Navigating Motherhood: A Black Woman's Journey Through Maternal Health Inequities
As my 30th birthday draws near, I recently asked my grandmother and aunt a pressing question: "Do you think I should consider freezing my eggs?" Medical science warns that my chances for pregnancy diminish with age, but as Black Maternal Health Week approaches, my concerns extend far beyond the biological clock. Black women's bodies have historically faced harsh surveillance, financial instability, and deep-seated health disparities.
The Stark Reality of Maternal Mortality
With a Ph.D. in maternal and child health, I am acutely aware that maternal mortality among Black women has been a persistent issue since the 1930s. In 2023, the maternal mortality rate for Black women was 50.3 deaths per 100,000 live births, significantly higher than rates for white, Hispanic, and Asian women. Although there was a slight decrease to 44.8 deaths per 100,000 live births in 2024, these statistics remain alarmingly high.
The elevated rates of maternal deaths are not due to a single cause. Black birthing individuals are dying, regardless of income or education, because of multiple interconnected factors:
- Structural and systemic racism
- Provider bias in healthcare settings
- Lack of quality, linguistically and culturally appropriate care
- Cumulative stress and weathering effects
These are known as the social-structural determinants of health, highlighting how influences at individual, interpersonal, community, and societal levels impact health outcomes. This knowledge has heightened my awareness of every aspect of my reproductive journey.
Reproductive Rights Under Attack
My autonomy is heavily influenced by my geographic location. In recent years, reproductive rights in the U.S. have faced significant assaults, with abortion access largely restricted across the country. Currently, 41 states have abortion restrictions in effect, including 13 with total bans. This means my ZIP code directly determines my access to reproductive care if I become pregnant, and my socioeconomic status would dictate the quality of care I receive.
As I grapple with these realities, I often encounter family and friends who eagerly anticipate my journey into motherhood. They express hopes to see what kind of mom I will be and what children I will raise, making it sound simple—as if the desire for motherhood alone can shield me from racism, pain, and dismissal. In a country where reproduction is coupled with risk, options are dwindling, and survival is uncertain, the decision to become a mother is profoundly political.
A Glimmer of Hope Amid Fear
Despite the challenges, I hold onto hope. I hope for a baby I will survive to greet, meet, and hold close. I hope for the long nights, ordinary days filled with extraordinary joy and stress. I hope to mother in a way that transforms life into a jubilant spectacle rather than an everyday terror. Yet, even this hope is often tinged with fear.
My studies in maternal health have led me to follow political attacks on vaccine recommendations by the Centers for Disease Control and Prevention, which are designed to protect birthing people during pregnancy and children in their early stages. Since 2025, federal officials have launched major assaults on established vaccine policies and public health recommendations, further eroding my trust in a government I never fully relied on. As gospel singer Tamela Mann once said, truth is ... I'm tired.
I am tired of dreaming in a country that seems indifferent to my awakening, tired of advocating for what is at stake, and tired of being asked, "Are you ever gonna get married and have a baby?" To which I often shrug and reply, "Maybe." With my 30th birthday less than three months away, that remains my answer, as I am still uncertain about my path to motherhood.
Call for Action and Support
When I discussed egg-freezing with my grandmother and aunt months ago, they reassured me not to worry, suggesting I have plenty of time. They may be right, and I am unsure if I will broach the topic at my next well-woman exam. However, one thing is clear: Black women's maternal autonomy and health deserve more than slogans and commemorative weeks. We deserve:
- Comprehensive and equitable care
- Safety in our healthcare experiences
- Genuine support instead of martyrdom
As a Public Voices Fellow with The OpEd Project in partnership with the National Black Child Development Institute, I urge a collective effort to address these critical issues. Black women's lives and well-being must be prioritized in medical systems and societal structures to ensure a future where motherhood is a choice made without fear.
