Perspectives: Black Maternal Health Week: Empowering mothers, protecting lives

Black Maternal Health Week is a time to talk about an often-overlooked problem: Black women are more likely to have problems or even die during or after pregnancy than others. It's a systemic inequality that is persistent. It can be fixed, but it will take time. This includes acknowledging that these inequities exist and being thoughtful and purpose-driven to eliminate these disparities.

Even though there has been some overall improvement in maternal mortality in the U.S. for birthing people, recent Centers for Disease Control and Prevention (CDC) data shows that there is still a big gap in maternal mortality between Black and white women. In 2023, for every 100,000 babies born, more than 50 Black women died compared to 14.5 white women.  

So, what's causing this problem? It's complicated. 

There are biases in the health care system, meaning sometimes doctors don't listen to Black women as carefully as they should. It's also harder for many Black moms to get good health care in the first place. Things like not having enough money, good food, or a safe place to live can also make pregnancy more dangerous. Even if a Black woman has a good job and education, she's still more likely to have problems than a white mom who doesn't. That shows how deep this problem goes. We need to change big things about our health care system and society to fix it.

As an OBGYN and director of Northwell Health's Center for Maternal Health, I see firsthand the challenges Black mothers face, and I'm encouraged by the positive changes happening. Health systems, government programs and community organizations are working hard to improve maternal health outcomes, including preventive and collaborative care. We're seeing initiatives like providing doulas, extending health coverage after pregnancy, and even tackling tough issues like food insecurity and housing during pregnancy. These are all important steps toward better care for moms.

Thinking about having a baby?

• Check-up before you get pregnant: See a doctor before you get pregnant to make sure you're healthy. This is called a preconception visit.
• See a specialist if you need to: If you already have health problems like high blood pressure or diabetes, see a doctor who specializes in high-risk pregnancies. They can help you have a safer pregnancy.
• Be good to your body: Eat healthy foods, exercise, and try to keep your stress levels down. Taking care of your mental health is super important too!

Already pregnant?

• Find a doctor you like: You need a doctor who listens to you, understands you, and makes you feel comfortable.
• Speak up: You know your body best. Don't be afraid to ask questions or get a second opinion. It can really help to bring a friend or family member to appointments for support, especially if you feel like your concerns aren't being heard.
• Learn about pregnancy: Read up on possible problems during and after pregnancy so you know what to look out for.
• Go to all your appointments: Don't miss any of your doctor visits, even if you're feeling good.

After your baby is born:

• Take care of yourself: Get lots of rest, eat well, and let people help you. This is a tough time, and it's okay to ask for support.
• Get help if you're feeling down: Many moms feel sad or anxious after having a baby. If you're struggling, talk to your doctor. There are ways to feel better.
• Keep talking to your doctor: Let your doctor know if anything feels wrong, physically or emotionally.

Black Maternal Health Week, which runs April 11-17 this year, is all about making things better for Black—and all—birthing people. By working together, we can make sure everyone has a healthy and happy pregnancy and a healthy baby.

Dawnette Lewis, MD, MPH, is the director for Northwell Health's Center for Maternal Health, where she guides the system's mission to reduce maternal morbidity and mortality rates. She is also the director of maternal-fetal medicine and associate director of patient quality and safety at North Shore University Hospital, physician lead for New York State Birth Equity Improvement Project, and associate professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.