Federal budget cuts threaten pregnant women’s health care access and lives

Black women in the United States are over three times more likely to die in pregnancy or postpartum than women of any other racial group.

Considering that more than 80% of pregnancy-related deaths in the United States are preventable, American leaders and policymakers should be focused on addressing maternal mortality.

Instead, Congress has passed a sweeping budget, the “Big Beautiful Bill,” that will slash Medicaid, destabilize Affordable Care Act marketplaces and allow enhanced premium tax credits to expire at the end of the year — jeopardizing access to care for millions.

Our country, Black American women in particular, consistently reports the highest maternal mortality rate among high-income nations due in large part to the following factors: the patchwork system of health care coverage, which often depends on employment or income level; the systemic biases still plaguing our health care system; and the fact that less than half (42%) of rural hospitals in the U.S. still offer labor and delivery services.

Rural hospital closures disproportionately affect Black women in the South, and one in six Black infants are born in maternity care deserts. This means that even women who can afford the care they need often have to travel long distances to receive it.

Factoring these longer distances into a busy everyday schedule can be challenging and can lead women to delay or skip needed prenatal and postpartum care.

Access to affordable health care — most often through access to insurance of some form — is also directly tied to an individual’s likelihood of keeping up with routine doctor’s appointments and screenings.

Women with health coverage are more likely to obtain needed preventive, primary and specialty care services, including regular prenatal doctors’ appointments, tests and ultrasounds. Uninsured women are significantly less likely to have a regular source of care, and many avoid routine screenings and appointments because of cost.

As it stands, 25% of reproductive-age Black women in Medicaid nonexpansion states — like Georgia — are uninsured, meaning that they are less likely to have regular prenatal and postpartum medical care.

Women who do not receive prenatal care are three to five times more likely to die from pregnancy-related complications than those who do. Regular prenatal appointments can detect complications like preeclampsia or early signs of postpartum cardiomyopathy, both of which have a mortality risk that is five times higher for Black women than white women.

Similarly, 60% of maternal deaths occur in the postpartum period, meaning that women should have access to attentive, timely care even after delivery. Here too, Black women are at a disadvantage, as they are less likely to have a paid leave policy through their employers and are therefore forced to shorten their recovery period and resume normal activities.