Black Motherhood in Crisis: Maternal Mortality from the U.S. to Sub-Saharan Africa

Photo by Joyce Arkoh

A Shared Emergency Across Borders

Across vastly different healthcare systems, one truth holds steady: Black women are more likely to die from pregnancy-related complications than any other racial or ethnic group. In the United States, Black women face a maternal mortality rate three to four times higher than white women. In Sub-Saharan Africa, maternal deaths account for nearly two-thirds of global maternal fatalities. Despite differences in geography, income, and infrastructure, these outcomes share common roots—systemic neglect, limited access to quality care, and the enduring legacy of racism and colonialism.

This is not just a public health issue—it is a global justice issue. Whether in a modern hospital in New York or a rural clinic in Nigeria, Black women are asking the same question: Why are we not being heard? The crisis reveals a deep structural failure that spans continents. But it also highlights the strength of communities fighting for change—from grassroots doulas in Detroit to mobile clinics in Ghana.

United States: Modern Medicine, Unequal Outcomes

The United States is one of the few high-income countries where maternal mortality is rising. According to the CDC, Black women in the U.S. are 2.6 times more likely to die from pregnancy-related causes than white women, even when education and income are accounted for. Underlying causes include preeclampsia, hemorrhage, and cardiomyopathy—but systemic racism is the thread that ties them together.

Black women frequently report being dismissed or ignored by healthcare providers. Pain is underestimated. Symptoms are overlooked. Delays in diagnosis and treatment occur not because of lack of knowledge, but because of implicit bias. The result is preventable death.

In response, many Black women-led initiatives are stepping into the gap. Organizations like the Black Mamas Matter Alliance advocate for policy reform and culturally competent care. Community-based doulas, midwives, and perinatal support groups are rebuilding trust and access, especially in underserved areas.

Sub-Saharan Africa: Scarcity and Survival

In Sub-Saharan Africa, maternal mortality remains one of the region’s most pressing health challenges. The World Health Organization reports that approximately 70% of global maternal deaths occur in this region. The leading causes include severe bleeding, infection, high blood pressure, unsafe abortions, and obstructed labor.

These deaths are not solely due to medical limitations. The underlying barriers include transportation, cost, gender inequality, and underfunded health infrastructure. Women in rural areas often give birth without skilled assistance, while emergency services are too few and too far.

However, community-driven models are making a difference. In Kenya, community health volunteers are trained to identify complications early and connect women to care. In Nigeria, mobile maternal clinics are expanding access to prenatal services. In Uganda, partnerships between local NGOs and international health agencies are helping provide emergency obstetric care and postpartum follow-ups.

Photo by Khan Studio

Global Frameworks, Local Failures

The United Nations’ Global Strategy on Women’s, Children’s and Adolescents’ Health set a goal to reduce global maternal mortality to less than 70 deaths per 100,000 live births by 2030. Progress has been made—but not equally. Countries with large Black populations remain disproportionately behind.

Policy gaps, funding shortages, and weak accountability mechanisms slow implementation. In both the U.S. and Sub-Saharan Africa, maternal health initiatives often fail to address racial disparities and localized social determinants of health. Even where care is technically available, it may not be culturally respectful or delivered without prejudice.

The global framework exists. But it must be paired with local investment, data transparency, and leadership by Black women themselves. Community health workers, midwives, and researchers must be empowered as co-designers—not just recipients—of healthcare systems.

Black Women Leading Solutions

In the face of this crisis, Black women are not passive. They are frontline leaders. In the U.S., telehealth platforms led by Black practitioners are expanding maternal health education and virtual care access. Apps like Irth allow Black mothers to review providers and share experiences, creating a feedback loop for accountability.

In Ghana, maternal health groups like the African Women's Development Fund are pushing for national reforms and funding maternal shelters. In Ethiopia, trained birth companions are helping bridge clinical and cultural gaps in maternity wards. Across the diaspora, Black women are documenting their birth stories, collecting data, and demanding systemic change.

These efforts emphasize not just survival, but dignity. They insist that quality maternal care must be equitable, respectful, and affirming. Health systems must be redesigned with input from those most affected. The lived experience of Black women must be at the center of any true solution.

How to Support Locally

Supporting Black maternal health begins with awareness and advocacy. Locally, this means attending public health forums, supporting Black-led birthing centers, and amplifying voices from the community. Donating to organizations like the National Birth Equity Collaborative or SisterSong can fund direct services and policy work.

Telehealth is also a bridge. Encouraging access to prenatal support via digital platforms can address gaps in transportation and provider shortages. Community training in birth advocacy and postpartum wellness can empower families from within.

For those in healthcare, examining implicit bias and pursuing ongoing anti-racism training is essential. Medical schools and public health programs must also integrate the history and present reality of racial disparities in maternal health into their curricula.

Photo by cottonbro studio

The Future of Birth Justice

Black maternal mortality is not a regional problem—it is a global alarm. It exposes the limits of wealth, the failures of policy, and the weight of systemic injustice. But it also illuminates the resilience of those most impacted. From the hospital rooms of Atlanta to the birth huts of rural Zambia, Black women are reclaiming their right to safe, supported motherhood.

This movement is not only about reducing death. It is about affirming life. Real change requires more than policy statements—it demands infrastructure, investment, and inclusion. It begins by listening to Black women and following their lead. Because no one should have to survive childbirth. They should be able to live through it—with joy, with dignity, and with their future intact.