The women died while pregnant, during childbirth, and up to 42 days after delivery, primarily due to excessive bleeding, blocked blood vessels, and infections, according to the Centers for Disease Control and Prevention (CDC). These causes were compounded by the closure of most rural hospitals and the Supreme Court’s decision to eliminate the federal right to abortion.

A total of 688 women died last year during pregnancy or shortly after giving birth, an increase compared to 2023. The Associated Press recently reported on 2024 data from the CDC, which also indicated a slight decrease compared to 2022 and 2021, the highest levels in more than 50 years.

For all these reasons, some doctors were restricted in their ability to handle pregnancy-related medical emergencies. The United States currently has one of the highest maternal mortality rates among developed nations, with wide racial disparities.

White and Black Women

No woman should die, and the disparity between white and Black American mothers is alarming. In 2022, the maternal mortality rate for white mothers was 19 per 100,000, compared to 49.5 per 100,000 for Black mothers, approximately 2.5 times higher.

This disparity has its roots in a centuries-old system of oppression and devaluation of Black people, reflected in health care policies and practices. Much of U.S. history and culture is marked by structural racism, particularly in medical care, living conditions, and education levels, according to the Aspen Institute, an international nonprofit founded in 1949 and based in Washington, D.C.

Among the abuses endured by enslaved Black women was being subjected to experimental surgeries by medical professionals to advance the study of obstetrics and gynecology.

Today, cesarean birth rates are higher for Black women than for white women. The Los Angeles Times reported the case of Angelica Lyons in Alabama, who in 2019 suffered weeks of abdominal pain that doctors ignored until she was rushed for an emergency cesarean section. She nearly died from undiagnosed sepsis months before her due date.

Lyons, a Black woman and public health instructor, knew the dangers of giving birth in the United States for Black mothers, having taught her college students that Black women are nearly three times more likely to die during pregnancy or childbirth than women of any other race.

She also knew this from personal experience, having been born in Alabama, which has the third-highest maternal mortality rate in the nation. When we were young, she showed us those pictures of all the Black people hanged and burned in trees, Lyons recalled of her mother, Shelonda Lyons, who educated her children on the realities of life in Birmingham, a city in the southeastern United States that became a focal point in the civil rights movement.

Discrimination and bias in hospital settings have been disastrous. Lyons underwent two additional surgeries after her cesarean to treat the infection and repair internal damage. She wore a colostomy bag for several months until she healed. Although her abdomen was left disfigured, her child survived.

For years, the health problems of Black Americans have been attributed to genetics or behavior, when in reality racism and historical lack of access to care are key factors in saving lives.

Over the past two decades, the higher mortality rate among African Americans has translated into more than 1.6 million excess deaths compared to white Americans.

Black Belt

Historian and author Deirdre Cooper Owens explains, The history of this particular branch of medicine begins on a slave farm in Alabama. The advancement of obstetrics and gynecology had a very intimate relationship with slavery and was literally built on the wounds of Black women.

Many refer to J. Marion Sims, an Alabama physician, as the father of gynecology. Along with other doctors in the 1840s, Sims conducted surgical experiments without anesthesia on enslaved Black women, acts tantamount to torture. Forced sterilizations and unnecessary hysterectomies were also performed on Black women through eugenics programs long after the abolition of slavery.

Even after the passage of the Civil Rights Act of 1964, most Black families were unable to access hospitals designated for white patients and received limited or inhumane care.

Some clinics attempted to fill the gap, but with few resources, leading to deep distrust that was not imagined by Black women, but earned through unequal care.

Regardless of education or income, Black women with a college degree have a pregnancy-related mortality rate more than five times higher than that of white women. In fact, Black women with a college degree face a pregnancy-related mortality rate 1.6 times higher than white women with less than a high school education.

We certainly know from national figures that Black women have worse maternal outcomes at all income levels, which is quite alarming, said Dr. Scott Harris, Alabama State Health Officer. Age matters, and in general, zip code matters. Unfortunately, where people live and where these children are born is strongly associated with infant mortality.

Black infants account for nearly 47 percent of infant deaths in Alabama, although they represent only 29 percent of births. I think we will see something similar for maternal outcomes, Harris added.

More than 2.2 million women of reproductive age in the United States live in areas without maternal care. Another 4.8 million live in counties with limited access to specialized maternal health services.

The lack of access to a physician is a major barrier for Black women living in rural areas. This problem is particularly visible in the crescent of fertile land stretching across parts of Mississippi and Alabama, historically home to numerous slave plantations.

Much of Alabama’s public health efforts are concentrated in the so-called Black Belt, named for its fertile soil but also for its history as a rural region with many slave plantations. Thirty-seven percent of Alabama counties, home to more than 240,000 women, have no obstetric care provider.

In 2021, Dr. Jamila Taylor, director of health care reform and senior fellow at The Century Foundation, presented the report Giving Birth While Black: An Analysis of the African American Maternal Health Crisis in the United States before the House Committee on Oversight and Reform.

Her testimony was based on her article in the Journal of Law, Medicine & Ethics, Structural Racism and Maternal Health Among Black Women.

During the first term of George W. Bush, the groundbreaking report Unequal Treatment, published by the Institute of Medicine in 2003, concluded that health disparities stem not only from the functioning of health care systems, but also from the legal, regulatory, and political environment in which care is delivered.

In 2023, Black women had a maternal mortality rate of 50.3 deaths per 100,000 live births, more than triple that of white women, and higher than that of Hispanic and Asian women, according to CDC data.

The years pass and the backsliding is evident. In May 2025, the case of a pregnant Georgia woman declared brain-dead at six weeks gestation drew national attention. Adriana Smith underwent an emergency cesarean section on June 13, 2025. Her baby, named Chance, was born prematurely and remains in the neonatal intensive care unit.

The case sparked legal and ethical debate over abortion laws and whether a fetus constitutes a person. The law is enforced in Georgia following the Supreme Court’s 2022 reversal of Roe v. Wade, which allows abortion restrictions from the detection of fetal cardiac activity and grants the fetus legal personhood.

Smith, 31, was a nurse and the mother of a seven-year-old boy, who still believes his mother has simply been asleep all this time.

According to her mother, April Newkirk, Smith went to a hospital complaining of headaches, was given medication, and discharged. Later, her boyfriend awoke to hear her struggling to breathe and called 911. Doctors at Emory University Hospital found blood clots in her brain and declared her brain-dead.

Fetal personhood laws are currently in effect in at least 17 U.S. states.