Maternal Mortality 

African Americans Remain at Higher Risk 

By Kauthar B. Umar, M.A.


Closing the Gap, Maternal Health • January/February 2004


I

n a decade-long study, the Centers for Disease Control and Prevention (CDC) found that African American women die three 

times more often from pregnancy-related complications than nonHispanic White women. This gap, which has persisted for more than 

60 years, is the largest and most difficult disparity to understand in 

the area of maternal and child health. 

“Any pregnancy-related death is one too many,” said Secretary of 

the Department of Health and Human Services (HHS) Tommy G. 

Thompson, in a February 20, 2003, press release. “We must focus our 

Indeed, there is a misconception that by focusing on high-risk 

women, incidents of pregnancy-related deaths will be easier to prevent, according to Dr. Margaret A. Harper, primary author of “Pregnancy-Related Death and Health Care Services.” 

But she said that about 10 to 15 percent of women who are 

thought to be at risk for a complication actually go on to have a 

problem. As a result, focusing on risk factors can give patients and 

providers a false sense of security, leaving them ill prepared if complications arise, Harper said. If lack of prenatal care and known risk 

research on finding ways to reduce these deaths.” 

Data from CDC’s Pregnancy Mortality Surveillance System (PMSS) from 1991 to 1999 indicate 

that although maternal mortality is rare, on average 

12 women die each year for every 100,000 live births. 

For African American women, though, the rate is 30.0 

deaths per 100,000 live births compared with 8.1 

deaths for White women. 

African American women are three times more 

likely to die from ectopic pregnancies, (when the placenta and fetus develop out- side of the uterus) and 

preeclampsia (a combination of hypertension, fluid 

retention and protein loss in the urine). African American women are also two times more likely to leak amniotic fluids during pregnancy, which leads to infection, according to the Almanac, the University of 

Pennsylvania’s faculty news journal. These three conditions account for 59 percent of all maternal deaths 

in the United States. 

Maternal Deaths in 2001 

White, Non-Hispanic 

6.5 maternal deaths 

per 100,000 live births 

Hispanic 

9.5 maternal deaths 

per 100,000 live births 

Black, Non-Hispanic 

24.7 maternal deaths 

per 100,000 live births 

Source: Healthy People 2010 

http://wonder.cdc.gov/data2010/ 

factors don’t fully explain the causes of maternal 

mortality then what needs to be done? 

Dr. Luigi Mastroianni, Jr., professor of Obstetrics and Gynecology at the University of Pennsylvania School of Medicine, argues for a “need to speed 

up the development of superior methods to predict 

risk, achieve timely intervention and develop effective therapies.” 

Dr. Sara Whitehead, a reproductive health epidemiologist at CDC agrees that there is a need to 

expand public health monitoring of pregnancy-related death. 

“We need to examine issues such as access to 

care, quality of care, health insurance status, language 

and cultural barriers to care, immigration issues and 

socioeconomic status,” she said. 

In order to reduce maternal mortality to achieve 

the nation’s Healthy People 2010 objective of no 

more than 3.3 maternal deaths per100,000 live 

According to a 2002 CDC study, it is the limited access that 

minority communities have to health care that possibly leads to higher 

maternal mortality rates. The study revealed that African American 

women were more than twice as likely as White women to receive 

delayed or no prenatal care. Moreover, the majority of women in the 

study said they wanted earlier prenatal care but were hindered by 

outside barriers like a lack of money or insurance and the inability to 

obtain an appointment. 

Removing barriers to and actively promoting the use of prenatal 

services is key to reducing maternal mortality according to Dr. Audrey 

Saftlas, professor of epidemiology at the University of Iowa College of 

Public Health. In a study published in the “American Journal of 

Epidemiology,” Saftlas argued that the health care system should make 

comprehensive reproductive health services more available to African 

American women while ensuring that women are able and willing to 

use services. 

“With current medical knowledge and technology, more than 

half of maternal deaths can be prevented,” Saftlas said. “We need to 

develop strategies to improve the content of and access to prenatal care 

for all Black women— not just Black women at high risk, 

but also those considered at low risk.” 

births, the CDC has called for improved surveillance efforts to pinpoint exactly why Black women are dying in greater numbers. 

In order to get a better understanding of such efforts, New York 

State, where the maternal mortality rate among African Americans 

exceeds the national average, launched an initiative in 2002 with a 

goal to increase awareness of maternal mortality, improve birth outcomes, and reduce pregnancy-related deaths and racial disparities. 

The initiative introduced a uniform statewide protocol form to 

be used by Regional Perinatal Centers (RPCs) to document and review pregnancy-related deaths. With uniform information, the state 

was then able to identify instances and causes of maternal death. 

There is hope that this data will yield some explanation of why a racial 

disparity in maternal mortality remains, so that programs can be created to keep mothers safe nationwide. 

For more information on the Centers for Disease Control maternal 

mortality study, go to http://www.cdc.gov/od/oc/me-dia/pressrel/ 

r030220c.htm

For more information on the Pregnancy Mortality Surveillance System, go to http://www.cdc.gov/reproductivehealth/ index.htm

Office of Minority Health Resource Center U.S. Department of Health and Human Services