The Crisis
The United States loses more women during and after pregnancy than any other high-income nation. More than 80 percent of those deaths are preventable, according to the CDC. The racial disparity — Black women dying at two to three times the rate of white women — persists across income and education levels, which means it cannot be explained away by socioeconomic factors alone.
Something is happening in clinical settings. That something involves race, implicit bias, and a health system that has consistently failed to treat Black women’s pain and concerns with the same urgency it applies elsewhere.
The Diagnostic Gap
Two conditions — preeclampsia and gestational diabetes — account for a significant share of preventable complications and deaths. Current screening approaches for both are inadequate in sensitivity and access. Evidence-based improvements in screening — including biomarker-based preeclampsia risk tools — exist but have been adopted unevenly.
The Policy Levers
Postpartum coverage under Medicaid has been extended to 12 months in many states following federal action — a critical development, given that a significant share of maternal deaths occur weeks after delivery. But this coverage must be protected, and states that have not extended coverage must be pressed to act.
Investment in the maternal health workforce — including midwives, doulas, and community health workers — is among the most evidence-based interventions for improving outcomes in Black and rural communities. Federal and state policy should fund this infrastructure explicitly.
What We Track
We monitor state Medicaid postpartum coverage decisions, federal maternal mortality data and policy responses, NIH maternal health research funding, and legislative activity affecting reproductive health access.
