In 2023, the maternal mortality rate was 18.6 per 100,000 live births. Although the U.S. rate is back to its pre-pandemic levels, the U.S. maternal mortality rate is still three times higher than in the United Kingdom, according to The Commonwealth Fund. While this rate is off-putting in any context, Black women face significant differences in maternal mortality with a 2023 rate of 50.3 per 100,000 live births. In contrast to the total overall trend of maternal mortality rates, the rate among Black women has risen consistently since 2018, with a small peak during the height of the COVID-19 pandemic. I learned of these significant disparities for Black mothers in Shanika Jerger Butts’ class titled U.S. Maternal Health Disparities in the Fall 2025 semester. 

The large disparity in maternal outcomes for Black women compared to the total maternal mortality rate can be attributed to systemic racism in the United States. Racism is the root cause for many social determinants of health that deeply influence future health outcomes. A Black woman is more likely to face factors such as low socioeconomic status, both limited access to healthcare, and a lower quality of it, and a lack of education. All of these factors negatively impact health. The stress of continual injustice causes chronic stress for Black individuals and has been linked to cardiovascular disease and other negative health outcomes. Social determinants and the effects of chronic stress have resulted in higher rates of chronic disease among the Black and African American populations. Many Black Americans are less likely to have access to improved healthcare for chronic disease due to inadequate insurance coverage and scarcity of care. 

Over 35% of U.S. counties received designation as a ‘maternal care desert’ according to Dimes’ March 2024 report on the subject. They define this term as “a county without a hospital or birth center offering obstetric care and without any obstetric clinicians.” The map of these ‘deserts’ directly overlaps with the concentration of the Black population in the United States. While there is a risk for all pregnant women living in counties designated as ‘maternal care deserts’, the risk is compounded for Black women. On average Black women experience higher rates of chronic disease, and have been historically neglected and mistreated in the medical establishment. 

‘Maternal care deserts’ are not naturally occurring. They have been intentionally created by purposeful neglect from these systems of governance on which our healthcare system is built. This sentiment was shared during a session of the American Public Health Association’s Annual meeting I attended in Washington, D.C in early November 2025. This session, under the maternal and child health section of the APHA, invited experts in the field of maternal health and ‘maternal care deserts’ to speak on the topic. Aza Nedhari, who is the co-founder and executive director of Mamatoto Village, spoke at this conference. 

Mamatoto Village provides perinatal care, education, and midwifery services to the obstetrically underserved community of D.C.’s Ward 7. In D.C. Black people account for half of the births, but 90% of maternal mortalities according to the District’s maternal mortality review committee. The concentration of Black residents is greater than 80% in Ward 7 and 8, resulting in 64% of maternal mortalities occurring within these areas. Despite poor outcomes and obstetric care located in affluent areas, D.C. is considered as a full access to care area. A more detailed designation for under-resourced but still full access areas will be useful for areas similar to Washington D.C. to recognize and thus direct more care resources toward such areas. 

Nedhari and other members of the panel discouraged the understanding of ‘maternal care deserts’ as inevitable, and they emphasized that they are instead intentionally under-resourced spaces created to harm Black communities. March of Dimes Chief Medical Officer, Michael Warren, also agreed with this idea. March of Dimes brings recognition to these disparities and implies intention behind care scarcity; they should recognize ‘maternal care desserts’ as a man-made issue in their annual report on the topic. Renaming ‘maternal care deserts’ as maternal care disinvestment zones will bring more attention to the intentional root of the problem. . 

Anna Morrow is a Political Science major and Public Health minor from Baltimore, MD. She can be reached for comment at [email protected].