Strengthening the Workforce for Black Maternal Health

By: Jennifer Uchendu

Black Maternal Health Week, which takes place in April each year, serves as an opportunity not only to raise awareness about persistent disparities but also to spotlight the structural solutions that can improve outcomes. Despite the fact that Black women are three to four times more likely to die from pregnancy-related causes than white women, they are far less likely to receive care from providers who understand their lived experiences or who have been trained to recognize and respond to the impact of systemic racism in healthcare (CDC, 2019). The lack of Black clinicians, particularly OB-GYNs, midwives, doulas, and lactation consultants, contributes to gaps in care and trust that have real consequences (Altman et al., 2020). Research has shown that when patients feel culturally misunderstood or dismissed by providers, it can lead to delayed care, decreased patient satisfaction, and poorer maternal health outcomes. Studies have shown that patient-provider racial concordance can improve health outcomes, particularly for Black patients, yet representation in maternal health remains critically low (Greenwood et al., 2020). To improve outcomes, we must prioritize the development of a diverse, representative, and equity-driven maternal health workforce. Proximate Learning has collected a few of the best evidence-based approaches to improve Black maternal health outcomes through workforce development efforts.

Approach #1: Expand Black Leadership for Maternal Health

In communities across the country, Black-led maternal health models are already showing us what is possible. Particularly, community birth centers run by Black midwives and doulas, such as The Birthing Place and Commonsense Childbirth, provide holistic, culturally relevant care that centers on dignity and autonomy (Black Mamas Matter Alliance, 2018). These care models challenge the traditional, often impersonal structures of hospital-based maternity care by emphasizing trust, support, and continuity of care. At the policy level, Black women are also leading transformative work through organizations like the National Birth Equity Collaborative (NBEC) and the Black Mamas Matter Alliance (BMMA). Their leadership has shaped critical conversations around reproductive justice, respectful maternity care, and maternal mental health, while pushing for data-informed policies that address the root causes of inequity (Black Mamas Matter Alliance, 2018).

Approach #2: Develop Culturally Competent Staff

In existing healthcare systems, several frameworks can be adopted to institutionalize racial equity in maternal health. Specifically, equity-centered leadership development programs within healthcare systems are increasingly incorporating racial bias training, cultural humility, and trauma-informed care practices to improve patient outcomes and workforce equity (Howell, 2018). Research has shown that racial bias training, combined with organizational change initiatives, can reduce racial disparities in patient-provider communication by up to 23% (Penner et al., 2016). These programs help providers recognize and address their own unconscious biases, improve trust-building with patients, and create safer, more respectful care environments. For example, initiatives like the California Maternal Quality Care Collaborative’s Equity Toolkit have demonstrated measurable improvements in respectful maternity care and reductions in racial disparities in maternal health outcomes (Howell, 2018).

Approach #3: Increase Diversity in the Perinatal Workforce

Federal legislation, such as the Black Maternal Health Momnibus Act, calls for expanded funding to diversify the perinatal workforce and support community-rooted care models (Black Maternal Health Caucus, 2021). Through targeted investments in scholarships, workforce development, and community-based organizations led by people of color, the Momnibus recommends a pipeline of providers who not only look like the communities they serve but are also equipped to deliver respectful, equitable care. It’s a bold step toward rewriting a system that has too often failed Black birthing people and a call to action we honor during Black Maternal Health Week. All in all, these interventions offer examples of how to diversify and train the maternal workforce for better outcomes. These changes cannot happen without Black leadership at every level of maternal care.

As we reflect on Black Maternal Health Week each year, we must reaffirm our commitment to building a workforce that reflects the communities it serves and to supporting the leadership of Black clinicians, researchers, and advocates. Ultimately, creating a truly equitable maternal health system will require more than inclusion. It will demand transformation, innovation, and unwavering investment in Black excellence.