However, these gains have not been universally sustained – with maternal deaths rising over time in the United States and spiking 40% between 2020 and 2021 due to the COVID-19 pandemic. Additionally, the remaining burden of maternal mortality is not equally distributed – with 95% of maternal deaths occurring in low and lower-middle-income countries.

Within this context of unequal progress, driven by global and national inequities in access to and quality of care, it’s time to return to proven strategies for saving birthing people’s lives, which will in turn positively contribute to our society, economy, and families.

We know what drives maternal mortality, and we know how to address it.

The direct causes of maternal mortality are well-documented, with severe bleeding after childbirth, infections, high blood pressure during pregnancy, delivery complications, and unsafe abortion as the underlying causes for almost 75% of maternal deaths. The solutions are also well-documented, with established interventions for labor, delivery, and newborn care poised to deliver the most cost-effective approach to reducing maternal deaths, with benefits of $60+ per $1 spent.

Given limited resources – both in terms of time and money – we need to prioritize investments in maternal health. If we, as a global community, chose to implement just one product to save birthing people’s lives, safe and inclusive contraception would have the greatest absolute impact on maternal mortality at scale. If birthing people who want family planning commodities were provided with safe and inclusive contraception, the effect would be substantial:

So then why are these solutions not implemented if we know how to improve maternal health? One answer is political will – both nationally and globally – and our collective assessment of the importance of birthing people’s lives. The other answer is that maternal health sits within the broader healthcare system, which in many places faces interrelated challenges of financing, workforce retention, and access to tools and technologies.

Inequities in care cost lives.

While these challenges to gender equity and health system failures impact maternal mortality in much of the world, social determinants of health and racism have an outsized influence on maternal outcomes in the United States. As an outlier in maternal mortality within high-income countries, racial disparities in maternal health in the U.S. have been documented for decades. Pregnancy-related mortality rates among Black, American Indian, and Alaska Native (AIAN) birthing people are over three and two times higher, respectively, compared to the rate for White birthing people. Infant health follows a similar pattern; infants born to Black, AIAN, Native Hawaiian and Other Pacific Islander (NHOPI) people have higher mortality rates than those born to White birthing people.

The National Bureau of Economic Research found that in the United States, the richest Black birthing people and their babies are twice as likely to die versus the richest White birthing people and their babies. This study is unique because it demonstrates that the risks of childbirth vary both by race and parental income and that Black families are disproportionately affected, regardless of their socioeconomic status. This significant gap demonstrates the effects of structural and systemic racial bias and discrimination in the U.S. for birthing people of color.

While this research is new, the problem is not, and coalitions continue to push for change. The Black Mamas Matter Alliance, Inc. (BMMA) is a national network of Black women-led organizations and multi-disciplinary professionals who work to ensure that all Black Mamas have the rights, respect, and resources to thrive before, during, and after pregnancy. BMMA is hosting the 6th annual Black Maternal Health Week (#BMHW23) from April 11-17, 2023 to change the state of Black maternal health through activism, awareness, and community-building.

We have the knowledge – it’s time to act.

In this time of unequal outcomes and stalled progress, the global community has an opportunity to decrease maternal deaths and reinvest in one of the cornerstones of public health – maternal health. The benefits of quality and equitable maternal health care will not only reduce mortality but improve health systems as a whole and improve outcomes for individuals beyond their pregnancy journey.

To get there, we need to:

  1. Prioritize the perspectives of those closest to the issues and address the social determinants of health
  2. Work across sectors and health areas to affirm the importance of quality, equitable maternal healthcare
  3. Tackle health system challenges around financing, workforce, access, and innovation with the lens of equity

Rabin Martin’s role, as it has been, is to bring the power of public, private, and community voices to drive focus on health systems strengthening and effective interventions, stay rooted in the data and birthing people’s needs, and keep equity at the center of the conversation.

What will your role be? 

Ariel Falconer
Associate Partner

Ariel works with leaders from major global health foundations and corporations to improve health for underserved and vulnerable populations globally. She has a deep understanding of health systems and global health partners, having worked closely with governments, NGOs, corporations, and community-based organizations on health equity, maternal health, reproductive health, and HIV/AIDS. She also serves as an evaluation and learning lead for her clients. Prior to Rabin Martin, Ariel supported public health research at Boston University, worked in service of educational equity for a national education reform nonprofit, and was selected for a fellowship in nonprofit and philanthropic leadership.

Asma Hussain
Senior Consultant

Asma has 14 years of experience in evidence-based processes and tools to improve efficiencies and reduce disparities in healthcare through continuous quality improvement methodologies, data analytics, and outcomes evaluation. Prior to joining Rabin Martin, Asma worked as a Data Analyst for the 18 Planned Parenthood health centers across Ohio, providing insights to increase healthcare access for communities of color and improve outcomes. She also co-founded a free clinic in her local community that serves refugee and immigrant populations around the Cleveland area. There, she was the Director of Performance Improvement where she fostered a culture of safety and quality in all processes to ensure patient-centered care that promoted well-being.

Khadija Mubasher
Senior Consultant

Khadija is a Medical Doctor with experience working in community health settings. She has since attained her MBA to serve her purpose of bringing about system-level change, specializing in qualitative research and human-centered business design. Khadija’s current work concentrates on strengthening health systems and supporting access to high-quality medicines/uterotonics to women in LMICs. She has worked as a general physician and within hospital administration in Pakistan implementing service design, organizing polio campaigns, and working in Tuberculosis clinics. She started her own not-for-profit baking business, concentrating on creating job opportunities for underprivileged women. She has experience in the start-up, venture capital and consulting space; where she helped her clients build equitable solutions for healthcare-focused clients.

Thea Lacerte

Thea advises clients on developing community-led solutions to reduce maternal mortality with the goal of leveraging the private sector contributions in mixed health systems. Beyond this, Thea’s work focuses on increasing equitable access to healthcare across a range of health areas. Prior to joining the firm, Thea worked for Health Leads, a non-profit that worked closely with hospitals and clinics to connect peoples with essential resources like food, housing and transportation to improve their overall care.