Understanding and Addressing Health Disparities for Black Birthing People and Babies

Pregnancy and childbirth bring excitement, love, and joy—from picking out baby names and setting up a nursery to imagining life with a new baby. These moments should be filled with celebration, from the baby’s first cry to their first words. However, for some communities, these moments are greatly shaped by systemic issues that affect the health of birthing people, their families, and their babies. Specifically for many Black birthing people, racism, systemic barriers, and other maternal and infant health disparities overshadow what should be a joyful time.

In February, members of the Aurrera Health Group team attended the 2025 Insure the Uninsured Project (ITUP) Annual Conference. Health leaders, experts, advocates, innovators, and future public health practitioners gathered at the conference to discuss ongoing healthcare inequities in California and strategies to close the gap between health coverage and access to quality care. Two sessions, Beyond Reparations: Systemically Protecting Health Equity for Black Californians and Shaping Health Outcomes Through Guaranteed Income, highlighted the disparities that Black birthing people and their babies experience and explored potential solutions to improve health outcomes.

Overview of Racial Disparities in Maternal Health

In the United States, many birthing people experience significant health consequences, including preventable deaths, following labor and delivery. While maternal health challenges affect all communities, Black birthing people experience disproportionately worse outcomes due to social drivers of health—such as racism, discrimination, disparate treatment, and limited access to quality healthcare—which significantly contribute to racial maternal health disparities.

Black, American Indian/Alaska Native (AI/AN), and Native Hawaiian/Pacific Islander (NHPI) birthing people experience significantly higher rates of pregnancy-related mortality, preterm births, and low birth weight compared to White birthing people. Black and AI/AN birthing people are more than three times as likely to die from pregnancy-related causes as white birthing people (63.4 and 55.9 vs. 18.1 per 100,000 births). Additionally, babies born to Black, AI/AN, and NHPI birthing people face disproportionately high mortality rates. These findings highlight the need to address these disparities and continue the work to improve health outcomes for birthing people of color and their babies.

What is Driving the Disparities?

The disparities in Black birthing people and infant health result from long-standing systemic inequities that make it harder for Black birthing people to access quality and comprehensive care, increasing their risk of complications during pregnancy, birth, and postpartum. Discussions during the Beyond Reparations: Systemically Protecting Health Equity for Black Californians conference session highlighted several key factors contributing to these disparities including:

• Systemic racism in healthcare – Black birthing people often experience both explicit discrimination and implicit bias in maternal care, affecting how their concerns are heard and treated.

• Limited access to maternity care providers – The closure of labor and delivery units in Black communities has made it more difficult for many to access essential prenatal and postpartum care.

• Underrepresentation of Black midwives and maternal health professionals – Many Black birthing people do not have access to culturally responsive care from providers who understand their experiences.

• Bias in labor and delivery settings – Research shows that Black patients' pain and complications are often dismissed or undertreated, leading to adverse health outcomes.

• Social drivers of health – Economic hardships, unstable housing, and transportation barriers make it more difficult for people to get the care they need when they need it.

Promising Strategies and Opportunities

Despite the challenges, many communities are working diligently to improve access to care and health outcomes and conference sessions highlighted several strategies to improve health for Black birthing people, their babies, and other communities. Below, we have outlined the strategies shared during the conference sessions, along with examples of programs we identified that are putting these practices into action.

1. Expand the Black maternal workforce – Increase the number of Black midwives, doulas, and maternal health providers to provide care that is more culturally responsive. In Kansas City, Missouri, Uzazi Village works to improve maternal and infant health outcomes by increasing access to Black doulas and culturally responsive maternity care.

2. Improve access to midwifery and doula services – Support community-based maternal care models that center Black birthing experiences. For example, the Los Angeles, California-based Kindred Space LA is a Black-owned birth center and midwifery practice dedicated to providing culturally affirming, holistic care to Black families.

3. Strengthen provider training – Ensure healthcare providers receive meaningful training, such as the Dignity in Pregnancy and Childbirth Training, funded by California Health Care Foundation (CHCF), to recognize and address implicit bias in maternal care to promote equitable treatment and improve patient-provider relationships.

4. Invest in Black-centered care models – Develop maternal health programs led by and for Black communities such as the BElovedBIRTH Black Centering in Oakland, California which integrates medical care, education, and peer support in prenatal and postpartum group-based care designed specifically for Black birthing people.

5. Address social and economic factors – Implement policies and programs, such as the Homeless Prenatal Program and California Abundant Birth Project (ABP), that provide support to people and families experiencing housing instability, food insecurity, and financial hardship and help ensure that birthing people have the stability they need for healthier pregnancies and positive birth outcomes.

Aurrera Health Group’s Capabilities

The promising strategies highlighted in this blog—including expanding the Black maternal workforce, investing in Black-led and centered maternal health programs, and addressing systemic barriers— are important tools that can help Black birthing people access high-quality and equitable care. A joyful, safe, and equitable birthing experience must be the standard for all, including for Black birthing people.

At Aurrera Health Group, our team has worked on multiple projects to better understand the maternal and infant health disparities in communities across the country. This includes our collaboration with Cardea to assess Black Maternal and Perinatal Health in Kansas City, Missouri, and our work on the 2021 and 2024 editions of the CHCF Health Disparities by Race and Ethnicity in California Almanac reports. To learn more about how Aurrera Health can support efforts to improve health for Black birthing people and babies, contact Kelly Murphy or Megan Thomas.

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Authors

Reatha Conn [Policy Consultant] (Copy)

Vimbai Madzura [Deputy Director] (Copy)