Will We Find the Courage to Change?

There must be a sense of urgency in addressing this crisis—because every mother and every baby, regardless of race or background, deserves an equal chance to survive and thrive.

Infant and maternal mortality rates are more than just statistics—they are a reflection of a society’s commitment to its most vulnerable citizens.
When mothers and babies thrive, communities flourish. When they struggle, it signals deep-rooted failures within our systems of care. These rates reveal truths about access to healthcare, social support, and economic equity that no economic indicator alone can fully expose.

Like a canary in a coal mine, rising infant and maternal mortality rates warn us of toxic conditions that threaten us all—conditions we might otherwise ignore until they become catastrophic. Protecting our newest lives and those who bring them into the world isn’t just about saving individuals—it’s about preserving the foundation of healthy, resilient communities.

Nowhere is this urgency more visible than in the racial disparities that define maternal and infant outcomes in the United States. These disparities are not the result of biological differences, but rather systemic inequities. Black women in the U.S. are 3.55 times more likely to die from pregnancy-related causes than white women. Black infants die at more than twice the rate of white infants—10.9 versus 4.5 deaths per 1,000 live births. Most troubling is that these gaps persist regardless of income or education. Even high-income, highly educated Black women face risks comparable to the poorest, least-educated white women.

Committees and task forces have long studied pregnancy-associated deaths among Black women. Many reports point to a higher prevalence of chronic health conditions—such as hypertension and diabetes—as contributing factors to increased rates of preterm birth. While these findings are accurate, they only scratch the surface of a deeper, more complex issue.

Structural factors—like reduced access to quality healthcare, higher rates of poverty, and the ongoing impact of systemic racism—further deepen these disparities. The preterm birth rate among Black birthing people is twice that of other racial and ethnic groups, illustrating how chronic health conditions intersect with broader social determinants of health.

Yet, few reports grapple with the persistent and perplexing truth: even when controlling for income and education, Black women still face disproportionately high risks. Despite the benefits that typically accompany wealth and education, Black women continue to experience health outcomes on par with the poorest white women.

This phenomenon cannot be explained away by personal choices or medical histories. Instead, it points to the cumulative toll of structural racism: unequal access to quality care, implicit bias in medical settings, and the chronic stress of navigating a world shaped by discrimination. The leading causes of maternal death among Black women—cardiovascular complications, preeclampsia, postpartum cardiomyopathy—are not simply medical conditions, but symptoms of a system that fails to protect them.

Similarly, the elevated infant mortality rate among Black families reflects not only preterm birth risks, but also the generational impact of stress, discrimination, and inadequate care. These disparities are not inevitable. They are preventable outcomes of systemic inequality. To address them, we must dismantle the structural barriers that perpetuate them and invest in policies that center equity—ensuring that every mother and every baby, regardless of race or background, has an equal chance to survive and thrive.