Blog: In Honor of the Eighth Annual Black Maternal Health Week- Black Maternal Health and Criminalization

Written by Taryn Graves

MPP candidate at George Washington University, Trachtenberg School of Public Policy and Public Administration

Policy Intern, Reproductive Rights at SiX

In Honor of the Eighth Annual Black Maternal Health Week: Black Maternal Health and Criminalization

April 11-17, 2025, is officially recognized as Black Maternal Health Week. Founded by the Black Mamas Matter Alliance, Inc., the White House formally recognized it on April 13, 2021, with President Biden signing the first-ever proclamation marking the holiday. Black Maternal Health Week acknowledges Black maternal health’s role within the reproductive rights, health, and justice community.

This year’s theme of Black Maternal Health Week is “Healing Legacies: Strengthening Black Maternal Health Through Collective Action and Advocacy.” It emphasizes the importance of community healing and recognizing the Black-led advocate organizations that continue to fight systemic oppressions in the health care system that contribute to maternal mortality. This observance provides an opportunity to understand the severity of the Black maternal health crisis across the United States and how policy advocates can develop legislative solutions to protect Black birthing people, their communities, and their families.

The United States has a long history of monitoring and criminalizing the reproductive health of Black birthing people, contributing to maternal health disparities within the Black community. From nonconsensual gynecological examinations throughout slavery to arrests and legal proceedings of Black people based on pregnancy outcomes, Black maternal health remains unfairly scrutinized and surveilled today.

During enslavement, slave owners were deeply invested in the reproductive capabilities of Black women and girls, viewing their fertility as essential to sustaining the institution and profitability of slavery. To protect their financial interests, they relied on physicians to monitor pregnancies,  assist with difficult births, and intervene in cases of infertility, miscarriage, and infant death. However, these medical inspections continued; physicians continued to exploit Black bodies even after their deaths, using them for medical experiments. These unethical practices severely impacted young Black women and children, as advancements within gynecology were built on physicians and other medical staff performing nonconsensual cesarean sections and other invasive gynecological surgeries without anesthesia.

The surveillance and nonconsensual medical testing of Black women during slavery laid the foundation for ongoing reproductive criminalization, fueling the current maternal mortality crisis. The policing of pregnancy escalated during President Nixon’s anti-drug campaign, infamously known as the “War on Drugs.” This initiative led law enforcement and medical institutions to target and surveil Black mothers, legitimizing drug testing of pregnant people and newborns, leading to widespread criminalization of Black pregnancy.

Nixon’s anti-drug campaign resulted in hundreds of arrests; 75% of whom were Black women living in the South, including in states such as Alabama, South Carolina and Tennessee. While these arrests initially focused on alleged drug usage, Black women have also been prosecuted for uncontrollable pregnancy outcomes such as stillbirths, sudden infant death syndrome (SIDS), or accidental deaths, often facing murder or manslaughter charges. Feticide laws, which permit these arrests, are legal loopholes enabling states to intervene and control pregnancies under the guise of protecting fetal rights. These laws fail to consider external factors affecting pregnancy outcomes, instead placing blame onto mothers and diminishing the rights of pregnant people.

The criminalization and surveillance of Black people’s pregnancies continues to have devastating consequences for Black mothers, children, and families. The 2022 overturn of Roe v. Wade has impacted the maternal mortality crisis as bans and restrictions on abortion care disproportionately affect Black women, who already face higher risks of pregnancy-related complications, including cardiovascular disease and lupus. Despite the fact that 80% of pregnancy deaths are deemed preventable, Black women are three times more likely to die from pregnancy-related causes than white women. In fact, 2023 data from the National Vital Statistics System reveals that as maternal mortality rates have significantly decreased for white and Hispanic women, the burden Black mothers bear has persisted.

Multiple reproductive rights, health, and justice organizations, including Black Mamas Matter Alliance, Inc. have put forth policy recommendations to protect Black maternal health and decriminalize the pregnancies of Black women and birthing people. These recommendations call for ending mandatory reporting laws, decriminalizing substance use and abortion care, and prohibiting the use of shackles, restraints, and other violent forces against incarcerated pregnant and postpartum individuals. It is important that these policy solutions not only support pregnant people already within and impacted by the incarceration system, but also dismantle anti-Black legislation while protecting Black mother’s bodily autonomy and reproductive health decisions.

In conclusion, the lack of access to comprehensive maternal health services, including abortion care, not only leads to poor birth outcomes, but also increases the likelihood of criminalization for circumstances beyond Black women and birthing people’s control. Without systemic change, including policy priorities highlighted in Black Mamas Matter: In Policy and Practice, Black women and birthing people will continue to be punished for pregnancy outcomes instead of receiving the support and medical care necessary to protect their health and lives.