Black Mothers Are Still Dying — And We Know Why

Black Maternal Health Week: The Crisis We Measure, But Don’t Fix

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Black Maternal Health Week arrives each April and asks the country to confront something it has long known and repeatedly failed to fix: in the United States, pregnancy is still far more dangerous if you are Black.

The week itself is relatively new. Founded in 2018 by the Black Mamas Matter Alliance, it emerged not from a sudden discovery, but from accumulated evidence; years of data, testimony, and loss that had outgrown the margins of academic journals and policy briefings.

The crisis needed visibility. It needed a name. It needed a moment each year where it could no longer be ignored.

Because the numbers have been consistent for decades.

In 2023, Black women in the United States died from pregnancy-related causes at a rate of 50.3 deaths per 100,000 live births — more than three times the rate of white women.

The disparity is not new, and more troublingly, it is not meaningfully shrinking. In fact, the maternal mortality rate slightly increased for Black women between 2022 and 2023, while decreasing across all other racial demographics.

The risk persists across geography, across income levels, across education. It persists even when the usual explanations are stripped away.

Step back far enough, and the pattern becomes difficult to dismiss as anything but systemic.

More than 80% of maternal deaths in the U.S. are considered preventable.

That figure alone reframes the crisis not as an inevitability, but as a failure of response. Prevention requires a system that listens, that recognizes warning signs, that treats patients equitably and early enough to intervene.

For many Black women, that system breaks down at multiple points along the way.

In recent years, the boundaries between healthcare and criminalization have begun to blur. Since the fall of Roe v. Wade, prosecutors have charged at least 412 women with pregnancy-related crimes, often using laws never intended to apply to pregnancy itself.

Some of those cases have become national flashpoints.

Women have been arrested after miscarriages — including cases where they sought medical care and were instead met with law enforcement.

Others have faced homicide or abuse-of-a-corpse charges tied to pregnancy loss, even when medical evidence pointed to natural miscarriage.

In Georgia this year, a woman was charged with murder after allegedly taking abortion medication — a case so legally tenuous that even a judge questioned whether it could stand.

The United Nations Human Rights Committee has recognized that criminalizing abortion and adverse pregnancy outcomes turns pregnant people away from needed health care and increases the likelihood that individuals will resort to unsafe abortion or forgo needed health care in violation of Article 6.

And these prosecutions do not occur evenly.

While there is no national or state-based apparatus that regularly records and publishes this data, we have enough studies from the CDC and other research groups to spot the trends.

These laws and arrests disproportionately affect low-income and socially vulnerable women, and they are more likely to target Black women — the same population already facing the highest maternal mortality risk.

At the same time, another pattern has emerged inside hospital walls, where autonomy can quietly erode under the weight of policy and bias.

A recent case in Florida documented a Black woman (a trained doula) being subjected to a cesarean section against her expressed wishes after a court became involved during her labor. Florida established the prioritization of fetus over mother more than 25 years ago.

The logic behind these interventions is often framed as protection — of the fetus, of the pregnancy, of liability. But in practice, it reveals something more unsettling: a system increasingly willing to override the autonomy of pregnant people, particularly Black women, while still failing to protect their health.

The contradiction is stark. The same system that too often dismisses Black women’s pain is also capable of overriding their consent.

The reasons for the broader crisis remain layered, and they interact.

Black women are more likely to experience chronic conditions such as hypertension, shaped in part by long-term exposure to environmental and social stressors.

Access to high-quality prenatal and postpartum care is uneven, and the quality of that care can vary dramatically depending on where and how it is delivered.

Within clinical settings, implicit bias continues to influence how symptoms are interpreted and whether concerns are taken seriously.

And beyond the walls of hospitals, the broader determinants of health, like housing stability, income, and environmental exposure, quietly shape outcomes long before labor begins.

What makes the crisis particularly stark is that it does not disappear with privilege.

Studies have repeatedly shown that Black women with higher incomes and advanced education still face significantly higher risks than white women with fewer resources. The disparity holds. It resists easy explanation. It points back, again and again, to the structure of the system itself.

And the consequences extend well beyond maternal mortality.

Infants born to Black women are more than twice as likely to die as those born to white women, with higher rates of stillbirth and complications that can follow them through the earliest, most vulnerable stages of life.

What begins as a disparity in maternal health becomes, over time, a generational one — a cycle in which inequity reproduces itself through both biology and policy.

There have been signs of improvement in recent years, particularly after the sharp increases seen during the COVID-19 pandemic.

Overall maternal mortality has declined from its peak. But that improvement has not been shared equally.

For Black women, the rates remain stubbornly high, a reminder that broad progress does not necessarily translate into equitable outcomes. The system may be improving in aggregate, but it is not improving for everyone.

This is why Black Maternal Health Week continues to exist — not as a symbolic gesture, but as a necessary interruption. Because what we are looking at is no longer just a health crisis. It is a system that, in different ways, both neglects and controls the same population.

The solutions, notably, are not elusive.

Many are already in place in pockets across the country, demonstrating measurable success.

Extending postpartum care to a full year after birth addresses a critical window when many complications arise.

Expanding access to doulas and midwives — particularly providers rooted in the communities they serve — has been linked to better outcomes and improved patient experiences.

Addressing bias within medical training and increasing diversity in the healthcare workforce can change how care is delivered and received.

And perhaps most fundamentally, improving outcomes often begins with something deceptively simple: listening to Black women when they say something is wrong.

What remains is not a lack of knowledge, but a lack of scale and consistency.

Effective interventions exist, but they are unevenly implemented, often limited by policy decisions, funding gaps, and institutional inertia. The distance between what is known to work and what is universally practiced is, in many cases, the space where lives are lost.

For individuals, the question of what to do can feel abstract, but the pathways are tangible.

Supporting organizations that provide direct maternal health services in Black communities, advocating for policy changes such as extended Medicaid coverage and improved data transparency, and amplifying verified, evidence-based information all contribute to broader change.

Accountability from healthcare systems, insurers, and policymakers remains central, and it often depends on sustaine public pressure.

There is a tendency to frame maternal mortality as a niche issue, something confined to healthcare policy or demographic analysis. But it functions more accurately as a measure of how systems respond under stress, of whose voices are heard, of whose lives are protected.

Black Maternal Health Week exists because the data refused to stay quiet.

The question now is whether the country will continue to ignore what it has already been told — or whether it will finally confront the reality that a system capable of both neglect and control is not broken in one direction, but in both.

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