The more benefits employers provide, the better prepared they are to alleviate employee health concerns and financial stressors. Employers must evaluate their benefits packages to determine how they can comprehensively support employees’ whole health. While these benefits may vary, there are a couple of absolute necessities:
Dental benefits can help detect and treat gum-related health concerns faster, including gingivitis, periodontal disease, pregnancy epulis and pyogenic granuloma. When left untreated, these diseases and others can lead to preterm birth and low birth weight.
Vision benefits can allow for early detection and intervention, giving medical practioners a glimpse into potentially larger issues, as symptoms for various diseases can show in the eyes. For example, cortical blindness, retinal detachment and other concerns can also be caused by pregnancy-specific eye diseases like preeclampsia and eclampsia.
GP: Benefits that go beyond medical care play a critical role in a family’s financial security. For example, disability and supplemental benefits can help maintain incomes during maternity leave and life insurance can be a valuable precautionary financial tool, as growing families proactively plan for the financial futures of their children. Despite advancements in modern medicine, death is still an unfortunate possibility during childbirth. The CDC reports that there was a 26.6 percent increase in the U.S. maternal mortality ratio, increasing from 18.8 deaths per 100,000 births in 2000 to 23.8 deaths per 100,000 in 2014. Life insurance can help cover medical and living expenses for families in the event of death, providing some financial support. Finally, employee assistance programs can help families with financial planning and emotional support.
How does the integrated benefits program impact new mothers throughout their pregnancy and return to the workforce?
GP: Integrated benefits combine claims information with management tools, allowing crossover between medical and specialty benefits. They also enable employers and providers to collaborate and equip employees with necessary information. This includes making available educational resources for pregnant employees about their benefits, or about signs and symptoms to recognize during pregnancy.
This medical and specialty benefit crossover also improves employee access to financial and medical resources to help ease stressors, including quicker disability payments to cover living expenses, alerts around potential health complications so new mothers can act quickly, and behavioral health support to help cope with the emotional challenges of becoming a new mother.
ACP: Integrated benefits provide support for pregnant employees by ensuring that they receive education on resources available to them during pregnancy. In addition, an integrated benefits program can provide information about other services that can support a healthy pregnancy like referral services to dentists or maternal fetal medicine in high-risk pregnancies
Once you’ve built an integrated benefits program, how do you get employees to access these benefits?
GP: Ask your insurer what materials they can offer your staff. Providers often have literature to educate employees on integrated benefits, or items to share directly with employees. In addition to educating them, it’s important to continually emphasize these benefits so employees know how these tools support them beyond their health, including the financial wellness of themselves and their families.
ST: Employees should also know how available programs integrate. Individually, each benefit is important but combined they can profoundly impact expectant mothers’ whole health. It’s important to show how integrating these benefits can help new moms swiftly address and prevent complications and create the healthiest path forward. We automatically add additional free preventative benefits, such as an additional dental cleaning or periodontal scaling or an additional eye exam, to the individual’s benefit program. Consumers also receive educational outreach regarding the importance of taking advantage of these services.
What are the results of programs like this?
ST: Anthem has a program called Future Moms, which offers pregnant members personalized support, education and coaching, starting at a pregnancy’s beginning and continuing postpartum. Future Moms has reduced C-section rates, increased postpartum visit attendance, and favorably impacted delivery costs and NICU admissions. While supporting mom and baby health, babies born to Future Moms participants spent 25 percent less time in the NICU resulting in 50 percent reduction in NICU costs. Giving pregnant employees access to information and resources creates more enjoyable pregnancy experiences.
ACP: Integrated benefits programs have seen success with employees planning ahead for their pregnancy. For some, this means preconception support so employees can prepare and seek guidance for pregnancy beforehand while for others it means faster access to early prenatal care. Most importantly, these programs help employees make healthier life decisions leading up to pregnancy. This includes quitting smoking, which leads to smaller birth sizes; addiction and drug use intervention, specifically with opioids; and weight management, as obese women often have more complications in pregnancy
GP: Supporting new mothers throughout the pregnancy process can be simplified though the integration of benefits such as life, disability, health, vision and dental. Understanding what pregnant employees are facing and giving them the support from the planning process throughout postpartum can alleviate stressors, keep employees and their newborns happy, and help make the return to work as seamless as possible, while improving workforce productivity.
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