Blog: Giving your life to give life: Unraveling the disproportionate health risks facing pregnant Black Americans

Author: Oksanna Samey

To those who knew her, Tori Bowie always made everything look easy. By age 18, Bowie had already been crowned an eight-time state champion in four different track and field events. Three years later, she’d won two NCAA championships, and by 2016, she had accomplished her biggest athletic feat yet – winning gold, silver and bronze medals at the Rio Olympics. Allyson Felix, who won gold alongside Bowie in the 4 x 100 meter relay, remembers Bowie’s running as “effortless.” “She was just such a bright light, and people were getting to see that,” Felix told Time Magazine. Already an accomplished runner by the fall of 2022, Bowie looked to supplement her athletic fulfillment with the joy of becoming a mother. But, on May 2, 2023, Tori Bowie was found dead in her Florida home. Having gone into premature labor, the eight months-pregnant Bowie quickly began suffering from eclampsia (high blood pressure) and respiratory distress. She was not found for several days, and neither Bowie nor her child survived.

The heightened pregnancy-related risks for Black women
While Bowie’s death came as a shock to many, her passing underscores a decades-long trend in health inequity: for Black women in the United States, the risk of death from childbirth-related causes is significantly higher than that for other women. In 2021, the Centers for Disease Control and Prevention found that the overall maternal mortality rate was 32.9 deaths per 100,000 live births. For Black women, the rate was found to be much greater: for every 100,000 live births, approximately 69.9 Black women died. This statistic is nearly three times (2.6) greater than the rate for white women (26.6 deaths per 100,000). Morbidity statistics reflect similar disparities. From 2002-2014, Black women were at a 70% higher risk of severe maternal morbidity than their white counterparts – showing the breadth of poor maternal outcomes in the Black community.

In line with other health disparities (e.g. COVID-19 death rates), educational attainment and income have been blamed for the disproportionate maternal deaths in the Black community. Yet, when these factors are controlled for, racial disparities in maternal mortality persist. Among college-educated women, the maternal mortality for Black women remains 5.2 times greater than the mortality for white women, despite both groups having the same education attainment. Tipping the economic tables in favor of Black women offers little reprieve. When college-educated Black women are compared to women of all other races who did not receive a high school diploma, Black women still experience higher rates of severe maternal morbidity.

Although socioeconomic status is also thought to correlate with access to medical care (and thus, could decrease the likelihood of pregnancy-related death), Black women with higher incomes fail to reap these economic benefits. In a report on maternal outcomes by the Center for Economic Studies, wealthy Black women showed much worse maternal outcomes than white women of low incomes. The study finds no convergence of maternal health outcomes between racial groups as incomes rise, making race – not class, education or opportunity – the true pallbearer in the pregnancy-related deaths of Black women.