Honoring Black Maternal Health: Why Advocacy, Education, and Community Support Matter

Black women in the United States are nearly three times more likely to die from pregnancy-related causes than white women, according to the CDC. These disparities reflect deep gaps in access, quality of care, and communication within the healthcare system—gaps that have persisted for decades, even as awareness has grown.

The recent death of Dr. Janell Green Smith, a midwife and Black maternal health advocate who experienced fatal childbirth complications while welcoming her first child, has renewed attention on the crisis. Her passing has also underscored a painful reality: even women who are experts in maternal health are not immune to systemic failures.

To better understand how these disparities affect families and what meaningful support looks like in practice, we spoke with Sahai Cole, Vice President of the Children & Family Health Institute (CFHI).

A Crisis That Continues to Impact Families

“This issue continues to affect many families,” Sahai said. “The disparities Black mothers face are real, and they need ongoing attention.”

Sahai’s perspective is shaped by both professional experience and personal identity. As a Black mother, she understands the emotional and physical challenges of pregnancy and childbirth, especially when families feel uncertain about whether their concerns are being taken seriously.

When Concerns Are Minimized, Risk Increases

One of the most common barriers families face is communication during medical care. Research shows that Black women are more likely to report having their pain or concerns dismissed during pregnancy and childbirth.

“Having providers who listen carefully makes a difference,” Sahai said. “Understanding pain, asking follow-up questions, and recognizing when something may need closer attention are all important. Education also helps families feel more prepared and informed.”

Advocacy can also take many forms. Sahai encourages families to bring a trusted support person to appointments whenever possible. A partner, friend, or family member can help ask questions, take notes, and advocate during visits that may feel rushed or overwhelming, particularly during high-stress moments in pregnancy and postpartum care.

Postpartum Care Is Often the Missing Link

While much attention is placed on pregnancy and delivery, Sahai emphasized that many complications arise after a baby is born—during a period when consistent care and follow-up are often lacking.

Too often, families disengage from the healthcare system once delivery has passed, even as physical recovery, mental health concerns, and new stressors emerge. Without regular check-ins or trusted points of contact, warning signs can be missed during a critical window.

“When care is responsive and continuous, outcomes can improve,” Sahai said. “Listening, checking in, and following up all matter.”

How CFHI Closes the Gap

The Children & Family Health Institute provides steady, ongoing support for families through programs that build relationships over time. One example is Nurse-Family Partnership, which offers in-home visits from registered nurses for first-time mothers, beginning in pregnancy and continuing through early childhood. The program’s strength lies in continuity: nurses build trust, monitor progress, and help families navigate challenges as they arise.

“Our nurses build strong, lasting relationships with families,” Sahai said. “That helps them check in regularly and better understand each family’s needs.”

Doula Support as a Community-Based Solution

CFHI also supports culturally responsive care through the Essex County Doula Learning Collaborative, now in its second year. The program trains doulas who live in the communities they serve and integrates mental health and reproductive health education through community partnerships.

By training doulas who share lived experience with the families they support, CFHI is helping expand access to culturally responsive care that goes beyond a single medical appointment.

Progress Through Community-Based Programs

Despite the ongoing challenges, Sahai sees progress in the growing recognition of Black maternal health disparities and the expansion of community-based solutions. Through its maternal health and nutrition programs, CFHI works to reduce gaps in care by meeting families where they are and staying connected through pregnancy, postpartum, and early childhood.

Black maternal health outcomes are shaped by more than individual circumstances; they reflect how systems listen, respond, and follow through. Progress depends on consistent care, education, and trusted relationships that support families before, during, and after pregnancy.