Black women in the United States are three times more likely to die from pregnancy-related complications than white women — and that sobering fact hasn’t changed, even as the national maternal mortality rate begins to decline.

That’s one of the core findings of Birthing While Black: The Urgent Fight for Maternal Health Reform, a new multi-part research series released by the Institute for Women’s Policy Research (IWPR). Led by reproductive justice scholar and mother, Dr. Martinique Free, the study aims to reframe the Black maternal health crisis not just as a medical emergency, but as a result of America’s economic policies and its racial inequities converging in devastating ways.

“The stats are the stats,” Dr. Free told BET. “Unfortunately, things aren't shifting much for Black women. We’re still being traumatized — not just by the pregnancies that go wrong, but by the ones that go right, too.”

While much of the public conversation has focused on disparities in hospital care, IWPR’s research widens the lens to include the structural roots of the crisis — from anti-abortion legislation and clinic closures to the privatization of maternal care.

“People think this crisis began with the fall of Roe v. Wade, but the erosion of family planning began more than a decade ago,” Dr. Free explained. “What we’re seeing now is the culmination of a long, strategic rollback — and Black communities are paying the highest price.”

Over 100 maternal health facilities closed in the past year, many in rural areas. These “maternal health deserts” often leave expectant mothers traveling 30 miles or more for care — with no car, no public transportation, and no alternative.

And even when access exists, quality isn’t guaranteed. “There are fewer obstetricians now than ever,” Dr. Free said. “And where you live politically determines what kind of care you can legally receive. That’s dictating where providers choose to practice — and it’s leaving our communities behind.”

Key findings from Birthing While Black:

• Black women are still two to three times more likely to die from pregnancy-related causes than any other group — a rate that remains unchanged even as national rates decline. 
• For every maternal death, 60 to 80 women experience “near-miss” complications — life-threatening conditions that often go underreported. 
• Maternal care deserts are growing, disproportionately impacting Black and low-income birthing people. 
• The collapse of reproductive protections is worsening maternal outcomes, especially in states with abortion restrictions.

But it’s not just data points. For Dr. Free, this issue is deeply personal.

 “I was bedridden in pain for three weeks during my own pregnancy, and my OB wouldn’t return my calls,” she shared. “I switched providers in my 36th week just to be heard. I know many women wouldn’t have done that. They would’ve just stayed in pain.”

IWPR’s report also outlines urgent policy solutions. At the top of the list: protecting and expanding Medicaid.

“Roughly 1 in 4 Black women rely on Medicaid for their pregnancy care,” Free said. “Without it, they’re completely shut out of screenings, follow-ups, and critical postpartum care.”

The report also calls for community investment in birthing centers as alternatives to hospital-only models, increased funding for doulas and midwives, particularly in underserved areas, and federal protections for abortion medication access and inclusion of postpartum care in all health insurance plans.

And while systemic change is necessary, Dr. Free also encourages grassroots advocacy — especially from those directly impacted.

“Support Black-led birthwork organizations. Pass along resources. Hound your representatives,” she urged. “We have to create our own community-based solutions, just like our mothers and grandmothers did before us.”

Despite the bleak outlook, Dr. Free remains hopeful — because she believes in the power of Black women.

“We fight. We don’t know any other way,” she said. “But we also deserve to rest. I hope we can strategize in community, take care of one another, and hold space for joy — even as we demand justice.”

As Birthing While Black makes clear, Black maternal health is not just a medical issue. It’s a justice issue — and time is running out.

“People are dying while this country plays political chess,” Dr. Free said. “We can’t afford to wait.”