Supporting Black Birth February 2026 and Beyond

By: Keegan Prempeh (they/them)
BSW, Birth and Postpartum Doula

Black History Month offers a profound opportunity to reflect on the experiences, struggles, and triumphs of Black individuals throughout history. While many often focus on the past, it's also an important moment to highlight contemporary issues impacting Black communities. One such area of concern is Black perinatal health. As a Black doula, I’d like to offer a reflection on the current state of Black birth and the importance of advocating for culturally competent care. 

The Current State of Black Perinatal Health 

Despite advances in medical care, Black people across the world continue to face disproportionate challenges in perinatal health outcomes. A recent Ontario study found that Black individuals were overrepresented in maternal deaths, whether in the early or later periods after childbirth (1). Other studies that looked at perinatal outcomes found that Black individuals faced higher risks of a range of complications such as gestational diabetes, preeclampsia and low five minute Apgar scores (1). 

In the United States, Black birthing people face some of the highest maternal and infant mortality rates in the country. The Centers for Disease Control and Prevention reports that Black birthers are about three times more likely to die from pregnancy-related complications than white birthers (2). In the United Kingdom, a study found that Black birthers were two times more likely to die than their white counterparts, while babies born to Black birthing people are at an increased risk of stillbirth (3). These disparities persist across socioeconomic classes, education levels, and even when controlling for other factors such as age and pre-existing health conditions. 

Culturally Competent Care as a Response to Medical Racism 

Structural racism is one of the primary factors driving disparities in Black perinatal health. Racism impacts every stage of the perinatal period, from conception to childbirth to postpartum recovery. It’s not only about explicit discrimination or bias but also about the way systems and policies have been built to disadvantage Black people. 

Studies have shown that Black pregnant individuals often experience lower quality of care, increased rates of medical mistrust, and greater dismissiveness from healthcare providers compared to their white counterparts. For example, a study by the National Institute for Health Care Management found that Black women are more likely to have their pain dismissed or undertreated by medical staff, which can lead to serious complications during labor and delivery (4). 

The history of medical experimentation on Black communities also plays a significant role in current health disparities. For centuries, Black individuals, particularly Black women, were exploited in unethical medical research, such as the infamous Tuskegee Syphilis Study and the forced sterilizations of Black women in the mid-20th century. Many Black birthers today carry the emotional and psychological weight of these past injustices, making them more reluctant to seek out or trust medical care. This reluctance can lead to delays in seeking professional medical help, which increases the risk of complications during pregnancy and childbirth (5). 

Culturally competent care can play a key role in addressing Black perinatal health disparities. When the cultural background of patients are acknowledged and respected, their outcomes improve (6). It is essential then that healthcare providers be trained to understand the unique needs of Black patients, acknowledging both the historical context and the present-day realities that influence health. Furthermore, we know that biases, prejudice, and stereotyping from providers or the system negatively impacts care delivery. As such, it is important that healthcare professionals become aware of their biases and work towards unlearning them. 

Culturally competent care also involves healthcare providers being aware of the social determinants of health, such as a lack of access to housing, education, food, and employment, many of which disproportionately affect Black communities. Without equitable access to these critical facets of life, it can be extremely challenging for Black patients to engage in effective care. This is where robust advocacy comes into play as it relates to changing the birth landscape. 

Support and Advocacy: Building a Better Future 

While the statistics paint a bleak picture, there is hope in the growing movement for change. Across the country, Black-led organizations, advocates, and healthcare professionals are pushing for better care, more education, and greater accountability within the medical system. 

One such initiative is the Black Mamas Matter Alliance, an organization dedicated to improving Black maternal health through advocacy, research, and support. Ancestral Hands Midwives also advocates for increased access to midwifery care for Black individuals, which has been shown to improve birth outcomes (7). Midwifery care often involves more personalized, culturally sensitive, and holistic care, addressing not only the medical needs but also the emotional and social aspects of childbirth. 

Additionally, the services of Black doulas are becoming increasingly popular. Research shows that doula support can reduce the risk of complications during pregnancy and childbirth, decrease the likelihood of preterm births, and improve overall maternal satisfaction (8). By providing emotional support, advocacy, and comfort during labor, doulas help ensure that Black birthing people feel empowered and heard. 

To improve Black perinatal health, we must focus on several key areas, including: improved access to high quality care, comprehensive education and training for providers, and addressing social determinants of health. A holistic approach that recognizes the unique barriers that Black individuals face will be a necessary step in fostering trust within the healthcare system. I’m so proud of the work organizations like the Rooted Birthwork Collective and the National Black Midwives Alliance have done in order to make these needed changes.

Conclusion 

Black History Month serves as a time to celebrate Black culture, history, and achievements, but it also calls us to reflect on the current realities that continue to shape Black lives today. Addressing the disparities in perinatal and infant wellbeing is not only an issue of healthcare, it is a matter of social justice. By advocating for systemic change, supporting culturally competent care, and uplifting Black voices in healthcare, we can create a future where Black families have the same opportunities for healthy pregnancies and births as any other group. 

Let’s use this month as a springboard for action, honoring the Black birthing people and families whose voices have too often been silenced by inequality, while working toward a future of health equity for all. 

References 

1. Black Maternal Morbidity and Mortality. Better Outcomes Registry and Network. 2. Black Pregnancy-Related Mortality in the United States. Jasmine Johnson. 3. Systemic Racism affects Maternity Care for Black Women in England, say MPs. Tobi Thomas at the Guardian. 

4. Health in colour: black women, racism, and maternal health. Elizabeth Dayo, Kayonne Christy and Ruth Habte. 

5. Racist experiences and skin tone discrimination linked to delays in prenatal care. University of Minnesota School of Public Health. 

6. Culturally competent healthcare. Shondelle V Hickson. 

7. How Midwifery is Essential to Black Maternal Healthcare. Elizabeth Doerr. 8. Continuous support for women during childbirth. Meghan A Bohren, G Justus Hofmeyr, Carol Sakala, Rieko K Fukuzawa and Anna Cuthbert.