Shortly after giving birth, Shané Darby, a Black woman living in Wilmington, Del., began experiencing symptoms of postpartum depression. She didn’t know where to turn. No one in her community talked about it, leaving her feeling alone. But statistics tell a different story. Black women are about twice as likely to suffer from postpartum depression as white women. And that’s not the only disparity.

Black women and babies suffer worse birth outcomes than any other group, regardless of education and income attainment. Black maternal and infant deaths are two to three times higher than those of white women and babies, and rates are on the rise. We must treat the Black maternal health crisis with the urgency it deserves.

Some of the leading drivers of this disparity are poor treatment of Black women in clinical settings, institutional racism, and implicit bias of health providers. Reforms include improving access to care and making care less biased by increasing the numbers of Black doctors and providing training for medical professionals who regularly dismiss concerns from Black patients, including, famously, Serena Williams, who nearly died after giving birth.

With fewer Black OBGYNs, the rapid closure of hospital labor and delivery wards across the country, and the widely accepted understanding that much of what contributes to health outcomes happens outside of the clinical health care setting, other interventions are needed. Shané and like-minded stewards, or community changemakers, invested in improving health outcomes for Black mothers and babies are creating those interventions, many of which are focused on a simple but transformative concept: strengthening belonging and civic muscle.

Belonging speaks to the inherent need that all people have to feel like an integral part of a community, embraced for who they are, and valued for what they bring. People must also have civic muscle to feel they are equipped with the resources and knowledge to advocate for their own health and well-being, as well as that of others in their shared community. Belonging and civic muscle are so important to well-being that they are at the center of the vital conditions the federal government recently acknowledged are key to addressing long-standing health disparities in America.

Shané, a councilwoman, mental health therapist, and founder of Black Mothers in Power, was motivated by her experience to help Black women feel more connected, supported, and empowered. Her organization trains and equips Black doulas to provide culturally appropriate care and to advocate for the well-being of pregnant women. Doulas have been shown to improve birth outcomes, and there has been an increased effort to provide free doula care in communities experiencing negative birth outcomes.

Further south, Healthy Mothers, Healthy Babies Coalition of Georgia (HMHBGA), situated in a state with one of the highest maternal mortality rate in the country, runs peer support groups for a variety of pregnant women, including those experiencing postpartum depression and mental health challenges. The groups provide a safe and welcoming space where women can share their experiences and feel a sense of belonging. They also share important resources to address the additional challenges faced by pregnant women who live in a state where half the counties don’t have a hospital with a labor and delivery ward and other prenatal services are lacking. One participant, who had survived a complicated delivery, called HMHBGA’s support a “life saver.”

Healthy Mothers, Healthy Babies Coalition of Georgia and Black Mothers in Power also provide Black women an opportunity to exercise their civic muscle by advocating for systems change, including expanding Medicaid postpartum coverage, and providing reimbursements to doulas for care provision. The advocacy is yielding results. In 2022, Medicaid coverage in Georgia was extended to cover a full year of postpartum care.

System change happens when people feel they belong and are valued. We need that change, and much more of it if we are truly committed to improving Black maternal and infant health.

Cierra Bryant is a senior learning and impact associate at the Rippel Foundation, which is committed to fostering an equitable future for health and well-being.

Brooke Muya is a senior program associate at the Rippel Foundation.


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