Reclaiming Birth: Community-Driven Solutions to Black Maternal Health Inequities
This Black Maternal Health Week (April 11–17, 2025), we join in a collective demand for awareness, accountability, and action. Founded by the Black Mamas Matter Alliance, this annual observance is more than a date on the calendar; it’s a clarion call to confront a longstanding and egregious public health injustice: Black maternal mortality and morbidity in the United States. It honors the vision, leadership, and solutions of Black women and birthing people who have long been on the frontlines, sounding the alarm and charting the way toward a future where surviving birth doesn’t mean defying the odds. Realizing that future begins with reckoning—starting with the data that lay bare a sobering picture of deep neglect, disparity, and preventable loss.
To support deeper understanding of this movement and the urgent need behind it, we’ve developed a white paper that unpacks the context, data, and most effective solutions to this crisis in greater depth. Click here to read it in full. To start, here are the core insights.
Black Maternal Mortality Is a Human Rights Issue
According to the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics, the United States has the highest maternal mortality rate (MMR) among nations with advanced economies, reaching 32.9 deaths per 100,000 live births in 2021. It is also the only highly industrialized nation where the MMR has more than doubled over the past two decades. Even more alarming, the CDC reports that over 80% of these deaths are preventable.
For Black women, the statistics are even more devastating: they are three to four times more likely than white women to die from pregnancy-related complications—a disparity that persists even in well-resourced states with the nation’s lowest maternal mortality rates and most robust healthcare systems. These inequities reflect the deep structural racism embedded in our healthcare system. Medical racism, implicit bias, provider neglect, and structural determinants of health—including housing instability, inadequate access to care, pre-existing conditions, and economic inequality—all converge to put Black birthing people at greater risk. Yet despite this reality, the causes of the crisis are often reduced to race or socioeconomic status alone—obscuring the deeper systemic forces at play. A 2023 study by the National Bureau of Economic Research challenges this harmful narrative, revealing that the wealthiest Black women still face a significantly higher risk of maternal mortality than the poorest white women. In other words, even money, education, and status do not insulate Black women from the dangers of childbirth in America.
Take Serena Williams, one of the most celebrated athletes in the world
After giving birth, she experienced symptoms that should have raised immediate concern given her medical history. Though she advocated for herself, her concerns were repeatedly dismissed. It was only after she persisted that a scan was finally performed, revealing life-threatening blood clots. Serena later wrote, "Giving birth to my baby, it turned out, was a test for how loud and how often I would have to call out before I was finally heard." Serena’s survival wasn’t guaranteed by her wealth, access, or health literacy—it was secured by her relentless self-advocacy. Her experience places her among countless Black women who have had to fight simply to receive adequate care. And tragically, despite ‘doing everything right,’ far too many do not live to tell their story.
A heartbreaking example is Dr. Sharon Irving, an epidemiologist at the CDC and a national expert on structural racism and trauma. Despite her deep medical knowledge and institutional access, she died three days after giving birth. If someone with her expertise and proximity to the system is not safe, who is?
When even the most resourced, medically informed, and institutionally connected Black women face dismissal, delay, and death, the depth of this crisis should be undeniable. The right to survive childbirth—regardless of race, income, or social status—is a fundamental human right. Until we confront the systemic conditions at the heart of this human rights crisis, Black maternal health will remain a barometer of racial injustice in the United States.
The Path Forward: Community-Led Birth Justice Efforts
Addressing this crisis requires far more than surface-level reform. The persistence of all-too-often deadly outcomes for Black birthing people demands a structural reset—one that rejects reductive framings and individualizing narratives, targeting the roots of racialized harm in maternal care and investing in the people and organizations already optimizing outcomes. This means confronting the crisis from multiple angles: through comprehensive healthcare policy reform, mandatory implicit bias training, a reorientation of medical education to confront entrenched racism, and—equally foundational to the work ahead—the legitimization and widespread integration of Black-led, community-rooted maternal health models as essential standards.
A growing body of research affirms that these models of care are essential to improving Black maternal health outcomes. Reports from Brookings, the Commonwealth Fund, and the National Healthcare Quality and Disparities Report all point to the critical need for multi-layered strategies that center equity, integrate birth workers, and close systemic gaps in care. A key finding is that the U.S. healthcare system undervalues both midwifery and culturally responsive care, missing a critical opportunity to reduce preventable deaths—particularly among Black mothers. Community-rooted midwives and doulas provide trauma-informed, culturally responsive support that extends beyond clinical care, restoring dignity and agency in moments of profound vulnerability.
These findings hold even greater urgency in today’s political landscape. As racial and reproductive justice advancements face mounting threats under the Trump administration—from active DEI rollbacks and draconian abortion restrictions to the United States’ withdrawal from the World Health Organization and the chilling potential of a fully realized Project 2025—the consequences that backsliding on health equity will have for maternal health are profound. In a nation grappling with the erosion of democratic norms and blatant attacks on civil and human rights protections, the stakes are impossibly high. We must look to community infrastructure as the frontline of resistance to Black maternal mortality. Grounded in deep relational care and uncompromising respect for the lived experiences of Black birthing people, local, Black-led perinatal support models are not only pathways to survival but also frameworks for liberation.
Community-Rooted Organizations Leading the Way
The need is undeniable—but so is the power of those responding to it. Across the country, grassroots maternal health organizations centering Black birthing people are building powerful, community-rooted alternatives to a mainstream healthcare system that continues to fail so many—and they are doing this work despite a mountain of systemic barriers.
Some of the national organizations at the forefront of these efforts include:
4Kira4Moms is a nonprofit committed to eradicating maternal mortality through advocacy, education, and policy change.
Mamatoto Village creates professional pathways for Black women in maternal health while providing perinatal care to underserved communities.
Black Women’s Health Imperative is the first and only national nonprofit solely dedicated to achieving health equity for Black women in America.
National Black Midwives Alliance provides a national voice for Black midwives and advocates for their role in improving birth outcomes.
Here at English Hudson, we’ve had the honor of partnering with the following organizations doing pivotal work in the maternal health and birth justice spaces:
The Bloom Collective, a nurturing, empowering space supporting mothers, parents, and families through holistic perinatal care.
Elephant Circle, advancing birth justice through policy advocacy and community engagement.
Institute for Medicaid Innovation, a nonprofit, nonpartisan research, policy, and community power-building organization transforming maternal health outcomes through equity-centered Medicaid models.
These are just a few of the many organizations driving this work forward. To truly sustain and scale their collective impact, the entire ecosystem of care requires sustained, intentional investment.
A Call for Transformative Investment
For too long, Black maternal health has been underfunded and deprioritized by philanthropy, with the organizations most proximate to the solutions receiving the least support. This must change. Funders have a critical role to play in ensuring sustainable, long-term investment in Black maternal health research, culturally grounded care models, and policy advocacy that reshapes systems. Now, more than ever—amid rollbacks on reproductive rights and racial equity—philanthropy must meet this moment with courage and unapologetic commitment.
We call on philanthropic institutions to commit to bold, sustained investments in the infrastructure needed to scale what we already know works:
Black-led maternal health organizations and community birthing centers
Culturally affirming models of perinatal care, including midwifery and doula support
Community-based patient advocacy and implicit bias training for medical providers
Policy and systems-level advocacy for birth justice and reproductive freedom
Black maternal health research and data collection, led by Black scholars and practitioners
These investments will not only strengthen maternal health outcomes in Black communities; they will help transform the standard of care for everyone—because when we reimagine what care looks like for those most at risk, we transform what care means for us all. Birth justice is not a niche issue. It is a matter of racial justice, gender justice, and human rights. If we are serious about building a world where surviving birth is not a privilege but a promise for everyone, then we must fund the people and movements bringing this vision to life. The future of maternal health depends on who we choose to listen to—and who we’re willing to follow.
To further expand your understanding of the drivers of this crisis and the path forward, take a deeper dive into the full white paper.