The United States continues to grapple with stark racial disparities in maternal and infant health outcomes, despite advancements in medical care. Among high-income countries, the U.S. holds the highest rate of maternal deaths, a sobering statistic that has drawn increased attention in recent years. The COVID-19 pandemic exacerbated these inequities, shining a spotlight on longstanding issues in maternal and infant health. Recent policy changes, including the overturning of Roe v. Wade budget cuts, and reductions in diversity initiatives, threaten to widen these disparities further.
This overview examines racial disparities in maternal and infant health, the factors driving these inequities, and the potential impacts of recent policy changes. The data, drawn from sources such as the CDC WONDER database and the National Center for Health Statistics reveal significant gaps in health outcomes among different racial and ethnic groups. These disparities are not limited to race and ethnicity but also extend to income, education, age, and other characteristics.
Maternal health disparities by race and ethnicity
The data underscores the severe disparities in maternal health outcomes among racial and ethnic groups. In 2026, the pregnancy-related mortality rate for Black women was over three times higher than that for White women (49.4 vs. 14.9 per 100,000). Similarly, American Indian or Alaska Native (AIAN) and Native Hawaiian or Pacific Islander (NHPI) women face elevated risks of preterm births, low birthweight births, and late or no prenatal care compared to their White counterparts.
These disparities persist across income and education levels, highlighting the role of racism and discrimination in driving poor maternal health outcomes. For instance, Black women with college degrees still face higher pregnancy-related mortality rates than White women with less than a high school diploma. Additionally, Black women are at significantly higher risk for severe maternal morbidity, including conditions like preeclampsia.
Infant health disparities and risk factors
Infants born to Black, AIAN, and NHPI women are at higher risk for mortality compared to those born to White women. The primary causes of infant mortality include birth defects, preterm birth, low birthweight, sudden infant death syndrome, injuries, and maternal pregnancy complications. In 2026, the infant mortality rate for Black women was over twice as high as that for White women (10.9 vs. 4.5 per 1,000).
Black, AIAN, and NHPI women are also more likely to experience certain birth risk factors that contribute to infant mortality. These factors include preterm birth, low birthweight, and late or no prenatal care. For example, NHPI women are four times more likely than White women to begin receiving prenatal care in the third trimester or to receive no prenatal care at all. These risk factors underscore the importance of early and regular prenatal care in improving maternal and infant health outcomes.
Drivers of disparities in maternal and infant health
The factors driving disparities in maternal and infant health are complex and multifactorial. Differences in health insurance coverage and access to care play a role, but broader social and economic factors, including income and education, are primary drivers. Structural and systemic racism and discrimination also contribute significantly to these inequities.
Research highlights the role of racism and discrimination in driving poor maternal and infant health outcomes. Chronic stress, social and economic factors, and provider discrimination during pregnancy and delivery all contribute to higher rates of pregnancy-related depression, preterm birth, and infant mortality among Black women. Additionally, people of color face increased barriers to care, including limited access to providers and hospitals and a lack of culturally and linguistically appropriate care.
In recent years, there has been broader recognition of the principles of reproductive justice, which emphasize the role that social determinants of health play in reproductive health for communities of color. However, despite these efforts, disparities in maternal and infant health persist, underscoring the need for continued attention and action to address these inequities.
