What’s Behind the Increased Numbers of Black Women Dying During Pregnancy and Childbirth in the United States?

three young African-American women
Photo: Devin Trent (CC)
By Amie Newman |

Editor’s note: OBOS is delighted to introduce new blogger Amie Newman. You can find out more about Amie here.

Rising maternal mortality rates in the United States are a domestic crisis and a critical human rights issue.  The numbers should also be a wake-up call. More women are dying from complications related to pregnancy and childbirth today than they were two decades ago. In fact, the United States is the only developed country where maternal mortality rates have increased in that time.

All women are not created equal amidst these stark statistics, however. There is a dividing line and it’s drawn between the maternal mortality rates of black women and of white women.

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According to the Centers for Disease Control (CDC), black women are dying during pregnancy, childbirth, and the year immediately following childbirth at nearly four times the rate of white women. While poor women are at greater risk of dying than women who have higher incomes, the disparity between black and white women is consistent at all income levels. Groups including Amnesty International and the reproductive justice organization SisterSong have called out this alarming racial disparity, yet unanswered challenges remain.

Despite the world’s costliest medical system, almost half of maternal deaths in the United States are  preventable. The leading causes of all maternal deaths in the United States are hemorrhage, pregnancy-induced hypertension, embolism, infection, and chronic medical conditions.  But, in many ways, that’s where the similarities between white women and black women end.

In 2014, the Center for Reproductive Rights, the National Latina Institute for Reproductive Health, and SisterSong released a shadow report for the U.N. Committee on the Elimination of Racial Discrimination called “Reproductive Injustice: Racial and Gender Injustice in U.S. Health Care.” In it they noted that “in some areas of Mississippi, the rate of maternal death for women of color exceeds that of Sub-Saharan Africa, while the number of white women who die in childbirth is too insignificant to report.”

The existence of disease may be a medical cause of death but racial inequities are in part responsible for the increased numbers of black women dying. We live in a country where a host of injustices contribute to this devastating gap in well-being, including lack of access to health care, affordability, and quality of health care.

Another study found that while black women don’t actually have a higher prevalence of the leading causes of maternal deaths cited above, they are more likely to die from such causes than are white women. This disparity may be attributed, in part, to data which shows nearly one-quarter of black women delay prenatal care or don’t initiate it at all.  It’s a rate that’s twice as high as the rate  for white women.

Racism is clearly a cause of detrimental health conditions for pregnant women, as it affects both  access to and quality of care. According to the 2010 Amnesty International report “Deadly Delivery: The Maternal Health Care Crisis in the USA”:

Research has demonstrated that maternal and fetal health may suffer from the effects of stress associated both with low income and with lifelong exposure to racism – stress which has been found to have a cumulative impact on the body that appears to have an adverse effect during pregnancy.

As Miriam Zoila Perez reports, the Affordable Care Act has helped close the gap in health insurance coverage disparities. But it hasn’t (yet) helped correct the racial disparity in maternal mortality. In part, this is due to particular states with higher populations of African-Americans opting out of available expanded Medicaid coverage programs. But closing the racial disparity in our country’s maternal mortality rates will require solutions more complex and expansive. We need to work towards the end of racism and discrimination against black women in American society.

The racial disparity issue so distressed the U.N. Committee on the Elimination of Racial Discrimination that in 2014 they called on the United States to adopt recommendations to fix it.

There is not one single path to fixing this serious, ongoing problem. But what surely is paramount is ensuring space for and listening to the stories of black women—those at the center of this crisis. Reproductive health and justice organizations like the Maternal Health Task Force and SisterSong are banding together to do just that:

The “Black Mamas Matter” convening included academics, public health practitioners, doctors, midwives, doulas, community organizers, policy experts, funders, and advocates. Participants—many of whom are Black women from the South—shared information, identified current challenges, articulated visions for the future, and discussed strategies.

The alarm has been sounded. The leadership, health, and lives of black women must be centered squarely in this fight. But addressing the racism and discrimination that continue to breathe life into our country’s maternal health crisis is within all of our power.

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8 Comments

  1. This article is so on point. As a certified birth doula, MSW social worker and black woman I observe the black maternal health disparities constantly. I am presenting on this very subject at the National Association of Black Social Workers 2016 Conference in New Orleans next week. I also am the host/producer of a very popular internet radio show: “Birthing While Black” Listen for free.

    • Lucy says:

      What a shame the group chose the title ‘Black Mamas Matter’, do USA black people think this will help them be taken more seriously? Here in the UK, black people feel less comfortable with these foolish terms, throw backs from the black & white movies and ridiculous roles of the black house-slaves.

      Aside from that, this topic is well worth researching and taking seriously because ‘Black Mothers’ do matter!

      • Destiny Parker says:

        What was the point of your comment Lucy, you sound so ignorant and vile. Mama is a normal term here in the states, both whites and blacks use it. Please do research next time you decide to spew ignorance.

      • Krystal says:

        The term you are referring to is “Black Mammy” not “Mama”. Mama is used more often in the home by black people in the USA than mother is. It’s a simple cultural fact.

    • Morbious Stone says:

      No retard the problem as the bgeing of the artical gave away has nothing to do with money you are already at twice the testosterone of a white female = not very viable and if you wern’t an idiot you’d know testosterone is one of the key reasons premature male babies die moree often than female babies it may make men strong but at high doses in the womb and after birth it weakens tissue… black women live that way their whole ugly lives it has nothing to do with income or any social/racial disparity, Ive never been to a Dr nor went with a female friend that their was not a black women waiting in the office with us receiving the same treatment or seeing the same dr That’s like saying the fact Blacks have more heart disease id because “wassism” we dindu nuffin rotfl … yet people neuter pit bulls later in life to extend the dogs life why… ultra high testosterone any hormone is to great of quantity especially Testosterone destroys cells and weakens them and its also the reason Asians life longer than anyone they don’t even go through a full “western” style puberty & thats why and thats what the studies say & its kinda obvious they have less body hair and boobs generally, whites have more and blacks have pubes everywhere deal with it you are a failure to launch race maybe all that cannibalism and black magic your people practice doomed you The Kuru you get from cannibalism sure can’t be good for your already smaller brains

  2. Arif Uddin says:

    The problem with looking thru the lens of race is it can never be wrong. That’s right because just about anywhere in the world, if two races exist with even slightly unequal power, there is legitimate possibility that some of the socioeconomic issues are due to racism. But is it 5% or 95%?

    And that’s where it seems we can lose the the direction — to reach our goal which here is higher mortality among pregnant women. As a New York Times article, Maternal Mortality Rates in the U.S. Rises, Defying Global Trends, Study Finds, reports that it could be due to chronic conditions pre-existing pregnancy such as obesity, a precursor of many other diseases, compromising chance at life during pregnancy.

    i understand the intuitive sense is More Funds, so let me invite you to CDC report that found that obesity rates in the US did NOT vary much in all three income levels. Now that should give us a pause. Obesity and Socioeconomic Status in Adults, 2005-2008, Fig 1

    Of the second puzzle is why there has been the OPPOSITE trend in obesity with increased information on healthy lifestyle. For that we need to look outside the silo of health sector and dig into philosophy: Seek flourishing life (Aristotle) And THIS need what we All have, even if in poor, like me

  3. One has only to read Ben Wattenberg’s book, “The Birth Dearth” to understand what is happening where the health of black women and their children is concerned. In a country where whites will be in the numerical minority in a few years, and where 60% of the fetuses that are aborted every year are white, the medical profession is being counted on to keep the number of live births among the populations of people of color as low as possible. Before you sit down to write a rebuttal to my remarks, read the aforementioned book.