Reprioritizing Black Maternal Health

August 06, 2025 | Lawrence Young

I do not have to look far to understand the urgency of the Black maternal health crisis. I have watched friends, colleagues, and loved ones from every walk of life struggle through pregnancies that should have been safe and celebrated. Some are highly educated professionals. Others are young mothers still finding their way. Many had access to quality insurance and still faced complications, long hospital stays, and minimal follow-up care. Many have shared unfortunate experiences that run the gamut from feeling unheard or perhaps unnecessarily undergoing a procedure — the care in health care was not there for them.

These are not isolated incidents. They are part of a larger, structural failure that demands our attention and our action. As public health professionals, we must ask ourselves: How can we better care for and about Black mothers? And what would it look like to center them in the systems that were created to protect women in one of the most vulnerable times of their lives?

Understanding the Root of the Crisis

Black women in the United States are three to four times more likely to die from pregnancy-related causes than their White counterparts. In many states, including Connecticut, this difference persists even when controlling for education and income. These outcomes are not the result of individual choices or biological differences — they are the result of systems designed with historical blind spots.

Education and income, often seen as protective factors, do not shield Black women from these outcomes. Research shows that pregnancy-related mortality rates are higher among Black women with a college degree than among White women with the same level of education or with less than a high school diploma. The same is true for women with respect to the risk of dying within the first year postpartum. These disparities grow with age and extend beyond mortality to include severe maternal morbidity, such as preeclampsia — a pregnancy complication related to high blood pressure — which can have lasting health impacts if untreated including death.

Additionally, American Indian, Alaska Native, Black, Native Hawaiian, Pacific Islander, Asian, and Hispanic women all experience higher rates of ICU admission during delivery compared to White women. ICU admission is considered a key marker for maternal complications and system-level failure.

Public Health as Partner in Progress

Public health has a responsibility to do more than document issues and concerns. We must be in the business of addressing them. In Connecticut, we are working across agencies and community organizations to move from acknowledgment to action.

One of the most important leaders in this work is #Day43, an initiative launched by Waterbury Bridge to Success Community Partnership. The name refers to the period between 43 days and one year postpartum, during which approximately 20% of pregnancy-related deaths occur. #Day43 exists to raise awareness of Black maternal health and transform systems to support mothers. Their work spans research, advocacy, policy, technical assistance, and storytelling grounded in lived experience.

Waterbury’s maternal health data reflects this crisis. According to the #Day43 Black Maternal Health Report, 18.6% of pregnant women in Waterbury received late or no prenatal care. Those in the city face higher rates of C-sections, limited access to postpartum care, and insufficient support for mental health and breastfeeding. The community described a significant lack of maternity care resources, particularly in the North End, where many Black and Hispanic families reside.

Through initiatives like this, residents are not just seen as stakeholders. They are recognized as storytellers, system builders, and agents of change. Their leadership is shaping how we define, measure, and deliver maternal care in Connecticut. This vision aligns with broader maternal health equity efforts across the state. For example, The Connecticut Health Foundation is developing a Maternal Health Equity Blueprint in partnership with community leaders, researchers, and families. Waterbury voices are essential contributors to this process.

Listening as a Path of Healing

The experiences of Black mothers reflect a broader truth. Too often, our systems are not built to hear them. That lack of trust is both historical and current. It shows up in rushed appointments, dismissed symptoms, and inaccessible services.

Community-based providers, such as doulas and midwives of color, are critical to bridging this gap. They do more than provide care — they restore dignity. Yet these providers are often underfunded and undervalued in mainstream health care systems. Public health must champion integrating these providers into existing systems and promoting long-term sustainability.

To maximize maternal health outcomes, the next phase of this work must intentionally include structured cross-sector collaboration. It must focus on building systems that educate both providers and families on urgent maternal warning signs, provide consistent discharge education, and strengthen local surveillance and outreach infrastructure. These strategies are essential, scalable, and lifesaving. We cannot improve outcomes without acknowledging the deep cultural, emotional, and psychological work required to rebuild trust. We cannot heal what we do not hear.

Re-Examining the “Public” in Public Health

Re-examining the public in public health means placing the needs of our most vulnerable communities at the center. It means investing in care that is integrative and supportive with community co-designed solutions. It also means wholistically addressing other intersecting systems that influence maternal outcomes.

We can start by:

1. Expanding funding for community-based perinatal health workers, including doulas and midwives.
2. Embedding relevant metrics into maternal health program design and evaluation.
3. Creating statewide listening sessions and family advisory councils to ensure policies reflect lived realities.
4. Partnering across sectors to improve access to safe housing, transportation, and mental health supports for new mothers.
5. Supporting local initiatives like #Day43 that lead from within communities and reflect community-defined solutions.
6. Educating families on health information and individual health rights through accessible, trusted channels.

To truly care for and about Black mothers, we must act beyond awareness months and social media campaigns. We must improve current processes and design opportunities that will support them and keep them alive. Public health was created to serve the public. The most powerful way to honor that mission is to focus on the public, ensuring they are a priority and not an afterthought.