Getting to the Heart of the Matter: Maternal Health Challenges for Black Women Imperative to Fight Against Chronic Disease

Becoming a new mother is often described as one of life’s most extraordinary experiences. Yet for many women, the period following childbirth is also marked by profound physical, emotional, and systemic challenges. As chronic diseases become increasingly common contributors to maternal complications and mortality, understanding and addressing the broader social determinants of health is essential to addressing the realities, especially those facing Black mothers and their babies.

Black women and mothers face a disproportionately high risk for a range of cardiovascular conditions. According to the American Heart Association, Black women experience higher rates of hypertension, heart failure, peripartum cardiomyopathy, and stroke, often beginning earlier in life and progressing more aggressively than in other groups. Added elements like chronic stress, limited access to preventive care, and inadequate postpartum follow-up intensify these risks during pregnancy and motherhood.

The Partnership to Fight Chronic Disease continues to shine a light on the disproportionate impact of chronic disease on maternal health outcomes. On December 3^rd, PFCD joins California State Senator Dr. Akilah Weber Pierson for another follow up event focused on supporting the health and wellness of Black mothers. This gathering will bring together clinicians, community leaders, researchers, and advocates to discuss how chronic disease management and equitable care access can transform maternal and infant outcomes.

A Crisis Rooted in Inequity

Black women in California are more than four times more likely to die from pregnancy-related causes than white women. Nationwide, they are nearly three times more likely to experience maternal mortality. These disparities cannot be separated from the chronic diseases that disproportionately affect Black women—conditions that often go undiagnosed, undertreated, or unsupported before, during, and after pregnancy.

Black women are:

• 60% more likely to have high blood pressure

• At significantly higher risk for diabetes and heart disease

• More likely to develop gestational diabetes, increasing future risk of Type 2 diabetes

• More likely to experience worsening hypertension postpartum, raising long-term heart disease risks

These chronic conditions can complicate pregnancy, delivery, and recovery, yet the barriers Black women face in accessing consistent, culturally competent care often make managing these problems deeply challenging.

Health outcomes are shaped by far more than biology. For Black mothers, the following factors play an outsized role in health outcomes:

• Limited access to high-quality healthcare

• Insurance gaps

• Financial stress

• Under-resourced neighborhoods

• Lack of culturally competent providers

• Distance from health facilities

Collectively, these systemic inequities not only make it harder to receive timely and appropriate care but more broadly create an environment where Black women must not only adapt to life with a newborn but simultaneously navigate chronic conditions without the level of support they need and deserve.

Chronic Disease: A Driving Force Behind Maternal Mortality

The connection between chronic disease and maternal health outcomes is stark. From 2020 to 2021 alone, the U.S. maternal mortality rate rose by more than one-third. The rate for Black mothers was more than twice that for white mothers.

Even before the pandemic, chronic diseases accounted for half of all maternal deaths in the United States. They remain the fastest-rising cause of maternal mortality today.

In San Diego County, Black infants are nearly three times more likely to die during their first year of life and are 60% more likely to be born premature—further demonstrating how chronic disease, inequity, and maternal health intertwine.

Sickle cell disease, which disproportionately affects Black women, carries its own heightened risks and women with sickle cell are more likely to deliver younger, live in under-resourced communities, and experience stillbirth.

PFCD remains committed to raising awareness, advocating for systemic change, and pushing for policies that eliminate racial discrimination in healthcare and address the social determinants that produce harmful disparities.

To meaningfully reduce disparities and improve outcomes, we must:

1. Invest in culturally competent and accessible care.

2. Strengthen chronic disease prevention and management. From early screening to long-term management, prioritizing heart health, diabetes prevention, blood pressure control, and sickle cell care is essential.

3. Expand access to mental health services. Support must be affordable, stigma-free, and rooted in community understanding.

4. Address social determinants of health. Transportation, childcare, housing stability, nutrition, and economic security directly shape maternal well-being.

5. Drive policy based on equity and evidence.

ALL mothers deserve not only survival but the opportunity to thrive. By prioritizing maternal health, addressing chronic disease, and confronting the systemic barriers that shape outcomes, we can build a future where every mother has the care, support, and dignity she deserves.