Still Dying to Give Birth: Inside the Southern Black Maternal Health Crisis
As U.S. maternal deaths decline, Black women — especially in the South — remain the highest at risk — falling victim at over twice the rate of White women.
Each year, Black Maternal Health Week (April 11-17) always arrives with deep urgency. The 2025 theme: “Healing Legacies: Strengthening Black Maternal Health Through Collective Action and Advocacy”— calls for bold solutions rooted in the expertise of Black women and community-led organizations. But even as the nation marks this moment with advocacy, recent data confirms the sobering reality that Black women are still dying to give birth, and nowhere more so than in the South.
“That’s one of the reasons why I’m very passionate about this work, because we see a lot of Black mamas dying unnecessarily,” Dr. Roneé Wilson, Associate Professor at the University of South Florida, told Bay 9 News earlier this year. “I think we start by listening to mothers. We start by listening to them because they know their bodies.”
While the overall U.S. maternal mortality rate declined from 22.3 in 2022 to 18.6 in 2023, the rate for Black women actually rose, climbing from 49.5 to 50.3 deaths per 100,000 live births, according to the CDC. Meanwhile, the rate for White women dropped significantly — from 19.0 to 14.5. These figures confirm that racial disparities are not only persisting — they’re deepening.
And in the South, it runs even deeper.
A Deep South Breakdown
Across 13 Southern states, Black maternal mortality rates (BMMR) consistently exceed those of White women (WMMR)—often by 2 to 4 times. The average Black maternal mortality rate across these states is an estimated 80.3 deaths per 100,000 live births, compared to an average of 34.6 for White women.
Alabama: BMMR is 100 per 100,000 vs. WMMR 27.5 — about 3.6× higher
Arkansas: BMMR is 89 vs. WMMR 42.5 — about 2.1× higher
Florida: Estimated BMMR at least 50 vs. WMMR 26.6 — about 2.6× higher
Georgia: Black MMR is 47 vs. WMMR 14.3 — about 3.3× higher
Kentucky: Black MMR is 230.4 vs. WMMR 114.2 — about 2× higher
Louisiana: Estimated BMMR at least 75 vs. WMMR 20 — about 3.75× higher
Mississippi: Estimated BMMR at least 65. vs. WMMR 16.2 — about 4.3× higher
North Carolina: Estimated BMMR at least 60 vs. WMMR 20 — about 3× higher
South Carolina: BMMR is 61.3 vs. WMMR 27.2 — about 2.3× higher
Tennessee: BMMR is 68.4 vs. WMMR 27.8 — about 2.5× higher
Texas: BMMR is 39.0 vs. WMMR 16.1 — about 2.5× higher
Virginia: BMMR is 47.2 vs. WMMR 18.1 — about 2.6× higher
West Virginia: Estimated BMMR at least 40 vs. WMMR 14 — about 2.9× higher
A Trifecta: Mississippi, Alabama, & Kentucky
Among the states, Mississippi, Alabama, and Kentucky are in a deadly league of their own.
In Mississippi, estimates suggest that Black maternal mortality exceeds 100 per 100,000 in some regions—and reaches as high as 339 in the Delta. The state’s Maternal Mortality Review Committee confirmed that Black women are four times more likely to die than their White counterparts.
Alabama, too, has been described as a maternal health desert. Black women in Alabama are three to four times more likely to die from pregnancy-related causes than White women. For those over the age of 35, the risk climbs to six times higher. And in Kentucky, the data is especially staggering. In 2020, the state reported a Black maternal mortality rate of 230.4 per 100,000 live births—double the already high rate for White women.
Known Causes — Many of Which Were Preventable
Black maternal deaths in the South stem from a known set of conditions: cardiovascular complications, embolisms, hemorrhage, preeclampsia, infection, and mental health issues (including overdose and suicide). These conditions are not rare. But in Black women—particularly in states like South Carolina, Texas, and Georgia—they too often become fatal.
In Louisiana, 93% of pregnancy-related deaths were deemed preventable. The state’s review found that Black women accounted for 62% of maternal deaths in 2020 while only comprising 37% of births.
North Carolina shows a similar pattern: where 22% of the population is Black, Black women make up 43% of pregnancy-related deaths. And South Carolina’s BMMR was 69.1 per 100,000 live births, more than 4x the rate for White women (16.4).
Medicaid, Midwives, and Mandates Help — But It’s Not Enough
Most Southern states have now extended Medicaid postpartum coverage to 12 months, a vital improvement. However, disparities persist in states like North and South Carolina, even with expanded access. Medicaid matters, but it’s not an overall fix. Midwifery and community doulas offer culturally relevant, person-centered care — but Black midwives remain underrepresented, and midwifery services are still restricted in some Southern states like Mississippi.
Mandates for implicit bias training and maternal review committees have also gained traction—but implementation is inconsistent. In Georgia, the entire maternal mortality review team was dismissed last year amid controversy. Maternal mortality review committees exist in every state. They are tasked with examining deaths of women during pregnancy or up to a year after and determining whether they could have been prevented.
The reality is that we know what helps. But if that’s the case, why isn’t the South doing it fast and fair enough to save lives?
A Southern Legacy Worth Healing
This Black Maternal Health Week advocates across the South are speaking out, not just to raise awareness—but to demand accountability and action.
“We really were disappointed when we saw increasing disparities in our state, and so we wanted to really start by creating change by first acknowledging the problem in the community,” said Marshara Fross, Director of the Florida Black Maternal Health Initiative.
The South holds over half of the nation's Black population. Healing must begin here —with policies that reflect care, hospitals that listen, and a healthcare system that values Black life from conception to postpartum and beyond.
13 & South is a new publication covering news, investigative stories, and insights on social justice, policy, and systemic inequities impacting Southern Black communities. I value your insights, and feedback and invite your perspectives to contribute to future issues. Please feel free to contact me here or follow me on my socials! LinkedIn, Twitter, IG, BlueSky, and Threads.
This is a great article. I love that you posted the facts of each state. I am studying to become a doula to give mothers another option outside of the hospital setting. Thank you for sharing.🙏🏽💚
I will dig into this later today. So looking forward to it! Ty!