Black women are nearly three times more likely to die or suffer harm during pregnancy and birth than white women, according to the Centers for Disease Control and Prevention (CDC).
While a March 2023 report published by the CDC’s National Center for Health Statistics (NCHS) found that maternal mortality rates in the United States are increasing across demographics, Black mothers are disproportionately dying during birth or pregnancy. According to the report, Black mothers had a mortality rate of 69.9 maternal deaths per 100,000 live births, and the highest-risk demographic of Black mothers (age 40 and over) had a 300.8 mortality rate.
Non-Hispanic white mothers had a mortality rate of 26.6 maternal deaths per 100,000 live births in 2021, while Hispanic mothers had a 28.0 mortality rate.
According to the U.S. Department of Health and Human Services, between 1955 and 1985, the U.S. maternal mortality rate decreased by 99%. Since then, the numbers have steadily crept back up. According to the CDC, the 2021 rate of 32.9 maternal deaths per 100,000 live births marked a 38% increase from the 2020 rate, and a 64% increase from 2019. Today, the U.S. has the highest maternal mortality rate among high-income countries, nearly triple that of the countries with the next-highest maternal mortality rates: France and Canada.
Lack of insurance, implicit bias can be deadly for Black women
Serious pregnancy and birth complications have impacted Black women across the financial and health spectrums, including global icons such as Serena Williams and Beyoncé. In May 2023, three-time Olympic medalist Tori Bowie died alone in her home during labor.
According to the CDC, the disproportionate mortality rate among Black mothers stems from a number of factors including variance in health care quality and preexisting health issues as well as structural racism and implicit bias.
Due to disparity in health care access and insurance coverage, American women consistently pay more money yet receive worse medical care during pregnancy and birth compared to their counterparts in other high-income countries.
According to a 2022 brief from the U.S. Department of Health and Human Services, Black Americans are also disproportionately uninsured compared to their white counterparts, although coverage statistics have gone up since the Affordable Care Act (ACA) was implemented in 2010.
At a macro level, much remains to be done to improve the standard of care across the board for all pregnant women, especially for Black mothers. On an individual level, here’s what you can do to give yourself and your child the best chance for a healthy, thriving life together.
Educate yourself on what’s normal and what’s not
Most women aren’t born knowing what to expect when expecting, especially if this is your first child. Read through pregnancy books and consult with your doctor to understand what aches and pains are a normal part of the process, and what signs could indicate that something is wrong. For example, most doctors will urge you to report any unexpected bleeding during pregnancy, even if you don’t experience pain or discomfort.
Be your own advocate
When something feels wrong, it’s crucial to speak up. This is especially true for Black mothers — multiple studies have shown that implicit bias in the health care system means the pain and struggles of pregnant Black women are often overlooked or devalued.
Inadequate medical care for Black Americans isn’t limited to pregnancy and birth: Studies have shown that Black Americans are consistently at risk for higher rates of heart disease, kidney failure and cancer amongst a number of other serious conditions, all of which can impact pregnancy and birth.
Medical providers who are not fully educated on these health disparities may be unaware of comorbidities or elevated risks. When in doubt, speak up about your concerns, and don’t hesitate to seek out different medical providers if you aren’t feeling heard by your current doctor.
Negotiate your pregnancy and childbirth finances
Familiarize yourself with the cost of prenatal, birth and postpartum care. Whether you’re insured or not, it never hurts to understand the average cost range of standard pregnancy procedures such as ultrasounds, sonograms and prenatal testing.
Many health insurance plans cover part or all of your pregnancy checkups, health screenings, labor and delivery costs and follow-up appointments. If you don’t have health insurance right now, you may qualify for low-income coverage.
If you must pay your childbirth costs out of pocket, shop around different maternity clinics to see if they are willing to negotiate lower rates, offer payment plans or provide discounts for paying up front or in cash.