The United States health care system is failing Black women. In 2021, the CDC reported 32.9 maternal deaths per 100,000 live births, a statistic that is 10 times higher than in countries of comparable income like Spain, Japan, and Australia. Sadly, a vast majority of those deaths were preventable — and 69.9% of the mothers lost were Black women.
The CDC cites several reasons for the disproportionately high rates of Black maternal mortality, including inequity in health care access, structural racism, and a disturbing history of medical abuse.
In her essay “Reproducing while Black,” celebrated anthropologist Dána-Ain Davis said these issues aren’t just constrained to birth. Her evidence reveals that Black women face hurdles even when seeking fertility treatment and starting their birth journey.
“Racism causes bedlam, and in certain situations – some more than others – requires the emotional and practical labor of avoiding it,” Davis observed. She added that racism multiplies “stress, uncertainty, and the need for profound vigilance in an already burdensome situation.”
For Wanda Irving, the issue of maternal care is deeply personal. Her daughter Shalon — a doctor with dual PhDs — died just three weeks after giving birth to Irving’s granddaughter. Post-birth, Shalon made repeated attempts to flag extreme pain, but her medical providers denied her care.
After the loss of her daughter, Irving recognized that the issue was bigger than her daughter’s care team and the hospital that failed her. It was systemic.
“The prevalence of the problem is deeply entrenched — embedded — in the very foundation of our health care system,” Irving explained in her 2020 TED Talk. “It is this broad-based failure that continues to allow disparities in maternal health and death, which result in Black women, like Shalon, dying at rates 300% higher than white women.”
While Irving acknowledged that improvements in data accuracy were rising, the first step to decades of trauma lies with accountability. Irving called on health care providers and hospitals across the country to acknowledge how they failed Black women, own responsibility, and actively take the steps to stop preventable deaths in the future.
“It is long past time that leaders in the medical community take steps to transform the health care system status quo,” Irving said.
Image via Anna Shvets
As pressure mounts for the health care industry to change, the maternal care movement is primarily being led by grassroots campaigns, community organizations, and women with lived experiences.
Ashlei Spivey — the founder and executive director of I Be Black Girl — spoke to Good Good Good about her work leading the only Black-led birth justice organization in Nebraska.
“It’s such an honor and a privilege to be able to lead this work and work alongside our community that we’re from,” Spivey said. “Within our birth justice portfolio, our goal is to ensure that Black women and people with the capacity for pregnancy not just live through their birth journeys, but thrive.”
Spivey said that one of the biggest obstacles in maternal care reform is the catch-22 of trying to create a better system in the future while being held hostage by the system of the present.
“If the system is not serving us, how do we radically imagine and dismantle that system and think of something else rooted in community, rooted in what we need?” Spivey asked. “That is a tension that we hold as we’re doing movement work.”
Spivey said that allies hoping to support reproductive justice can subscribe to newsletters, stay informed through social media, and donate directly to I Be Black Girl and other Black-led community-focused organizations like Reproductive Health Impact and Black Mammas Matter Alliance.
“We are doing a lot of system change to work around medical mistrust and how the medical system provides support, and really try to reimagine what care, abundance, and joy can look like through a community lens,” Spivey added.
Ultimately, Spivey said that the success of the movement relies on reframing it — not as a battle that Black women should face alone — but as a human rights issue that needs broader support.
“It doesn’t just take the people that are impacted, it’s going to take everyone,” Spivey said. “How people become part of this movement in a different way and really, truly show up is going to be integral to seeing some change.”
2026 UPDATE: The article above was originally written for the 2024 Gender Edition of the Goodnewspaper. Since then, the fight for Black maternal mortality has continued to be an uphill battle.
The word “Black” has been almost completely removed from a package of bills known as “The Momnibus Act,” which has long been viewed as Congress’ main legislation for addressing the Black maternal health crisis.
“There is a painful irony in a bill that originated as the Black Maternal Health Momnibus Act, that was named to address the Black maternal health crisis, no longer naming the population it was created to serve,” Angela D. Aina, co-founder and executive director of the Black Mamas Matter Alliance, said in a statement.
Democratic Rep. Lauren Underwood of Illinois, a lead sponsor of the Momnibus package, also expressed her disappointment.
“It suggests that there’s something wrong with it being about Black women,” Underwood said. “I think that is the piece that I am really concerned about: Is that there’s nothing wrong with having a bill that is trying to close the gap for Black women dying.”
Despite the language policing, Underwood and her peers remain undeterred. On May 18, she was joined by Representative Alma Adams and Senator Cory Booker in reintroducing the Momnibus Act.
“80% of maternal deaths in America are preventable, and the Momnibus is designed to stop them,” Underwood said in a statement. “This bill has the tools we need to make America a safer place to give birth, especially for the Black moms who are at the highest risk. The Momnibus will save moms’ lives, and Congress must act urgently to pass it.”
See Wanda Irving’s full TED Talk below:
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Header image via Anna Shvets
