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Updated: Feb 28, 2026

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Black-White Disparity in Maternal Mortality: A Systematic Review and Meta-analysis.

Vibooshine Ratnam1, Jessica Healy-Profitós, Shu Qin Wei

  • 1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, the Institut national de santé publique du Québec, the University of Montreal Hospital Research Centre, the OriginElle Fertility Clinic & Women's Health Centre, the Department of Pediatrics, Sainte-Justine Hospital Research Centre, and the Department of Medicine, University of Montreal, Montreal, Quebec, the Department of Obstetrics and Gynaecology, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, and the Maternal and Infant Health Section, Public Health Agency of Canada, Ottawa, Ontario, Canada; and the School of Public Health, Imperial College London, London, United Kingdom.

Obstetrics and Gynecology
|February 26, 2026
PubMed
Summary

Black patients face significantly higher maternal mortality rates compared to White patients. This widespread Black-White disparity highlights the urgent need for systemic, structural interventions to address maternal health inequities.

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Area of Science:

  • Public Health
  • Epidemiology
  • Health Disparities

Background:

  • Maternal mortality remains a critical public health issue, with significant racial disparities observed in the United States.
  • Existing literature suggests a persistent gap in maternal health outcomes between Black and White individuals.

Purpose of the Study:

  • To conduct a comprehensive literature review and meta-analysis examining the Black-White disparity in maternal mortality.
  • To quantify the association between race and maternal mortality risk.

Main Methods:

  • A systematic literature search was conducted across multiple databases (PubMed, CINAHL, Cochrane Library, etc.) through October 31, 2024.
  • Included observational studies with follow-up to 1 year postpartum, comparing maternal mortality between Black and White patients.
  • Meta-analysis used random-effects models to calculate pooled odds ratios (ORs) and adjusted odds ratios (aORs).

Main Results:

  • Thirty observational studies involving over 69 million Black and 258 million White patients were analyzed.
  • Black patients exhibited significantly higher odds of any maternal mortality (aOR 2.82) compared to White patients.
  • Increased mortality risk for Black patients was observed within 42 days (aOR 1.90) and up to 1 year postpartum (aOR 4.40), particularly from hypertensive disorders and direct obstetric causes.

Conclusions:

  • A widespread and significant Black-White disparity in maternal mortality exists.
  • The findings underscore the necessity for systemic and structural interventions to mitigate maternal health inequities.