One major disparity amongst pregnancy-related deaths is the high proportion of non-white mortality in comparison to that of white mothers.
This inequity is especially true for African American women within the United States. According to the Centers for Disease Control and Prevention, 50,000 women experience pregnancy-related complications each year. However, Black women are up to three times more likely to die from such issues than their white counterparts.
Additionally, maternal deaths related to infectious diseases have been found to be 4 times higher for African American women than their white counterparts, and the rate of death by respiratory conditions has been found to be 2.9 times greater. These numbers reveal the alarming difference in pregnancy outcomes of mothers of differing races within the United States.
While there are a multitude of factors that contribute to this inequality, the social determinants of health, mixed with the influence of systematic racism, greatly impact the maternal well-being of Black mothers. The social determinants of health refer to any non-medical issues that influence a person’s health care outcome, such as one’s physical environment, socioeconomic position, governmental policies, and general access to medical services.
Numerous findings suggest that a scarcity of maternity providers, as well as a lack of access to comprehensive postpartum support, such as maternity care coverage and mandated paid leave, lead to increased rates of maternal mortality. These issues fall under the category of social determinants of health and disproportionately affect women of color, which helps to explain why African American mothers are at a higher risk for pregnancy-related deaths.
On top of this, racism plays an extremely large role in the pregnancy outcomes of women of color. The American Public Health Association has even declared racism a public health emergency, showing just how great an impact it has. Occurrences of racism within the medical field often happen out of implicit bias—attitudes or stereotypes that influence actions and decisions unconsciously. Many studies have found that implicit bias is most likely one of the main influences of the high rates of racial health care disparities in the United States.
Even more, implicit bias has been found to directly correlate with patients receiving lower quality of care. It is also likely to be activated under stressful situations like those of a maternity ward, suggesting that implicit bias may influence actions when patients are entering labor and thus affects the rate of maternal mortality of non-white women. This therefore reveals that the effects of racism are present within medical treatment and are accurately impacting outcomes, even if these events are due to a provider being unaware that their actions have unintentional racial biases.
Such unconscious mannerisms may stem from the history of inequities endured by women of color throughout the history of the medical field. For example, infertile slave women were often treated as experiments, and pregnant slaves were not exempt from any strenuous labor activities. Additionally, African American women, as well as Latina and Indigenous women, have been subject to forced sterilization and have been part of medical experiments against their will.
Not only can these historical injustices lead to implicit bias and thus adverse pregnancy outcomes, but they have also resulted in numerous ethnic and minority groups’ distrust of the medical system. Persistent distrust may create hesitancy to get help from a physician, which can also lead to a less healthy pregnancy and therefore increase the risk of maternal mortality.
Furthermore, women from certain minority groups are also often subject to lower quality of care in hospitals, adding to the likelihood of post-pregnancy complications. One study from 2012 found that African American women and Latina women were more likely to receive cesarean sections than their white counterparts. Cesarean sections give rise to a greater number of health risks for both the mother and her baby. They also increase the risk of three of the six main factors that contribute to maternal mortality, those being hemorrhage, infection, and complications from anesthesia.
Plus, in the United States, around 30% of Black and Hispanic women who delivered in hospitals reported mistreatment from their providers, while only 21% of White mothers reported such mistreatment.
These statistics reinforce the disparities seen amongst the maternal mortality rates of certain races. Women of minority groups repeatedly experience a lower quality of care, one of the social determinants of health, leading to a higher probability of adverse outcomes.
It is extremely important that the healthcare system addresses these issues and takes the appropriate measures to reduce such alarming inequalities.
Sources:
Cilenti, Dorothy, et al., editors. The Practical Playbook III: Working Together to Improve Maternal Health, Oxford University Press, 2024. Chapters 17-18; Chapter 22.
Gunja, Munira Z., et al. “Insights into the U.S. Maternal Mortality Crisis: An International Comparison.” Commonwealth Fund, 4 June 2024, www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison#:~:text=The%20U.S.%20maternal%20mortality%20rate,die%20from%20pregnancy%20or%20childbirth.
Maternal Mortality Is on the Rise: 8 Things to Know > News > Yale Medicine, http://www.yalemedicine.org/news/maternal-mortality-on-the-rise. Accessed 21 Oct. 2025.
Njoku, Anuli et al. “Listen to the Whispers before They Become Screams: Addressing Black Maternal Morbidity and Mortality in the United States.” Healthcare (Basel, Switzerland) vol. 11,3 438. 3 Feb. 2023, doi:10.3390/healthcare11030438
Saluja, Bani, and Zenobia Bryant. “How Implicit Bias Contributes to Racial Disparities in Maternal Morbidity and Mortality in the United States.” Journal of Women’s Health (2002) vol. 30,2 (2021): 270-273. doi:10.1089/jwh.2020.8874
Singh, Gopal K, and Hyunjung Lee. “Trends and Racial/Ethnic, Socioeconomic, and Geographic Disparities in Maternal Mortality from Indirect Obstetric Causes in the United States, 1999-2017.” International journal of MCH and AIDS vol. 10,1 (2021): 43-54. doi:10.21106/ijma.448
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