The challenges faced by Black Americans across many aspects of life are profound, and, in maternal health, they are especially stark. While maternal deaths have declined or stabilized for most groups in the U.S., Black women continue to experience rising rates of pregnancy-related mortality.
Closing this gap could save thousands of lives and generate an estimated $24 billion in U.S. GDP—highlighting the degree to which tackling this systemic challenge presents a major opportunity for lives, economies and economic mobility.
The scope of the gap
Black women have much higher maternal mortality rates. In 2023 (the latest year for which information is available), the rate of maternal mortality for Black women was 50.3 per 100,000 live births—more than three times that of White women (14.5) and far higher than rates for Hispanic (12.5) and Asian (10.7) women. Since 2018, the rate for Black women has surged from 37.3, while rates for other groups have declined or remained steady. Though Black women account for about 1 in 7 American women, they account for 4 in 10 maternal deaths.
The disparity extends to maternal health complications. On average, a woman giving birth in 2025 will spend roughly 10 days each year, for the rest of her life, in which her health is affected by a disability connected to pregnancy or childbirth.
Black women in the U.S. face higher rates of postpartum hemorrhage, preeclampsia, gestational diabetes and postpartum depression. McKinsey analysis finds these conditions cost Black mothers 350,000 healthy life years—reflecting deep and prolonged suffering. (Editor's note: Adetosoye and Berchuck are affiliated with McKinsey.) The consequences also extend to infants: Black babies die at a rate of 10.93 for every 1,000 live births, nearly double the national rate (5.61).
If outcomes for Black women matched the national average, by 2040, the U.S. could prevent up to 3,100 maternal deaths and 35,000 infant deaths.
A preventable gap
The Centers for Disease Control and Prevention estimates that more than 80% of pregnancy related deaths are preventable. The question, then, is how to bridge what could be done and what is being done.
What gets measured gets managed, and data are the place to start. Data are inconsistent and incomplete, from how outcomes are defined and reported to how they are analyzed and used. Definitions for essential terms like “pregnancy-related” and “maternal mortality” vary by reporting agency, and race- and ethnicity-disaggregated data are often missing or unavailable.
Almost a decade ago, research in New York City found that Black women were much more likely to deliver in hospitals with high risk-adjusted severe maternal morbidity rates—accounting for nearly half of the city’s disparity. This has led to the city starting a Citywide Doula Initiative and a guaranteed-income program for low-income perinatal women. Standardizing definitions, linking clinical and social data, and aggregating outcomes across health systems can provide a fact base needed to close these gaps.
Underinvestment in maternal health research compounds the problem. Globally, four out of five research dollars directed at women’s health goes to cancer, leaving little for maternal and infant health. Of nearly 19,000 compounds in clinical development, just 91 refer to maternal and infant health—a seventh of the total for dermatology. Additionally, conditions that largely affect U.S. women get less investment than those that largely affect men.
How the gap can be closed
Examples show progress is possible. Louisiana’s Reducing Maternal Morbidity Initiative, launched in 2018, set out to improve outcomes related to hemorrhage and hypertension, while reducing racial disparities. Within three years, the hemorrhage gap between Black mothers and others narrowed significantly. The initiative succeeded by combining rigorous data collection and analysis to support continuous improvement; partnerships with a range of experts, including perinatal care providers, public health professionals and advocates; and broad hospital participation (47 of 48 birthing hospitals).
Gaps persist. Thirty-five percent of U.S. counties are home to maternity care deserts. One in 6 Black babies is born in these areas. Black Americans overall are more than twice as likely as white Americans to live in regions with limited healthcare outlets. Expanding postpartum care and coverage, investing in telehealth and strengthening maternal mental health support are all practical ways to reduce access gaps.
Why closing the gap matters
Closing the maternal health gap is a national imperative. The benefits extend beyond Black mothers and infants: Solutions that improve maternal healthcare also strengthen the health system overall. McKinsey analysis estimates that narrowing the gap could yield $25 billion in lifetime economic GDP value through lower healthcare costs and greater workforce participation, including $285 million in annual healthcare costs from avoidable cesarean sections and preventable NICU stays.
Other high-income countries report far lower maternal mortality rates, showing that better outcomes are achievable. The U.S. has the medical capability—it now requires the focus and determination to close the gap.
The path forward is clear: Prioritize maternal healthcare, improve data and research, invest in and scale proven solutions, and include all women in our efforts. By closing the maternal health gap, the U.S. can save lives, improve health and strengthen the economy.
The opportunity is before us: Closing the gap is not only possible, but necessary.
Fadesola Adetosoye is an associate partner with McKinsey & Company and an affiliated leader of the McKinsey Institute for Economic Mobility. Caroline Berchuck, M.D., is an associate partner with McKinsey & Company and the co-director of Women’s Health with the McKinsey Health Institute.