The Color Of Health: Understanding The Black Maternal Health Crisis—What Needs To Change?
Despite its wealth and medical technology, the United States continues to lag behind peer nations, with the highest maternal mortality rate among developed countries, and that said reality is harming Black women. According to the Centers for Disease Control and Prevention (CDC), maternal mortality rates in 2023 declined significantly for White non-Hispanic and Hispanic women.
However, the rate for Black non-Hispanic women increased slightly, from 49.5 in 2022 to 50.3 deaths per 100,000 live births. The disparity remains stark: Black women faced a maternal mortality rate more than three times higher than white women (14.5), and significantly higher than Hispanic (12.4) and Asian (10.7) women.
Alarmingly, the CDC found that over 80% of maternal deaths are preventable, a red flag toward deep systemic failure in the U.S. healthcare industry. So, what’s driving this crisis?
Medical bias and racism are Factors.
Black women are three to four times more likely to die from pregnancy-related causes than white women, an alarming statistic that could be erased quickly if the concerns of expectant Black mothers were listened to and cared for by medical experts. Racism and implicit bias lead to dismissal, delayed diagnoses, or less effective pain management, compounding the danger of complications, studies show, according to SheIs.
Location can also determine whether a Black mom can receive quality treatment during pregnancy. As noted by Cure, more than a third of U.S. counties lack obstetric services or maternity clinics. These “deserts” disproportionately impact rural and low-income areas. Black and Indigenous mothers are more likely to live in these counties, increasing the risks of late or no prenatal care. Women in rural areas face about a 9% higher probability of maternal morbidity or mortality compared to urban women, The Hill notes.
This could be dangerous as Black women are more likely to experience pregnancy-related complications like preeclampsia or severe bleeding post-delivery, putting their lives in danger.
“If you have preeclampsia or bleeding after delivery, you have minutes to deal with it. If you don’t have obstetric care close to you, that’s a big problem,” said Dr. Elizabeth Garner, MD, MPH, the Chief Scientific Officer of Ferring Pharmaceuticals US, during an interview with Cure in 2024.
Fragmented Insurance, over-reliance on C-Sections, and Postpartum Gaps.
Nearly half of all U.S. births are paid for by Medicaid, according to The Hill, but sadly, many women lose Medicaid coverage just 60 days postpartum, despite more than half of maternal deaths occurring in the first year after childbirth. Lack of universal coverage and gaps in access degrade continuity and quality of care during pregnancy, further fueling this insidious disparity.
Alarmingly, studies show that even when Black women do have proper healthcare, medical experts don’t always have their best interests in mind. A study conducted by the National Bureau of Economic Research in 2024 found that Black women are almost 25% more likely than white women to have unnecessary C-sections, putting them at risk of surgical complications like severe bleeding and hemorrhaging. How do we change this?
Government intervention is needed now more than ever. Pregnancy-related complications and the complex factors behind postpartum receive minimal attention in healthcare research. Most medical funding treats the fetus rather than centering on the mother’s health; pregnancy research is chronically underfunded, limiting evidence-based improvements, studies show.
Political decisions—like the recent cancellation of grants issued by the National Institutes of Health—have further destabilized critical research projects targeting Black maternal outcomes. The Trump administration revoked 1,902 awards totaling over $4.4 billion between January and the end of July, Grant Witness reported.
In an Aug. 2 interview with The Guardian, epidemiologist Jaime Slaughter-Acey expressed deep frustration and disbelief after learning that her federally funded research into the adverse birth outcomes among Black families had been abruptly cancelled earlier this year. Slaughter-Acey, an associate professor at the University of North Carolina at Chapel Hill, said the notification from the university left her stunned.
“It felt like the rug was pulled out from under us,” she recalled.
The study, which had been backed by the NIH, was terminated because it no longer aligned with the agency’s strategic priorities or demonstrated potential to increase life expectancy, reasons Slaughter-Acey found both dismissive and troubling.
“It was heartbreaking,” she added. “And honestly, infuriating given the high rates of maternal and infant mortality in this country.”
Recently, actions taken by President Trump and his administration have raised more concerns about the future of reproductive rights for Black women. In April, several maternal and child health programs were either eliminated or significantly scaled back as part of a massive layoff initiative by the Department of Health and Human Services (HHS), led by Health Secretary Robert F. Kennedy Jr.
Kennedy announced plans to cut 10,000 jobs as part of a department-wide restructuring. Combined with additional reductions made by Elon Musk’s unofficial “Department of Government Efficiency,” HHS stands to lose up to 20,000 employees, nearly a quarter of its workforce. These cuts threaten the very programs that are critical to advancing Black maternal and reproductive health.
What can we do to stop this Crisis?
Extending Medicaid coverage to 12 months postpartum and ensuring early follow-up visits within the first three weeks after birth are proven strategies to reduce preventable maternal deaths from undetected complications. While Congress took an important step by passing the American Rescue Plan Act of 2021, which allows states to extend postpartum Medicaid coverage from 60 days to 12 months, full implementation and enforcement are still urgently needed.
Equally critical is the need for culturally competent care. Midwifery-led models, particularly those grounded in preventive prenatal and postpartum support, have shown improved outcomes, especially in Black communities. In 2023, Faisa Farole made history by opening Washington state’s first Black woman-owned and operated freestanding birth and midwifery center. Her facility, the Federal Way Birth Center in Seattle, provides a community-focused, culturally informed environment that centers the needs of women and babies of color.
As Madamenoire reported, Farole’s center offers more than care; it offers trust, dignity, and a response to the disproportionate rates of maternal mortality Black women face in the U.S. Facilities like hers not only provide vital services but also serve as models for combating implicit bias in healthcare. When paired with anti-racism training for providers and policies that prioritize Black maternal health, culturally competent care can begin to restore trust and reduce deep-rooted disparities.
Hospitals must also take responsibility for protecting the health and safety of Black mothers. Some are rising to the challenge. According to the 2024 U.S. News & World Report, which analyzed maternity care outcomes across the country, 26 hospitals in 13 states stood out for their commitment to Black maternal health. These hospitals were recognized for delivering excellent care, particularly in managing cesarean sections and newborn complications among Black patients.
Each of these hospitals treated at least 20 Black patients annually and achieved notably low newborn complication rates (under 2.62%) and cesarean section rates below 23.9% (for advanced care facilities) or 23.6% (for non-advanced care facilities). Their performance is a direct example of the impact that intentional, equitable care can have on improving outcomes for Black families.
The U.S. maternal health crisis is a public health emergency. Solutions exist, but only if we invest in equitable care, robust research, support postpartum transitions, and prioritize marginalized communities.
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