In the weeks and months following childbirth, mothers should be able to focus on bonding with their baby. Yet, for many Black women, surviving childbirth is only the beginning of ongoing risk. The postpartum period remains one of the most dangerous phases of the maternal journey — and despite advances in modern medicine, racial disparities persist.
Maternal health providers share why this postpartum gap continues to exist among Black mothers, and what needs to be done to improve continuity of care and outcomes.
Midwife Saonjie Hamilton points to a sobering reality: “The postpartum period is uniquely dangerous for Black women due to persistent racial disparities that exist regardless of socioeconomic status, education, or pre-existing co-morbidities.” These disparities are often rooted in structural racism.
Data from the CDC shows that Black women are about three times more likely to die from pregnancy-related causes than white women — and most of these deaths are preventable. More specifically, Black women die at a rate of 44.8 deaths per 100,000 live births, compared to 14.2 for white women.
The danger does not end at delivery. In fact, a significant portion of maternal deaths occur in the postpartum period, with many happening up to a year after discharge.
Leading causes of death at this time include preeclampsia, cardiomyopathy, and hemorrhage. Despite higher risk among Black women, these symptoms are often missed.
“Too often our clinical concerns are dismissed, and our voices are not taken seriously by the healthcare system,” Hamilton explains. When Black women report symptoms like shortness of breath, swelling, or persistent headaches, they are often told that what they are experiencing is “normal.” These dismissals can delay diagnosis and treatment, turning manageable conditions into fatal ones.
The postpartum gaps in care are not just clinical; they are systemic. Insurance limitations play a major role in shaping postpartum outcomes. Many plans cover care for only a short window after birth, even though recovery can take up to a year. The traditional six-week postpartum visit is widely considered inadequate, particularly given that complications frequently arise well after that point.
Social determinants of health (SDOH) further compound these risks. Without reliable transportation or childcare, attending follow-up appointments becomes difficult. Limited parental leave policies force many women to return to work before they are physically or emotionally ready. At the same time, food and housing insecurity create chronic stress that interferes with healing and increases vulnerability to complications.
A lack of continuity in care compounds these systemic gaps. As Saleemah McNeil, MS, MFT, a reproductive psychotherapist, lactation consultant, and founder of the Oshun Family Center, explains, “Too often, care drops off after delivery, leaving Black women without the follow-up and support they need to heal.” The abrupt transition from frequent prenatal visits to minimal postpartum contact leaves many women navigating recovery alone.
“This lack of listening and continuity can lead to serious, preventable complications,” McNeil adds. Many of the women she works with seek care only after experiencing harm, feeling unheard, disrespected, or unsafe within traditional healthcare settings.
These experiences are increasingly described as birth trauma. While often associated with emergency interventions, trauma can also stem from being ignored, dismissed, or excluded from decision-making. Even medically “routine” births can leave lasting psychological harm when patients feel powerless in their care.
Hamilton notes that this trauma is one of several factors driving Black women toward alternative care models like midwifery. “Midwifery care offers a different approach — one that is holistic and deeply patient-centered,” she says. Unlike the standard model, which often includes a single six-week postpartum check-up, midwifery care typically involves multiple visits that address physical recovery, mental health, and social support.
Still, individual care models alone cannot solve a systemic crisis. Addressing postpartum risk for Black women requires structural change: expanding insurance coverage through the full postpartum year, investing in community-based care, improving provider accountability, and addressing the social conditions that shape health outcomes.
Both providers emphasize that this issue extends beyond healthcare — it is a matter of equity and justice, rooted in systematic failures that continue to put Black women at risk. Without meaningful structural change, the postpartum will continue to carry an unequal burden of risk. For Black mothers, what should be a time of healing will remain, far too often, a time of danger.
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