The Maternal Mortality Crisis: Why Black Women Are 3× More Likely to Die

The United States has the highest maternal mortality rate of any high-income country in the world. And within that alarming national statistic lives a crisis within a crisis: Black women in America die from pregnancy-related causes at three times the rate of white women.

This is not a new problem. It is not a mystery. And it is not inevitable.

According to the Centers for Disease Control and Prevention (CDC), the maternal mortality rate for Black women in 2022 was 49.5 deaths per 100,000 live births — compared to 19.0 for white women and 16.9 for Hispanic women.

That gap has been documented for decades. And it has not closed.

What makes this disparity particularly striking is that it persists across income and education levels. A 2016 study published in the American Journal of Public Health found that Black women with college degrees had higher maternal mortality rates than white women who had not completed high school. Money and education do not protect Black women from this disparity the way they protect other groups.

The CDC identifies the top causes of pregnancy-related deaths as:

• Cardiovascular conditions (accounting for over 26% of deaths)
• Infection and sepsis
• Hemorrhage
• Cardiomyopathy — a condition Black women are disproportionately affected by
• Hypertensive disorders of pregnancy (preeclampsia, eclampsia)

Black women are significantly more likely to experience severe maternal morbidity — the near-miss events that precede maternal death — including blood transfusions, hysterectomy, and prolonged ventilation.

The most important thing to understand about the Black maternal mortality crisis is that it is not caused by biological differences between Black and white women. Race is a social construct, not a biological category. The disparity is caused by:

Research consistently shows that Black patients — including Black women in labor and delivery — are less likely to have their pain taken seriously, less likely to receive adequate pain management, and more likely to have their concerns dismissed by providers.

A landmark 2016 study found that a significant percentage of medical students and residents held false beliefs about biological differences between Black and white patients — including the belief that Black people have higher pain tolerance. These beliefs directly affect clinical decision-making.

The "weathering hypothesis," developed by public health researcher Dr. Arline Geronimus, proposes that the chronic stress of living with racism accelerates biological aging in Black women — increasing their risk for cardiovascular disease, hypertension, and pregnancy complications. This is why the disparity persists even among highly educated, high-income Black women.

Black women are significantly less likely to have access to providers who look like them, understand their cultural context, or have been trained to recognize and counteract their own implicit biases. Research shows that Black patients have better outcomes when treated by Black physicians — but Black physicians represent only about 5% of the U.S. physician workforce.

Black women are more likely to live in "maternity care deserts" — counties with no hospitals providing obstetric care and no obstetric providers. They are more likely to be uninsured or underinsured. They are more likely to face transportation barriers to prenatal appointments.

If you are pregnant or planning to become pregnant, here is what DaisyMe wants you to know:

You have the right to be heard. If a provider dismisses your concerns, you can ask for a second opinion. You can request a different provider. You can bring an advocate — a partner, family member, or doula — to every appointment.

Know the warning signs. Preeclampsia can develop rapidly. Warning signs include severe headaches, vision changes, sudden swelling in your face or hands, and upper abdominal pain. If you experience these symptoms, seek care immediately — and be persistent if you feel dismissed.

A doula can save your life. Research shows that continuous support from a doula is associated with significantly better maternal outcomes. Several states now cover doula services through Medicaid. Ask your provider or contact DaisyMe to find doula resources in your area.

Your postpartum period matters too. Most maternal deaths occur in the days and weeks after delivery — not during childbirth. Know the warning signs of postpartum complications: fever, heavy bleeding, chest pain, difficulty breathing, and signs of infection.

DaisyMe Foundation advocates for every Black woman's right to be heard, believed, and treated with dignity throughout her pregnancy and postpartum period. Our programs include:

• Health literacy workshops on maternal health warning signs and self-advocacy
• Care navigation support to help community members find culturally responsive providers, doulas, and postpartum resources
• Community partnerships with faith communities, community organizations, and employers to bring maternal health education directly to the communities that need it most
• Advocacy for Medicaid expansion, doula coverage, and policies that address the structural causes of maternal health disparities

The Black maternal mortality crisis is a public health emergency. It is caused by racism — structural, interpersonal, and internalized — not by biology. And it is preventable.

Every Black woman deserves to survive pregnancy. Every Black baby deserves a mother. DaisyMe Foundation is committed to the work of making that a reality.

Sources: CDC Maternal Mortality Surveillance, 2022; American Journal of Public Health, 2016; ACOG Committee Opinion on Racial and Ethnic Disparities in Obstetric Outcomes; Robert Wood Johnson Foundation Health Equity Report, 2023.

This article is for educational purposes only and is not a substitute for medical advice. If you have concerns about your pregnancy, please contact your healthcare provider.