Blog Series: SiX Repro’s ICYMI Research Roundup Spotlight on Black Maternal Health

SiX Repro’s ICYMI Research Roundup is a new regular update and short summary of recent sexual and reproductive health fact sheets, toolkits, and journal articles.  We bring you these latest and most relevant insights in the reproductive health, rights, and justice landscape to support state legislators in advancing evidence-based policymaking. These updates cover a wide range of reproductive health, rights, and justice topics, from abortion to contraception to maternal health to assisted reproductive technology and from the intersections of climate change or disability justice or gender affirming care and beyond. We value engagement from our state legislator community and invite you to join us as we explore these latest developments.

During this year’s Black Maternal Health Week (April 11-17th, 2025), this ICYMI Research Roundup is highlighting recent research focusing on Black Maternal Health. Black Maternal Health Week is a week-long campaign founded and led by the Black Mamas Matter Alliance to build awareness, activism, and community-building to amplify the voices, perspectives, and lived experiences of Black Mamas and birthing people.

The United States continues to have the highest rate of maternal deaths compared to its peer nations with more that 80% of maternal deaths deemed preventable. Over the last decade there has been an increase in maternal health advocacy, research, and programs focused on lowering the maternal mortality rate in the U.S. Although recent data shared by the Centers for Disease Control and Prevention (CDC) on 2023 maternal mortality data indicates that the maternal mortality rate decreased, it decreased for every racial and ethnic group except for Black women.

In the U.S., Black women are three times more likely to die from pregnancy-related causes than white women. In the U.S., the leading cause of maternal death is mental health, and Black women are twice as likely as white women to experience maternal mental health conditions but half as likely to receive care. Black women are also 25% more likely than white women to deliver by C-section, putting them at greater risk for negative health outcomes. Systematic racism significantly contributes to the disparities in the maternal health outcomes of Black women. These disparities will only widen with the disinvestment in government programs, like Medicare and Medicaid, and defunding invaluable research programs under the current Trump administration as well as the continued increase in maternity care deserts, maternal health provider shortages, and increasing attacks on abortion care. Centering the experiences of Black women in continued research, advocacy, and policy level solutions are needed to improve maternal health outcomes for Black women.

Blog Posts

• Caring For Black Women Seeking Fertility Treatment: Challenges, Stigma, And Hope (American Society for Reproductive Medicine, 20 February 2025): This blog post addresses the unique challenges for Black women experiencing infertility.  Research has shown that Black women are almost twice as likely to experience infertility compared to white women, yet they are significantly less likely to seek or receive timely referral or treatment.  Drs. Gloria Richard-Davis, Lasha Clarke, Benjamin Harris, Teru Jellerette-Nolan, and Michael Thomas share advice for understanding racial disparity, the toll it takes on patients, and seeking solutions.

Fact Sheets

• Black Women, Birthing People, and Maternal Mental Health (Maternal Mental Health Leadership Alliance, July 2023): This factsheet provides data on Black maternal mental health, barriers to care, and additional factors impacting Black women and families.

Research Briefs 

• State Abortion Bans Threaten Nearly 7 Million Black Women, Exacerbate The Existing Black Maternal Mortality Crisis (National Partnership for Women & Families, 2024): This new analysis from the National Partnership for Women & Families and In Our Own Voice: National Black Women’s Reproductive Justice Agenda reveals the harmful impact of the Dobbs decision on Black women.

• Maternal Health: Reproductive Justice And Health Equity (Institute for Women’s Policy Research, February 2025):  In light of the ongoing maternal health crisis in the U.S.—and in the face of the recent Dobbs decision overturning Roe v. Wade and subsequent rollback of reproductive health care access throughout the country— addressing maternal health should be a priority for policymakers, in particular prioritizing ending the Black maternal health crisis. This brief provides an overview of maternal health data in the U.S., and focuses on how this state of emergency can be addressed through a myriad of systems and legislation.

• Built for Our Survival: Reclaiming Black Birth from a History of Harm (Institute for Women’s Policy Research, April 2025):  This brief is the first in the Birthing While Black: The Urgent Fight for Maternal Health Reform Series by the Institute for Women’s Policy Research (IWPR), which will examine different dimensions of the Black maternal health crisis. In this first brief, IWPR lays the groundwork for the series by focusing on the history of our economic and health systems, and linking maternal health to IWPR’s existing work on economic and health issues that uniquely impacts the lives of Black women.

Research Reports

• Drivers of Racial Differences in C-Section (National Bureau of Economic Research, August 2024): This study of nearly one million births in 68 hospitals in New Jersey, found that obstetricians are more likely to give unnecessary C-sections to Black pregnant people.  The report highlights that the gap is highest for people with the lowest risk and is reduced by only four percentage points when controlling for observed medical risk factors, sociodemographic characteristics, hospital, and doctor or medical practice group. Although c-sections can be lifesaving, unnecessary c-sections increase costs of medical care and involve a higher risk of maternal complications, can be a contributor to the higher rates of Black maternal morbidity, and can complicate future pregnancies.

• Why Access to Abortion Care Matters for Black Maternal Health (The Century Foundation / Black Maternal Health Federal Policy Collective, 16 October 2024):  More than half of all Black women in the United States live in states that have already banned or are likely to ban abortion care. These bans exacerbate racial and socioeconomic inequities in reproductive and maternal health outcomes. Continued attacks on abortion access will worsen maternal health outcomes, with Black birthing people at the highest risk of dying during and after childbirth, and experiencing adverse health outcomes.

• Nowhere to Go: Maternity Care Deserts Across the US (March of Dimes, 2024):  The report examines how factors like fertility rates, chronic disease, and social drivers of health influence access to care and maternity care access, and its association with birth outcomes are examined. Policy actions and recommendations that can improve access to care are also incorporated throughout the report.

Journal Articles

• State insurance mandates and racial and ethnic inequities in assisted reproductive technology utilization (Fertility and Sterility, January 2024): This study found that racial and ethnic inequities in utilization of Assisted Reproductive Technology (ART) were reduced in states with comprehensive infertility coverage mandates. Mandates alone, however, were not sufficient to eliminate disparities. These findings of this study can inform future strategies aimed at improving ART access under a social justice framework.

• Examining the Perceptions of mHealth on Racial and Ethnic Disparities in Postpartum Health for Black Women: A Scoping Review (Health Promotion Practice, March 2024):  A total of eight articles were included in this synthesis, encompassing mobile phone-based interventions for Black women. Researchers argue that tailored mHealth (mobile health) interventions can effectively promote behavior change and improve health care outcomes for Black women; however, there is a critical need for more research to assess user engagement and retention and whether these improvements indicate long-term sustainability.

• Black Women Should Not Die Giving Life”: The lived experiences of Black women diagnosed with severe maternal morbidity in the United States (Birth: Issues in Perinatal Care, April 2024):  In this study,  researchers sought to understand the lived experiences of Black women diagnosed with severe maternal morbidity in communities with high maternal morbidity. They argue that future interventions to reduce obstetric racism and improve patient outcomes should center the experiences of Black women, and focus on improving patient-provider communications.

• “Because I Was a Criminal and Drug Addict.”: Experiences of Anti‑Black Gendered Racism and Reproductive Injustice Among Black Pregnant and Postpartum Women with a  Substance Use Disorder and Incarceration and Family Policing Histories (Journal of Racial and Ethnic Health Disparities, May 2024): The researchers recruited and conducted semi-structured interviews with 15 Black mothers who described their experiences navigating overlapping systems of surveillance and control. Drawing on models of systemic anti-Black racism and sexism and reproductive justice, the researchers assessed participants’ experiences of racism and gender-based violence within these oppressive systems.  These narratives emphasize the need for action to measure and address experiences of reproductive injustice during care delivery and treatment.

• “Patients want to see people that look like them”: Aspiring midwives of color as resistance to racism through concordant care in the United States (SSM – Qualitative Research in Health, June 2023):  In One-on-one interviews with 20 aspiring midwives from diverse racial, ethnic, and geographic backgrounds, and analyzed using thematic analysis, researchers found that aspiring midwives see themselves and their work as a means of active resistance against racism through concordant care.  They argue that facilitating the career pathways of individuals like those interviewed is key to diversifying the workforce, improving perinatal health outcomes, enhancing agency, building trust in individuals and communities that have long experienced mistreatment, and fighting against individual and systemic racism.

Podcasts

• BMHW25 – Black Maternal Health, Medicaid Cuts, and Community-Based Care (the Population Institute, rePROs Fight Back): Listen to Elizabeth Dawes, Director of Maternal and Reproductive Health and Senior Fellow at the Century Foundation and Co-Founder of the Black Mamas Matter Alliance, talk about the status of the Black maternal health crisis in the U.S. and the myriad, ongoing attacks to the Black community’s health, rights, and wellbeing from the new Trump administration.

Webinars 

• How Abortion Restrictions Are Worsening America’s Maternal Health Crisis (The Century Foundation, 2024): Researchers have found that if abortion care is banned throughout the United States, the number of maternal deaths would rise by 24%. This number is even worse for Black women, whose deaths would rise by 39%. Panelists discuss how to both safeguard abortion and tackle the maternal health crisis in these challenging political times.

We welcome your feedback on content and format. Are you a state legislator and have questions? You can reach out to Melissa Madera, Senior Associate of Research and Education, Reproductive Rights, at melissa@stateinnovation.org.  If you’re a researcher or partner and want us to highlight your research, send materials to melissa@stateinnovation.org.