Inside the Beltway

Metrocentered: Tackling the Black Maternal Health Crisis

AU changemakers step up and show up in our community 


Pregnant Black woman hugging a small child

Black maternal mortality in the District is a crisis upon a crisis upon a crisis. According to new data from the Commonwealth Fund, the maternal mortality rate in the US is 23.8 deaths per 100,000 live births—more than any other developed nation in the world. Among African American women, the rate is more than twice as high: 55.3 per 100,000. And in DC, the Black maternal mortality rate is 70.9 deaths per 100,000 live births.
The city’s Maternal Mortality Review Committee, established in 2019 by Mayor Muriel Bowser, SPA/MPP ’00, reports that Black Washingtonians account for about half of all births in recent years—and 90 percent of pregnancy-related deaths. 
“Too often, pregnancy and childbirth are a scary experience for Black moms and their families,” Bowser said on April 14, during Black Maternal Health Week. “The issue of how we support healthy moms, healthy babies, and healthy families is one that we must be focused on year-round.”
Maternal mortality is defined by the Centers for Disease Control and Prevention as the death of a woman during pregnancy, at delivery, or within a year of giving birth. Among Black women, it’s rooted in “social and political decisions that create unequal conditions that negatively affect maternal health [and are] shaped by structural racism,” says health studies professor Jessica Owens-Young, CAS/MA ’10, whose research focuses on social factors that affect Black maternal health outcomes, including income, education, and access to care.
Black women are more likely than their White peers to develop gestational diabetes, preeclampsia, and other life-threatening pregnancy-related conditions, and they’re nearly 50 percent more likely to go into preterm labor. Importantly, they’re also far less likely to be heard by health care providers. 
Medical racism and the dismissal of Black women’s pain cut across class lines, according to a 2018 report from the New York Times, which revealed that in the US, an African American woman with an advanced degree is more likely to lose her baby than a White woman with less than an eighth-grade education.

AU changemakers strive to improve health outcomes for Black women and their babies, ensuring they not only survive but thrive. Meet a few of them here.

The major determinants of maternal health are attributable to the way society is organized, not individual lifestyle. Conditions that threaten the life and health of Black women in the US—including variable access to quality health care, housing, transportation, and underlying chronic conditions—do not magically disappear when a woman becomes pregnant. We need to stop blaming Black women for the appalling state of maternal, infant, and child health in this country.” 
—Jeanne Flavin, CAS/PhD ’95, sociology professor, Fordham University, and president of the board of directors, National Advocates for Pregnant Women

Nationally, Black women are at higher risk for birth-related complications and mortality, and DC is no different. But we must also recognize that advocates and community leaders are leading important efforts in DC to fight against these inequities and ensure that Black birthing people have the resources and support they need to have healthy births.”
—Jessica Owens-Young, CAS/MA ’10, AU health studies professor 

It’s about taking on the systems that put Black and brown women at greater risk before, during, and after pregnancy. And now we face a new challenge: We know that the systems and structures that perpetuate inequalities and disparities in health outcomes have been exacerbated by the pandemic, and that women—particularly women of color—have been hit hardest both personally and professionally.” 
—DC mayor Muriel Bowser, SPA/MPP ’00, during the 2021 Maternal and Infant Health Summit, part of her Thrive by Five initiative 

The Black people from whom I am birthed have built communities of care over centuries. We will always take care of each other. But at some point, our system should be caring for us too.” 
—Brittany Packnett Cunningham, SOE/MAT ’09, activist, writer, and new mother, on the June 23 episode of her podcast, Undistracted, “Having a Baby While Black”

For some Black women in Washington, DC, maternal health care [means] not always participating in the processes that have been normalized and getting services à la carte—for example, getting blood work done at a hospital or birth center but getting prenatal and labor and delivery support at home with a certified professional midwife. This allows [women] autonomy during their birthing experience and protects their mental well-being.”  
—Tanya Upshur, SOC/MA ’18, producer and director, Birth! Place? and CEO, She UnShushed! Productions