Black mamas matter

State maternal mortality review committees and the reproduction of race

Abstract

The maternal mortality ratio (MMR) in the United States has doubled over the past three decades, representing a crisis in maternal health. The overall death rate obscures the reality that Black mothers are significantly more likely than white mothers to experience severe morbidity and death while pregnant, birthing, and during the postpartum period. Research demonstrates that obstetric racism operates as a core contributing factor to high and racially disparate MMRs in the United States. In response, states have legislated the creation of maternal mortality review committees to review mortality cases, determine causal factors, and make recommendations to reduce the rate of maternal deaths. This research examines the extent to which these committees acknowledge and address obstetric racism in their annual reports and recommendations. The analysis reveals that only three of 51 review committees comprehensively address obstetric racism, and the remaining committees vary in their commitment to birth equity. By reducing high mortality rates to patient-level factors, these state actors absolve health care providers and delivery systems of their role in the deaths of Black mothers while also reproducing controlling stereotypes of Black mothers.