Summary

The upward trend in the number of Black maternal deaths between 2005 and 2020 warrants an in-depth assessment of risk factors associated with the increased maternal mortality rate in the United States for this subgroup population. The risk factors are multifactorial and, in part, have been organized into several categories: demographics, social determinants of health (SDOH), medical conditions, and the quality-of-care interventions by health systems providers. In addition, the overall trends, causes, and solutions to decrease maternal mortality current rates reflect the social inequities in our society.

Black maternal deaths have been rising in recent years due to complex causes which stem from structural and systemic health inequities. In part, unvaccinated pregnant women were at greater risk of severe illness and hospitalization and even death if they were diagnosed with COVID-19. While Black Americans were disproportionately impacted by the pandemic, the disparities in maternal mortality predate and extend beyond the pandemic. In part, and together, the leading causes of pregnancy-related deaths include cardiovascular disease, other medical conditions and infections, cardiomyopathy, blood clots in the lung hypertensive disorders related to pregnancy, adverse pregnancy outcomes, racial bias of providers, and perceived racial discrimination from patients. In addition, an overview of nonmedical factors referred to as SDOH, which intersect with health status outcomes, will be discussed.

An overview of Black women’s maternal mortality and morbidity, factors contributing to poor maternal health status outcomes, and intervention strategies at the provider, health systems, and policy levels are provided. Social workers in health care systems function as health care providers and clinicians. Therefore, contributing medical and nonmedical issues are factors to consider for a holistic perspective during engagement, assessment, and intervention. The terms Black women and Black birthing persons are used interchangeably.