Persistent Racial Disparities in U.S. Maternal and Infant Health Highlighted Amid Policy Shifts

Racial disparities in maternal and infant health persist in the United States despite medical advancements and contribute to higher mortality and morbidity rates among Black, American Indian or Alaska Native (AIAN), and Native Hawaiian or Pacific Islander (NHPI) populations compared to White populations. Maternal mortality rates are over three times higher for Black women than White women, with minority groups also facing higher rates of preterm births, low birthweight infants, and inadequate prenatal care. These disparities are influenced by systemic social and economic inequities including racism, discrimination, and differential access to healthcare and insurance. Medicaid plays a critical role in providing maternal care for women of color, covering a significant share of births among Black and AIAN women, yet recent federal budget and policy changes threaten coverage and access to care, potentially worsening outcomes. The overturning of Roe v. Wade and subsequent state-level abortion restrictions have heightened access barriers for marginalized groups, exacerbating maternal health inequities. Additionally, federal actions under the Trump administration, including cuts to diversity, equity, and inclusion programs and reforms in health agencies such as the CDC, have reduced funding and support for maternal health initiatives, potentially reversing progress on health equity. Data indicate that maternal deaths are largely preventable, and disparities persist across education and income levels, underscoring the role of structural factors beyond socioeconomic status. Infant mortality rates remain disproportionately high for Black, AIAN, and NHPI infants, driven by factors such as preterm birth and lack of timely prenatal care. Mental health concerns during and after pregnancy, including pregnancy-related depression, disproportionately affect women of color and are linked to poorer maternal and infant outcomes. Access to culturally competent care and addressing provider bias are critical issues, with research showing that discrimination and lower quality of care contribute to adverse outcomes for minority populations. The cumulative impact of healthcare access limitations, provider shortages—particularly in rural and Southern areas with large Black populations—and systemic racism underpins persistent disparities in maternal and infant health. Ongoing funding cuts to Medicaid and family planning services, including Title X and Medicaid payments for clinics like Planned Parenthood, threaten to exacerbate these disparities and limit preventive and reproductive care options for low-income and minority women. A multifaceted approach addressing social determinants, insurance coverage, provider availability, and systemic bias is essential for mitigating disparities and improving maternal and infant health equity in the U.S.