When Olympic gold medal track and field athlete Tianna Bartoletta arrived at the hospital to deliver her baby at 26 weeks, she brought along a medical advance directive and her will. Turns out she nearly needed both when she came close to dying during labor.

Pregnancy and childbirth should be a joyous occasion, but for Black women in the United States, it can be a matter of life and death. Black women are three times more likely to die from pregnancy-related causes than white women, a health disparity rooted in centuries of racism. Women in the U.S., in general, are dying at a higher rate than any other high-income countries globally. 

Consider some of the following sobering statistics from the CDC:

  • 700 women die from pregnancy or delivery complications each year in the U.S. 
  • The rate of maternal mortality in the U.S. is increasing.
  • Black women are three times more likely to die from pregnancy-related causes.

Addressing the stark reality of Black maternal mortality requires identifying and implementing evidence-based solutions, such as…

  • Rectifying inequitable healthcare practices
  • Investing in community-based solutions
  • Expanding access to quality prenatal care 
  • Enacting policy changes

Only by making changes across multiple systems can we ensure all women have the opportunity to experience a safe and healthy pregnancy and childbirth.

Black maternal mortality affects every sector

No Black woman is spared the increased risk of Black maternal mortality –– despite education, fitness and income levels. 

  • In November 2020, a Black medical resident at Indiana University School of Medicine, Chaniece Wallace, M.D., died from preeclampsia four days after giving birth to her daughter. Shalon Irving, M.D., Ph.D., an epidemiologist at the Centers for Disease Control and Prevention and a lieutenant commander in the U.S. Public Health Service, died of complications related to high blood pressure three weeks after giving birth in 2017.
  • Three-time Olympic medalist Tori Bowie died alone in her home from labor complications. News of her death in June 2023 prompted her former teammate, Tianna Madison, to share that three of the four Black women on the 4x100 relay team nearly died or did die in childbirth. 
  • A large population study in California published in January 2023 in the National Bureau of Economic Research found that maternal and infant mortality rates remained high even among the highest-income Black women. It was the first study of its kind to show that racial disparity in maternal mortality is not just economic-related.

Causes of Black maternal mortality

There is no one cause of Black maternal mortality. Improving disparities in the health system requires acknowledging multiple challenges. Following are some of the causes of higher rates of Black maternal morbidity:

  • Diversity among clinicians: Black women have healthier outcomes when Black doctors treat them. Yet, Black doctors represent only 5.7% of doctors. 
  • Chronic health conditions: Hypertension, obesity and diabetes disproportionately affect the population, increasing the risk of pregnancy complications.
  • Risk of preeclampsia: Black women in the U.S. have higher rates of preeclampsia than other women, including Black women from outside of the U.S.
  • Socioeconomic disparities: Lack of insurance coverage and geographic barriers often prevent Black women from receiving timely and comprehensive prenatal and postpartum care. This can result in undetected or untreated health conditions, increasing the risk of complications during pregnancy and childbirth.
  • Racism: In a CDC study, approximately 40% of Black, Hispanic, and multiracial mothers reported discrimination during maternity care, and 45% of all mothers reported holding back from asking questions or discussing concerns with their providers.

Addressing the causes of Black maternal mortality requires a comprehensive approach that tackles these disparities, addresses racism and improves access to quality healthcare. 

Improving care to address disparities in Black maternal mortality

Since the pandemic, many states have expanded postpartum Medicaid benefits to a full year rather than the required 60 days. More Black women rely on Medicaid for prenatal and postpartum care than white women –– 65% compared to 42% of U.S. mothers overall. More follow-up care can help reduce maternal morbidity.

Research shows that increasing the representation of Black women in healthcare professions is crucial for building trust, enhancing communication and ensuring culturally sensitive care for Black women. This can be achieved through targeted recruitment efforts, mentorship programs and initiatives designed to support Black women in pursuing healthcare careers. At OBHG, the diverse clinical workforce –– 63% female, 40% racial and ethnic minorities –– receives regular cultural bias training.

Awareness among all physicians about the high prevalence of chronic health conditions among Black women can help more patients access preventative measures, such as low-dose aspirin for preeclampsia prevention.

OB hospitalists help reduce Black maternal mortality

OBHG hospitalist programs are a key solution to addressing Black maternal mortality and morbidity. A recent study found that using OB hospitalists reduces the rate of maternal mortality.

Here are some reasons why OB hospitalists help reduce maternal mortality rates:

  • Standardized methods and measurements: Quality of care and outcomes vary in each location. OBHG has developed standard protocols for delivery complications such as preeclampsia and postpartum hemorrhage. We also developed a C-section reduction toolkit to combat medically unnecessary C-sections. We track the data within each of our partner hospitals.
  • Continuous coverage: No matter the day or time, an experienced OBHG-employed hospitalist is on-site, ready to evaluate patients and tackle any emergency.
  • Expert postpartum care: With clinicians onsite 24/7, care is available for any emergency care patient.
  • Unbiased care: An analysis by OBHG showed that clinical outcomes at hospitals with OB hospitalists significantly outpaced national performance measures across all races - demonstrating that OB hospitalist programs elevate community maternal health.

Policy and advocacy efforts

Healthcare organizations alone can’t reduce Black maternal mortality rates. Policies at the state and Federal levels are necessary to improve outcomes. Nationally, the White House released the Blueprint for Addressing the Maternal Health Crisis in June 2022, following a spike in maternal mortality rates during the pandemic. 

One month later, the Centers for Medicare & Medicaid Services (CMS) released a maternity care action plan. The Health Resources and Services Administration (HRSA) committed $350 million to states to strengthen maternal and child health, and the Office of the Assistant Secretary for Health (OASH) invested $8.5 million in initiatives designed to reduce pregnancy-related deaths and complications that disproportionately impact people of color and rural residents.

Over 80% of pregnancy-related deaths are preventable, according to the CDC. Every one of the lives saved improves the lives of the children, the family and the community.

Oops! We could not locate your form.

More Topics