There’s a disquieting truth that too many mothers in the United States carry: we are supposed to be one of the richest, most medically advanced nations in the world. Yet, our outcomes for birthing people often tell a different story. While many countries have steadily improved maternal health and cut deaths related to pregnancy and childbirth, the U.S. continues to lag behind its peers.
An Outlier in a Rich World
In 2022, the U.S. maternal mortality rate stood at approximately 22 deaths per 100,000 live births, a figure that is more than double, and in some cases triple, the rate found in other high-income nations. Meanwhile, many comparable countries report rates under five deaths per 100,000. Even more troubling: more than 80% of these U.S. maternal deaths are deemed preventable.
Despite the U.S. spending more on health care than nearly all other high-income countries, the outcomes for mothers don’t match that investment.
Why Are We Failing? Four Big Reasons
1. Access and Continuity of Care
In many developed nations, mothers receive consistent prenatal care, midwifery support, home visits postpartum, and systematic follow-up. In the U.S., large pockets of the country are considered “maternity deserts: areas where obstetric or midwifery services are scarce or non-existent.
When pregnant people don’t have easy, affordable access to skilled providers, complications can go unchecked. Even when care is available, the continuity of care, like seeing the same provider, having consistent follow-up, is often missing.
2. Racial and Socioeconomic Disparities
The racial divide in maternal health is stark. Black women in the U.S. face a maternal mortality rate of nearly 50 deaths per 100,000 live births, compared to roughly 19 for white women. This disparity persists regardless of income or education level, pointing to systemic issues like implicit bias, unequal treatment, and structural racism in healthcare.
Women in low-income, rural, or underserved communities face additional risk: lack of transportation, limited hospital staffing, and delayed emergency response all contribute.
3. Lack of Postpartum Support
Many of the worst outcomes happen after birth, in the weeks and months when new mothers are supposed to be healing and bonding. In the U.S., postpartum care often ends at six weeks, and the support systems (home visits, mental health checks, lactation help) are far less robust than in other countries.
In contrast, countries with strong maternal health outcomes often have extended support networks built into policy and practice.
4. Fragmented Healthcare and Policy Gaps
The U.S. healthcare system is fragmented: insurance transitions, gaps in Medicaid eligibility, and variability in hospital protocols all create risk. Additionally, policies such as paid family leave, guaranteed postpartum care, and universal access to midwifery are limited or inconsistent here. Other countries embed these supports more uniformly.
What This Means for Mothers
If you’re pregnant or planning to become pregnant in the U.S., you may find yourself navigating a complex system. You might hear that things are getting better... and in some places, they are... but compared to other nations, we still trail behind. Trust, advocacy, and knowing your rights matter more than ever.
For those supporting mothers (midwives, doulas, community advocates) the challenge is not only medical, but political, social, and structural. Changing outcomes means shifting systems, not just individual practices.
A Moment to Ask: How Can We Fix It?
Here’s where you come in... share your voice. Think for a moment:
What change would you help create to improve maternal health outcomes in your community?
Would you advocate for extended postpartum care and home visits?
Would you create a local support network for pregnant and postpartum people?
Would you lobby for paid family leave or increased midwifery access?
Would you share maternal advocacy information in churches, community centers, or online?
Pick one problem you see (in your hospital, your state, your community) and imagine one action you can take this week to move toward a solution. Write it down, share it, and ask someone else to join you.
A Call to Invest in Mothers
We keep hearing that “children are our future.” But we must remember: mothers are the foundation. A mother who receives safe, supported care is more likely to carry that strength into families, communities, and generations.
We provide better outcomes when we:
Ensure universal access to high-quality prenatal and postpartum care
Address racial inequities head-on through training, accountability, and policy
Build continuity and support into every mother’s journey, not just medically but socially, emotionally, and economically
Prioritize systemic change over individual success cases
Because the truth is: we know what to do. It’s been studied. It’s been proven. What’s missing is the will, the policy, and the investment.
Closing Thoughts
Mothers in the U.S. deserve better than our current status quo. They deserve to enter pregnancy knowing their lives and health are valued. They deserve to leave birth not just alive, but strong, supported, and whole. They deserve a system that honors the miracle of life with the care to match.
Let’s stop accepting “good enough.” Let’s push for maternal care that rises to the level of our wealth, technology, and moral responsibility. Because when mothers thrive, families thrive. And when families thrive, communities heal.
Let’s start the change today.
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