Working to Improve Black Maternal Health

Whether you’re planning a pregnancy or swaddling your newborn, the journey from conception to parenthood can bring feelings from joyous excitement to understandable worry. For Black mothers and moms-to-be, it can also bring realities of disparities in outcomes, due to factors including variations in health care quality, implicit bias, and underlying medical conditions.

While health care professionals and institutions work to address systemic issues to improve health outcomes, physicians like Janice Aubey, MD, MPH, are helping their Black patients empower themselves to combat risk factors and embrace their best possible health before, during, and after pregnancy.

“In general, pregnancy is an incredibly joyous time for families; individuals enter this phase of life with great expectations for their future and want the best for themselves and their newborn,” says Dr. Aubey. “I want Black birthing people to experience the same joy, respect, hopefulness, and cultural affirmation that many patients experience.”

The 2026 theme of Black Maternal Health Week, "Rooted in Justice & Joy," honors the resilience and leadership of Black birthing people and acknowledges systemic injustices that continue to shape Black maternal health outcomes, Dr. Aubey adds. “Justice calls for accountability, systems change, and respect. Joy centers on rest, healing, cultural affirmation, and the right to thrive.”

Dr. Aubey explains current disparities and ways to address them, and shares health recommendations for mothers and moms-to-be.

Why are Black women more at risk of illness and death due to pregnancy- and delivery-related problems?

“Disparities in health outcomes are deeply connected to social determinants of health, health behaviors, engagement with health systems, and racial bias within health systems,” says Dr. Aubey. “Racial differences in the maternal mortality rate in the US reflect larger, longstanding social disparities.”

Heart disease, hypertension, and hemorrhage are among the leading causes for maternal mortality. Older maternal age and medical conditions, even those diagnosed at an early stage, (such as prediabetes or stage 1 hypertension) can increase risk for pregnancy-related complications.

In addition, unintended deaths associated with pregnancy caused by social and mental health conditions—such as drug overdose, suicide, and homicide—contribute to rising deaths in pregnancy and the postpartum period (one year after birth).

“I would like for us to take a more comprehensive approach to pregnancy—one that considers how to best bolster physical, emotional, environmental and social factors during pregnancy and postpartum, if not earlier.”

What does research show about disparities in pregnancy outcomes for Black patients?

Maternal mortality remains unacceptably high among all racial and ethnic groups in the US, says Dr. Aubey.

However, among non-Hispanic Black women, the maternal mortality rate was nearly 3.5 times higher than the rate for non-Hispanic White women, according to 2023 statistics from the CDC. Between 2022 and 2023, deaths decreased for all racial and ethnic groups except Black women.

The rate of preterm birth among Black women was about 1.5 times higher than the rate of preterm birth among White or Hispanic women, according to CDC data.

In addition, Black pregnant and postpartum women are more likely to develop mood disorders but less likely to receive treatment.

How can health care professionals and institutions address these disparities?

Interventions are needed at many levels, says Dr. Aubey. At the individual level, it’s crucial to recognize and address implicit bias (an unconscious negative attitude against a group).

At the systems level, hospitals and states need to sponsor evidence-based training that standardizes responses to obstetric emergencies and increases the availability of high-quality care.

At the federal level, advocacy and sponsorship is needed for legislation to support paid parental leave, extend health insurance for at least a year following birth, and invest in maternity facilities in rural communities to eliminate maternity deserts and increase workforce capacity.

What strategies have been effective?

Because the majority (63%) of pregnancy-related deaths occur postpartum, social support networks and education after birth are a key community strategy. Doula programs, for example, have expanded in NYC and throughout the country. These programs support families and evaluate individuals in the home after childbirth, which can help identify changes in a mother’s health in the early postpartum period.

How can mothers and moms-to-be support their own maternal health?

Planning a healthy pregnancy doesn’t start with the positive pregnancy test or end with birth. Maternal health is one phase in the span of women's health care; thinking about it in this way gives women agency over health care before pregnancy and after childbirth.

“Ideally, I would like all patients to begin thinking about their health and engaging with health care before becoming pregnant,” says Dr. Aubey. “This provides the opportunity to address health conditions prior and potentially decrease the condition’s impact during pregnancy.”

However, because such planning may not be an option for everyone, Dr. Aubey suggests that individuals bring up any issues and concerns during their medical visits. “Your provider is a tremendous resource during the pregnancy; talk to them.”

In addition, Dr. Aubey recommends the following:

• Support your body’s transition to pregnancy: A healthy diet, sleep, and exercise are useful ways to adapt to the physical changes of pregnancy, manage stress, and prepare for the marathon of childbirth and the postpartum period.
• Build your team: Choose the people who you want to be along for the ride during your pregnancy, such as reliable friends and family, a mental health provider, and a doula.
• Trust your doctor rather than online search: Come to each appointment with a few questions to jumpstart a conversation and help develop a relationship with your health care provider.
• Recognize key warning signs: Understand which symptoms could indicate a serious or life-threatening condition and get medical care.
• Take advantage of resources: Ask your provider about any helpful services available to you, such as women’s mental health programs and postpartum support programs.

Ideally, the themes of embracing justice and joy in Black maternal health will increasingly resonate at every level, from personal agency through federal legislation. “This approach highlights healing driven by dignity and care,” says Dr. Aubey.

Janice Aubey, MD, MPH, is an associate professor of obstetrics and gynecology at Columbia.