Although previous posts have discussed the racial and geographic factors that affect maternal mortality rates, we have not yet discussed the socioeconomic influences that contribute to the high occurrences of pregnancy-related deaths within the United States. Read on to learn more about this significant inequality in maternal mortality rates.
To start, “during 2013-2017, women in the middle- and most-deprived area groups had 23% higher risks of maternal mortality from indirect causes than women in the most-affluent area group” (Singh and Lee). This statistic reveals the alarming difference between the death rates of wealthier women in society versus those from all other socioeconomic backgrounds.
Much of this disparity is due to the United States’ healthcare policies.
First, “the U.S. is the only one of these [high-income] countries that does not have universal health care, leaving nearly 8 million women of reproductive age uninsured. The racial or ethnic groups that are the least likely to have health insurance and the most likely to face cost-related barriers to getting care are Black, Hispanic, American Indian and Alaska Native, and Native Hawaiian and other Pacific Islanders” (Gunja et al.).
Not only does this indicate that a large portion of women in the United States are unable to pay for the treatment needed to ensure a healthy pregnancy, but it also reveals the ties between socioeconomic disparities and racial ones. Since eight million is an extremely large number of women who cannot afford quality care, and certain minority groups make up the majority of that population, it is evident why non-white women experience adverse pregnancy outcomes more frequently, because they are at even more of a disadvantage.
On top of a general lack of insurance, the United States’ healthcare policies on mothers in the workplace can cause an even greater number of women to miss postpartum check-ups, further increasing the risk of later complications.
The United States is the only high-income country that does not mandate paid leave for new mothers, with black women and low-income women being even less likely to receive paid leave. Thus, it will be more challenging for low-income women who cannot afford to miss work without compensation to maintain exceptional post-pregnancy health for themselves and their infant, heightening their risk of death from adverse effects later on.
Plus, black women have also been shown to be without paid leave at higher levels, revealing how disparities can build on each other as these mothers face both racial and socioeconomic barriers within their healthcare journeys.
Furthering this concept of certain minorities being affected due to several aspects of their identity, African American families in the United States have a net worth that is ten times less than that of white families. They are also more frequently denied housing, employment, and are more likely to live without food security, all of which contribute to worse health outcomes of Black mothers.
To add, “ten states have yet to expand their Medicaid programs, leaving hundreds of thousands of women of reproductive age, disproportionately Black or Latina, in the Medicaid coverage gap and vulnerable to having their coverage terminated 60 days postpartum, as current policy allows” (Gunja et al). Once again, individuals who do not have medical insurance on top of living in certain areas are unfairly put at a higher risk of maternal mortality. This reinforces the idea that certain minorities are impacted by a multitude of factors, not just race or solely socioeconomic background, contributing to the overall high rates of maternal mortality.
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.
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
“43,400+ Socioeconomic Stock Illustrations, Royalty-Free Vector Graphics & Clip Art.” iStock, http://www.istockphoto.com/illustrations/socioeconomic. Accessed 9 Nov. 2025.
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