Black women already have a higher maternal mortality rate than women of other races. They die from pregnancy-related complications almost five times more than Asian women, three times more than White women and about four times more than Hispanic women of any race.
Not only is the Black maternal mortality rate higher, but it also has not improved significantly over the years. Black women died from pregnancy-related complications at roughly the same rate in 2023 as they did in 2022, according to the Centers for Disease Control and Prevention’s National Center for Health Statistics.
Marie Boone-Clark, founder and executive director of Birthing the Magic Collaborative, wasn’t shocked, but she was angry and disappointed at those statistics. “Anger and disappointment were tied because it confirms what we live every day,” she said to The Final Call.
The National Center for Health Statistics published a report in February titled, “Maternal Mortality Rates in the United States, 2023.” The study found that from 2022 to 2023, the maternal mortality rate for Asian women fell from about 13 to about 11 deaths per 100,000 live births. The rate for White women fell from 19 to 14.5. The rate for Hispanic women fell from about 17 to about 12.
For Black women, the rate rose from 49.5 to a little over 50.
According to several sources, maternal mortality or maternal death is when a woman dies during pregnancy or up to 42 days after the end of pregnancy from health problems related to pregnancy. Pregnancy-related death is when a woman dies during pregnancy or within one year after the end of their pregnancy from health problems related to pregnancy, according to the March of Dimes.
Why Black mothers are dying
Severe bleeding, infections, high blood pressure, complications from delivery and unsafe abortion account for nearly 75% of all maternal deaths, according to the World Health Organization. On its page on Black maternal mortality, the CDC reported that more than 80 percent of pregnancy-related deaths in the country are preventable.
So why did 247 Black women die in 2023, according to the CDC report?
“The main cause is the dismissal of their humanity,” Ms. Boone-Clark said. “We’re not addressing the needs of Black mothers.” People need to listen to Black women, she explained.
“We don’t necessarily need another diaper drive. What we need is for the system to recognize and hear women when they say something is not right. What we need is a system that responds to issues like a woman bleeding,” she argued.
Though socioeconomic status can play a role in a woman’s ability to get quality healthcare, it is not the sole factor, as college-educated Black women and Black women in high-income brackets also suffer from severe maternal morbidity, or “unexpected outcomes of labor and delivery that can result in significant short- or long-term health consequences,” at higher rates than women of other races, according to the CDC.
“Even if you don’t have a serious complication of death—that’s the tip of the iceberg—a significant number of mothers are experiencing traumatic births because of the mistreatment that they’re experiencing, disrespect, neglect, dismissal,” Dr. Leslie Farrington, a retired OB-GYN turned birth justice advocate, said to The Final Call.
“When you’ve been an obstetrician, you’ve seen what it’s like inside that world, and then you see it from the community side, you can’t unsee the paternalism and the obstetric racism going on,” she added.
College-educated Black mothers in New York City were more than twice as likely to suffer from severe complications than White mothers without a high school diploma from 2008 to 2012, according to a report by the New York City Department of Health and Mental Hygiene Bureau of Maternal, Infant and Reproductive Health.
High-earning Black mothers in California had higher severe maternal morbidity and maternal mortality rates than women of other races, according to a study on maternal and infant health inequality analyzing data from 2007 to 2016.
Ms. Boone-Clark named three primary reasons why Black mothers die: bias and ‘-isms’ such as racism, sexism, ageism and sizeism, dangerous stereotypes such as the “strong Black woman” trope, and power dynamics, the refusal to give Black women room to have a voice and ask questions.
“We also have to stop and say that the foundation of modern-day obstetrical care came at the pain and torture of Black women if we understand that the ‘father’ of modern obstetrical care is J. Marion Sims,” she said. “And how did he learn all the things that he learned that are now literally woven into the practices of OB-GYNs? By torturing Black women.”
Most mothers die after giving birth, during the postpartum period, according to a 2024 study on the U.S. maternal mortality crisis by the Commonwealth Fund. The study found that 65% of pregnancy-related deaths occur up to one year after the woman has given birth.
“The health care systems are implementing improvements in care around the time of the hospitalization. But even if you apply improvements unequally, then some people get a benefit, and some people do not.
They’ve learned to reduce the number of emergencies, complications, that are occurring around the time of birth in the hospital, but people go home, and most of the deaths are after the birth,” Dr. Farrington said. “(If) they go home and they are having issues, and they aren’t listened to, then they can become a statistic,” she added.
Dr. Farrington is the co-founder and executive director of the Black Coalition for Safe Motherhood. The organization teaches Black women to ACTT: ask questions until they understand the answers, claim their physical and mental space, trust their body and tell their story.
Based on numbers in another CDC report, 40% of Black women experienced discrimination while receiving maternity care.
Dr. Yamicia Connor, an OB-GYN, thought she would have a traditional career in academic medicine. But then she witnessed and experienced the amount of racism in the health system. She is the founder and CEO of Diosa Ara, a women’s health company focused on improving obstetrical and gynecological outcomes for Black and other non-White women.
“I think if anything, the last year or so has really revealed just how much pure hatred there is in this country for Black people, Black women, and that, of course, is going to translate into poorer health outcomes,” she said.
Dr. Farrington also described how growing up Black in America can affect the body. “(Black women) come into the birthing situation with a certain amount of stress on the body. That’s called weathering,” she said. “Weathering can impact preterm birth (and) low birth weight.”
She used her granddaughter as an example. “She was working three jobs before she got pregnant. She was working two jobs while she was pregnant and barely able to make ends meet.
After she gave birth, she had to go right back to work within two weeks, not given enough time to heal or recover,” she said. “And so, we have the full distress on the body from the lack of a living wage, the lack of support, paid maternity leave.”
For Shafia Monroe, a midwife of over 40 years and a doula trainer for over 25 years, the problem is twofold. “We hear the stories of Black women. ‘I told them I didn’t feel right. I had a headache. They said go home.’
‘My blood pressure was high. They said don’t worry about it,’” she said. “At the same time, we’re also entering pregnancy as Black women as a whole unaware of how to be healthy before we become pregnant. So that preconceptional health.”
Black women may enter pregnancy not knowing they have underlying conditions such as uncontrollable diabetes, hypertension or anemia and low iron, she added. She and others also noted the problem of postpartum depression and mental health conditions as one of the leading causes of maternal mortality.
In the 1980s, the Honorable Minister Louis Farrakhan, National Representative of the Most Honorable Elijah Muhammad, delivered a 5-part series titled, “How to Give Birth to a God,” where he spoke on the importance of preconception conditions, the effect of a mother’s thoughts and actions while pregnant and the role the father’s thoughts play on the sperm and on pregnancy.
“When we are young, sometimes we already are ruining our lives. We have to understand our connection to the future. Teenagers have to start building the tissues, blood and bones of their bodies; that is the future of our people,” the Honorable Minister Louis Farrakhan said.
“When we smoke, the thousands of poisons in the cigarettes become a part of us, therefore it becomes a part of the sperm. As smoking and drinking weaken the human being, smoking and drinking attack the head of the sperm, in which is carried the genetic coding,” he added.
“So, wise scientists continue to feed us cigarettes, alcohol, crack, marijuana, pork, denatured food and canned goods that do not have any life in them. The more we ingest and digest these poisoned chemical products, we begin to kill, not only our brain power and beauty, but we kill our future.”
What must be done?
One of the primary solutions to help Black mothers? “Believe her,” Ms. Boone-Clark said.
She also believes that every woman should have a blood pressure cuff to help monitor blood pressure and know when something is not right. Fathers can play a critical role in a woman’s support system.
“He needs to understand how the hormones are … and why she may not be logical for a while and why she doesn’t feel like going out or cleaning the house or cooking,” she said. The woman is carrying an entire growing and developing human being, Ms. Boone-Clark continued.
“So, the first part is, they (the father) need to understand that they have a critical role,” Ms. Boone-Clark said. She points out these things are critical regardless of what the relationship may be between the pregnant woman and the child’s father.
Dr. Farrington pointed to men’s groups such as Reaching Our Brothers Everywhere. “Husbands can even learn some of the skills that doulas have, in supporting mothers,” she said.
Maternal health advocates also explained the importance of someone accompanying women to their doctor’s appointments.
“This is an SOS situation, save ourselves. We must educate the families, build skills for self-advocacy, making our voices heard and supporting mothers and making their voices heard,” Dr. Farrington said.
“That means husbands, family members, listen and help them (expectant moms) get their points across in those medical settings. Someone should be there.
If you go to the hospital, if you go to the doctor’s office for anything other than a routine checkup, bring someone with you,” even if it’s on the phone. They will pay better attention to her if someone else is there,” she added.
Dr. Connor believes it’s naive to feel that people are going to be “trained out of” racism and she doesn’t expect the system to change much. She is instead an advocate for giving women the tools to protect themselves.
“That’s why our organization focuses on obstetrical emergencies, providing patients tools at that time, and those tools can look like anything from just education and reassurances to offering or requesting direct medical intervention on the patient’s behalf all the way up to legal interventions or facilitating a transfer in real-time,” she said.
Ms. Monroe is hosting her 3rd annual Black Doula Conference in September. She described the importance of midwives for Black mothers and getting a trained doula who can understand the language used by medical staff and ask the right questions.
Midwives are trained medical professionals who provide comprehensive care during pregnancy, labor, delivery, and postpartum, and doulas are non-medical professionals who offer emotional, physical, and informational support during pregnancy, labor, and postpartum.
Ms. Monroe says midwives train differently and see birth as “normal.” “They’re more attentive. They’re just more hands-on,” she said. “I always tell the doulas; tell your client by law she can have a hospital birth with a midwife. It doesn’t have to be a home birth.”
She believes Black faith communities should also be part of the conversation on maternal mortality and also believes in celebrating the joys of Black birth. “Birth should be a time of joy. We have women so afraid.
They’re so afraid, which means that you’ll do anything a doctor says, and we don’t want that,” she said. “Birth is beautiful. There are great resources out there. There are tons of women who are birthing and having wonderful experiences.”
“We need to have our own culture around birth,” she concluded.
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The Final Call asked OB-GYNs and maternal health advocates for resources that could help pregnant Black women. Below is a list of their recommended resources and tips to research and look into further. Disclaimer: The Final Call does not endorse any of these resources and check with your doctor before making any adjustments to your healthcare practices.
• Have a blood pressure cuff. There is one from Navigate Maternity, a Black-owned company
• Operation MIST, a Black-owned organization that offers remote health monitoring
• Diosa Ara, a Black-owned telehealth service that partners with the in-person care team
• The Irth app, an app for Black women to find prenatal, birthing, postpartum and pediatric reviews
• Chocolate Milk Cafe, a Black-led lactation support group
• Evidence Based Birth, an educational and research-based organization that can help mothers with decision-making
• Partner to Decide, an organization that helps women decide between induced labor and spontaneous labor
• Baby Blues Connection, a mental health support hotline for mothers suffering from postpartum depression and other mental health conditions
• Find a community and a culturally congruent care team, including a doula and a lactation consultant
• Mothers must take ownership of their care and not assume the right thing is being done
• Reading the “Black Birthing Bill of Rights” by the National Association to Advance Black Birth
• Education via the New York City Standards for Respectful Care at Birth
• Safer Births Now, a free virtual maternal health fair offering a week of sessions from April 7-12
• Taking part in Black Maternal Health Week events from April 11-17
—Anisah Muhammad, Staff Writer