Representation, access, and education are key to saving lives. Nurses must lead the charge to end racial gaps in maternal healthcare.
by Teya Mongsaithong
In the U.S., giving birth has become a death sentence for many women of color. In fact, Black/African American mothers are three to four times more likely to die from birth-related complications than white women regardless of socioeconomic status or education level. According to the Center for Disease Control and Prevention (2023), the number of preterm births was about 50% higher for Black women (14.6%) than White (9.4%) or Hispanic women (10.1%).
This shocking disparity goes beyond medical issues, it is rooted in implicit bias, structural racism, and gaps in delivering culturally competent care. Without realizing it, even the most compassionate nurses can cause harm. To address this public health crisis, nurse leaders must empower change through standardizing implicit bias training, enhancing community services in high-risk populations, and promoting nurses of color into leadership roles.
Nurse leaders have a responsibility to bridge the gap between underserved communities.
First, implicit bias training should be a national standard across all hospitals. It is important for healthcare providers to confront their assumptions and stereotypes when caring for minorities. Specifically for Black women, there is a misconception that their pain tolerance is higher, and they are “forced to endure pain beyond what [is] considered normal" during labor and delivery. Delivering culturally competent care in this case is necessary for patients to feel safe to express their needs and highlights the importance of implicit bias training. Nurse leaders can standardize this training through embedding it within onboarding and continuing education requirements. By institutionalizing this training, we can ensure black maternal equity is not optional, but foundational to nursing practice. Beyond education, nurse leaders must also recognize the impact of the barriers to accessing quality care. Limited access to prenatal and postpartum care is a key factor for poor maternal outcomes. In the U.S., over 35% of counties are considered maternity health deserts, which affects approximately 2.3 million women of reproductive age. To address this, nurse leaders collaborate with organizations to push for policies that would: increase the use of mobile maternity units, incentivize the use of telehealth for obstetrics/gynecologists, midwives, and extend Medicaid coverage for prenatal and postpartum care. Furthermore, nurse leaders can promote virtual training for nurses to provide telehealth care to increase access for patients with limited transportation means. Nurse leaders have a responsibility to bridge the gap between underserved communities and access to care to ensure mothers of color receive quality and equal treatment. To serve these communities to a higher degree, it is necessary to diversify the workforce. Representation in healthcare matters deeply. Being able to address the unique needs and experiences of individuals allows mothers to have a more active role in their care. To do this, nurse leaders can create mentorship programs for students, advocate for targeted scholarships, and promote more nurses of color into leadership positions.
Black mothers continue to face disproportionately higher health risks due to systemic bias, neglect, and structural racism.
When underrepresented populations see themselves reflected in authority positions, it enhances trust and promotes cross-cultural care for patients and healthcare professionals alike. Moreover, embracing diversity ensures health care equity for marginalized communities and they “report better health experiences from healthcare practitioners from the same background” . However, many believe that nurse leaders are incapable of leading changes in health outcomes. It is a misconception that physicians or policy makers hold more power over nurse leaders to drive systemic change. This view underscores the significant role of nurses and their expansive expertise. The role of nursing has evolved into a multifaceted position that not only involves caring for patients, but also educating, advocating, and leading change. Nurses are the most trusted profession, and they are often the first ones to notice when something is “off”. This unique position allows nurses to offer powerful insights during policy decision-making that directly impacts maternal health care. The racial disparities in maternal mortalities in modern healthcare are unacceptable. Black mothers continue to face disproportionately higher health risks due to systemic bias, neglect, and structural racism that exists in our healthcare system. Nurse leaders must demand policy reform, mandate implicit bias training for all staff, and support diversifying the workforce. With unwavering commitment, nurse leaders can transform the healthcare system to ensure every mother, regardless of race, has an equal opportunity of survival.
Teya Mongsaithong is a nursing student at University of West Florida. After graduation, she plans to pursue Mother Baby or NICU. "I want to be the kind of nurse that patients feel safe around and that they can trust me with their care." When she isn't studying, Mongsaithong loves crocheting stuffed animals - which she sells online, and reading fantasy novels.
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