The journey of carrying a child is often described as one of the most beautiful moments in a woman’s life. Yet in America, for many Black women, it has become one of the most vulnerable and dangerous experiences. The maternal mortality rate is 3.5 times higher for Black women than for white women. It is a statistic many already know, but in Washington, the burden is especially heavy for mothers in Wards 7 and 8, who face the city’s highest rates of disease and complications.
In 2019, Mayor Muriel Bowser established the Maternal Mortality Review Committee to improve safety for pregnant women. According to American University, “Black Washingtonians account for about half of all births in recent years — and 90 percent of pregnancy-related deaths.”
In 2025, Bowser announced that the District would receive $17 million through the Centers for Medicare & Medicaid Services’ Transforming Maternal Health initiative. The funds, spread over 10 years, are meant to expand affordable maternal health programs and increase access to care for pregnant women. But without tangible efforts, Black women across the country will continue to face life-or-death risks during childbirth.
Black women are predisposed to specific conditions that can cause pregnancy complications, yet their care is often not treated with urgency. Frueshana Cruishnick, a senior consultant in women’s maternal-child health at Kaiser Permanente, said, “Pregnant Black women require more blood transfusions than any other race or ethnicity,” leading to higher risks of severe conditions such as preeclampsia and postpartum hemorrhage.
According to the Centers for Disease Control and Prevention, “Anemia prevalence was highest in Black non-Hispanic females (31.4%).” Anemia reduces the body’s ability to maintain healthy blood flow and contributes to hemorrhage, a leading cause of maternal death. The American Society of Hematology reports that “8 to 10 percent of African Americans have sickle cell trait.”
While the exact number of pregnant women who carry the sickle cell trait or disease is not disclosed, this information alone should shift how providers assess Black patients.
Dr. Rochanda Mitchell, an obstetrics and gynecology specialist in maternal-fetal medicine at Howard University Hospital, said providers lack “cultural competence,” contributing to maternal mortality among Black women.
“We are not looking at the entire spectrum or environment that contributes to maternal morbidity and mortality,” she said — referring to factors such as social determinants of health and chronic disease burden.
Understanding how environment, income, diet and family structure shape medical outcomes is key to closing the gap.
Change Must Begin
The Transforming Maternal Health initiative says that “In the first two years, up to $3 million will support planning, including collaboration with providers to design and analyze program components.” Health care professionals must consider the social determinants of health when assessing pregnant women. These determinants — defined as the “nonmedical factors that impact your health and longevity” — include income, environment and access to care.
The first obligation of medical providers is to do no harm. Routine appointments, intake questions, and prenatal guidance profoundly influence women’s survival. Questions matter: Does the patient struggle to get to appointments because of work or transportation? Has she applied for maternity leave? If not, why?
Access is only the beginning. Policies across the country often fail to support mothers. Dr. Mitchell notes that some cultures allow women to rest for weeks after childbirth, supported by family, honoring the physical and emotional recovery required after a 39-week pregnancy.
According to the European Parliamentary Research Service, “EU legislation sets the minimum period for maternity leave at 14 weeks.” Policies like this protect maternal and infant health. In the United States, many mothers cannot heal without worrying about work, finances, or childcare.
Pregnant women in D.C. must apply for prenatal leave. In Europe, maternity leave is a statutory right. America needs a cultural framework that centers on the stability and health of mothers.
This brings us back to Wells. What if her husband had not been there? What if she had been a single mother? Would she or her baby have survived? According to D.C. Action for Children’s Data Tools 2.0, 42 percent of D.C. families are single-parent households.
Women need a village. When that village does not exist at home, providers must advocate for women’s health and support policies that strengthen maternal care.
The Medical System Is Part of the Community, Too
In a statement about the Transforming Maternal Health initiative, Melisa Byrd, senior deputy director and Medicaid director for the D.C. Department of Health Care Finance, said, “We can expand initiatives like midwifery services, doula services and behavioral health support, ensuring more mothers receive timely, equitable care.”
Research from the American Journal of Public Health shows that doula services significantly improve maternal outcomes. A doula is a trained, nonmedical professional who provides physical, emotional and informational support before, during and after childbirth.
Renee Goodman, a doula with Doulas of Capitol Hill, has witnessed the impact firsthand. She describes her role as being an “advocate” and offering “necessary knowledge on what to expect.”
A study in the American Journal of Public Health found that women who had doulas were 47% less likely to have a cesarean delivery, 29% less likely to give birth prematurely and 46% more likely to attend a postpartum checkup. But Goodman worries that the women who benefit most from doulas often cannot afford them.
This new funding has the potential to save the lives of Black women in Washington, offering resources that help them look inward and outward throughout pregnancy.
Black women are losing their lives because of bias, systemic failure, and outdated norms embedded in health care. That is the bloody truth. Childbirth in America is dangerous, and women of all backgrounds deserve informed, compassionate, and equitable care. This initiative will only make a lasting impact if women are empowered to advocate for themselves.
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Featured image/photo by freestocks on Unsplash.