Why Black women in the United States die from pregnancy at about three times the rate of white women, what changed in 2025 and 2026, and what action you can take this week.
Black women in the US die from pregnancy-related causes far more often than white, Hispanic or Asian women. In March 2026, the National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC) released final data for 2024 (CDC). That year, 649 women died of maternal causes, a rate of 17.9 deaths per 100,000 live births. The rate for Black women was 44.8, about three times the rate for white women (14.2) (CDC). The Black rate fell from 50.3 in 2023, but the CDC said the change was not statistically significant (CDC). The CDC reports these deaths for women. Trans men and nonbinary people also give birth in the same maternity care system.
The gap has several causes that stack on top of each other. Maternal mortality review committees (MMRCs), which study each death in their state, found that more than 80 percent of pregnancy-related deaths from 2017 to 2019 were preventable. More than half happened between one week and one year after the pregnancy ended. For Black women, heart conditions were the leading cause (CDC). Researchers and families point to structural racism, provider bias and gaps in access. In 2024, a federal civil rights review of Cedars-Sinai Medical Center, where Kira Johnson died in 2016, found concerns that Black patients received a lower standard of care for obstetric hemorrhage than white patients (LAist). Education and income do not close the gap. Dr. Shalon Irving was a CDC epidemiologist with a doctorate and good insurance when she died in 2017, three weeks after giving birth (NPR).
Where a person lives also shapes the care they can get. March of Dimes reported in 2026 that 34.6 percent of US counties are maternity care deserts, with no obstetric clinicians and no birthing facility. About 2.4 million women of reproductive age live in those counties (March of Dimes). At least 96 hospital labor and delivery units closed in 35 states between January 2024 and May 2026 (March of Dimes). Doulas and midwives can fill part of this gap. Doulas give nonmedical support during pregnancy, birth and after. Midwives provide clinical care. Black midwives once attended many births in the rural South, but state licensing rules that followed the 1921 Sheppard-Towner Act pushed most of them out of practice (Time).
In 2026, federal policy is moving in two directions. Medicaid pays for about 4 in 10 US births (KFF). Every state except Arkansas, plus Washington, D.C., now covers people on Medicaid for 12 months after birth instead of 60 days. Wisconsin signed its extension into law in March 2026 (Georgetown Center for Children and Families). The Congressional Budget Office (CBO) estimates that the 2025 reconciliation law, known as the One Big Beautiful Bill Act, cuts federal spending on Medicaid and the Children's Health Insurance Program by about $1 trillion through 2034 (Center for American Progress). Pregnant people are exempt from its new work requirements, which start in 2027 (Policy Center for Maternal Mental Health). Hospitals say lower Medicaid funding adds pressure to close labor and delivery units (National Partnership for Women & Families). In April 2025, federal layoffs eliminated the CDC team that ran the Pregnancy Risk Assessment Monitoring System (PRAMS), a national survey of new mothers. The cuts left data gaps for 2024 and 2025 births (Commonwealth Fund). Congress kept funding for the CDC's Safe Motherhood programs, which support PRAMS and state MMRCs, in a spending law passed in February 2026 (Policy Center for Maternal Mental Health). In March 2026, members of Congress reintroduced the Black Maternal Health Momnibus Act, a package of 14 bills (Office of Rep. Emilia Sykes). It has not passed.
10 actions — for yourself, your community and the country. Start with one.
Read the CDC's Hear Her list of warning signs that apply during pregnancy and up to one year after. They include a severe or worsening headache, trouble breathing, chest pain, vision changes and severe swelling. Send the page to anyone you know who is pregnant or recently gave birth. Send it to the people who live with them too.
Find your representative and senators, then call their offices. Sample script: "Hi, my name is ___ and I live in ___. I'm calling to ask [Representative/Senator ___] to cosponsor the Black Maternal Health Momnibus Act. Black women in our country die from pregnancy at about three times the rate of white women, and CDC review committees found most of these deaths were preventable. Will they cosponsor? Thank you." You can read the package's 14 bills on the Black Maternal Health Caucus site.
Offer to attend appointments with a pregnant or postpartum friend or family member, in person or by phone. Before the visit, help them write down their symptoms and questions. During the visit, take notes and ask the provider to repeat anything that was unclear. Serena Williams and Shalon Irving both described having to push to be heard about their symptoms.
Irth is a review app, like Yelp, where Black and brown parents rate doctors and hospitals on prenatal, birth, postpartum and pediatric care. Share it with Black friends who are pregnant or planning a pregnancy. If you are a Black or brown parent, leave a review of your own care.
Ancient Song is a birth justice organization that has trained more than 2,000 people as full-spectrum doulas since 2012 and serves Black and Latinx families. Give a one-time or monthly gift so more families can have a doula. Ask your employer to match it.
The Black Mamas Matter Alliance (BMMA) is a Black women-led alliance founded in 2016 that works on policy, research, care and culture change for Black maternal health. It organizes Black Maternal Health Week each April. You can direct your gift to its workforce education programs.
Ask your HR or benefits team whether your company's health plan pays for birth and postpartum doulas. If it does not, ask them to add doula coverage at the next plan renewal and invite coworkers to sign your request. Sample wording: "Doulas give continuous support before, during and after birth. Please add birth and postpartum doula coverage to our health plan at renewal." DONA International explains what doulas do.
Use the National Health Law Program's map to see whether your state's Medicaid program pays for doula care. If it does not, email your state legislators and ask them to add it. In Arkansas, the only state that still ends postpartum Medicaid at 60 days, ask for a 12-month extension instead; Arkansas Advocates for Children and Families tracks the issue.
Use March of Dimes' PeriStats to see whether your county or nearby counties are maternity care deserts. If a local hospital has closed or plans to close its labor and delivery unit, attend the public hearing or write to your county commissioners and state health department.
Black Maternal Health Week runs every year from April 11-17. Download BMMA's State Resolution Guide and use it to ask your city council or state legislators to pass a resolution recognizing the week. Put the dates on your calendar now.
In Alabama, Dr. J. Marion Sims performed repeated experimental surgeries without anesthesia on enslaved women, including Anarcha, Betsey and Lucy, to develop a repair for vesicovaginal fistula. He was later called the "father of modern gynecology". Read more ›
President Warren G. Harding signed the Sheppard-Towner Act, the first federal funding for maternal and infant health. Many states used it to start requiring midwife licensing and training, and the programs that followed excluded most Black midwives. Read more ›
Federal funding for the Sheppard-Towner Act lapsed after opposition from the American Medical Association. By 1930, midwives attended about 15 percent of US births. Read more ›
Midwives attended 5 percent of all US births but still attended 25 percent of nonwhite births, many of them in the South. Read more ›
Kira Johnson died at Cedars-Sinai Medical Center in Los Angeles from internal bleeding after a C-section. Her husband, Charles Johnson, said he pleaded for help for 10 hours before staff took her back to surgery. Read more ›
Dr. Shalon Irving, a 36-year-old CDC epidemiologist, died from complications of high blood pressure three weeks after giving birth to her daughter, Soleil. NPR and ProPublica published her story on Dec. 7, 2017. Read more ›
Vogue published Serena Williams' account of a pulmonary embolism after the birth of her daughter in September 2017. She said she had to insist on a CT scan and a blood thinner before staff found clots in her lungs. Read more ›
New York City removed the statue of J. Marion Sims from Central Park and moved it to the cemetery where he is buried. Read more ›
States gained a federal option to extend postpartum Medicaid coverage from 60 days to 12 months. Read more ›
Federal layoffs at the CDC eliminated the team that ran PRAMS, the national survey of new mothers, along with most of the Division of Reproductive Health staff. Read more ›
President Trump signed the One Big Beautiful Bill Act. The CBO estimated it cuts federal Medicaid and Children's Health Insurance Program spending by about $1 trillion through 2034. Read more ›
Members of Congress reintroduced the Black Maternal Health Momnibus Act, a package of 14 bills first introduced in 2020. The day before, Wisconsin's governor signed a 12-month postpartum Medicaid extension, leaving Arkansas as the only state without one. Read more ›
A historian traces how 19th-century doctors, including J. Marion Sims, built the field of gynecology through experiments on enslaved and Irish immigrant women.
A history of medical experimentation on Black Americans and how it shaped distrust of the medical system.
A legal scholar documents how US law and policy have controlled Black women's reproduction, from slavery through forced sterilization and welfare rules.
A journalist and former Essence editor reports on how racism affects Black Americans' health, with a close look at maternal and infant deaths.
Essays from scholars, doulas, midwives and parents on Black birth experiences and community efforts to change them. A second edition came out in 2024.
The oral history of a Black midwife who delivered thousands of babies in rural Alabama and saw state rules end the work of midwives like her.
A short introduction to the reproductive justice framework, which Black women created in 1994 and which SisterSong helped spread.
An anthology on healing justice, a strategy of collective care that Black, Indigenous and queer and trans organizers of color built in response to harm from the medical system. It centers reproductive and disability justice.
From our Banned Books Book Club list: Disability Justice
Shop the Banned Books Book Club. Every book above links to our Banned Books Book Club shop on Bookshop.org, which supports independent bookstores. Related lists:
Downloadable materials on urgent maternal warning signs for pregnant and postpartum people, their families and health workers. Health departments can request to co-brand them.
Federally funded, evidence-based practice sets for hospitals on conditions such as obstetric hemorrhage, severe hypertension and cardiac conditions, plus webinars and a video library. Clinicians and hospital staff can use them.
Resources for organizing events during Black Maternal Health Week and for asking elected officials to pass resolutions.
Training for community members to become doulas who support abortion, birth, postpartum and antepartum care, based on the midwifery model of care.
Customized training sessions and technical assistance for health systems and organizations that focus on racism as a root cause of health inequities.
Enslaved women in Alabama on whom J. Marion Sims performed repeated surgeries without anesthesia in the 1840s. Their names are among the few recorded from his experiments.
A CDC epidemiologist and lieutenant commander in the US Public Health Service who studied health inequities. She died in January 2017, three weeks after giving birth, after seeking care repeatedly for her symptoms.
Kira Johnson died in 2016 at Cedars-Sinai after a C-section. Her husband, Charles Johnson, founded 4Kira4Moms in 2017 and has testified before Congress on maternal health.
The tennis champion nearly died from a pulmonary embolism after giving birth in 2017. She has written about it for Vogue, CNN and Elle.
The Olympic sprinter had an emergency C-section at 32 weeks in November 2018 because of severe preeclampsia. She described it to the House Ways and Means Committee at a May 16, 2019, hearing on racial disparities in maternal deaths.
An OB-GYN who founded the National Birth Equity Collaborative (NBEC) in 2015. NBEC works on research, training and policy on Black maternal and infant health.
The co-founders of the Black Mamas Matter Alliance in 2016. Simpson is also executive director of SisterSong.
A journalist and maternal health strategist who founded Irth, a review app for Black and brown parents, and hosts the Birthright podcast.
The House members who lead the Black Maternal Health Caucus and first introduced the Momnibus Act in 2020.
Covers the Black Maternal Health Caucus, the first Momnibus, postpartum Medicaid gaps and reproductive justice, with a clarification that trans men and nonbinary people are also affected.
Shares a doula reader's case for full insurance coverage of doulas and for treating doulas as part of the care team.
Explains intersectionality and Kimberlé Crenshaw's work through the killing of Breonna Taylor.
The founder of the Irth app shares positive Black birth stories. Some episodes follow people who had traumatic births as they work with professionals to heal.
A 2017-2018 radio and print investigation into US maternal deaths. It includes the story of Dr. Shalon Irving, published Dec. 7, 2017.
A doula and postpartum educator interviews perinatal professionals and new parents in nearly 350 episodes. Search the episode list for doulas, birth equity and postpartum care.
Parents tell their own birth stories. The site has a BIPOC Stories category.
Income and education do not explain it. Dr. Shalon Irving had a doctorate, a job at the CDC and good insurance when she died in 2017. A colleague told NPR, "You can't educate your way out of this problem" (NPR). Legal scholar Kimberlé Crenshaw coined the term intersectionality in 1989 to describe how racism and sexism combine in Black women's lives (Columbia Law School).
The rate fell from 50.3 to 44.8 deaths per 100,000 live births, but the CDC said the change was not statistically significant. The 2024 rate for Black women was still about three times the rate for white women (CDC).
The law does not directly cut pregnancy or postpartum coverage, and pregnant people are exempt from its new work requirements (Policy Center for Maternal Mental Health). It does cut federal Medicaid and Children's Health Insurance Program spending by about $1 trillion through 2034 (Center for American Progress). Hospitals and advocates say lower Medicaid payments add pressure to close labor and delivery units. A June 2026 National Partnership for Women & Families report counted 32 labor and delivery unit closures since the law passed (National Partnership for Women & Families).
A doula gives nonmedical support, such as help with comfort, information and speaking up during appointments and birth. Some state Medicaid programs and private plans pay for doulas, and many families pay out of pocket. The National Health Law Program keeps a map of state Medicaid doula coverage (National Health Law Program).
The CDC says to get medical care right away for any urgent maternal warning sign, which can appear up to a year after birth. When calling a provider or 911, say that you are pregnant or were pregnant in the past year (CDC). The full list is on the CDC's Hear Her site. This guide is not medical advice.
As of May 2026, every state except Arkansas, plus Washington, D.C., covers 12 months postpartum (Georgetown Center for Children and Families). KFF keeps a state-by-state tracker (KFF).
No. It was first introduced in 2020 and was reintroduced in the House in March 2026 as a package of 14 bills (Office of Rep. Emilia Sykes). It has not passed either chamber (Black Maternal Health Caucus).
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