Black Women's Health

The maternal mortality crisis alone demands urgent attention. According to the Centers for Disease Control and Prevention, Black women die from pregnancy-related causes at a rate of 49.5 per 100,000 live births — more than three times the rate of white women (19.0 per 100,000) and nearly double the national average. These deaths are overwhelmingly preventable: the CDC estimates that 84 percent of maternal deaths could be avoided with appropriate care and intervention. The disparity persists across education levels, income brackets, and geographic regions. A Black woman with a college degree is at higher risk than a white woman without one. This is not a socioeconomic gap. It is a race gap — produced by a healthcare system that consistently underestimates Black women's pain, dismisses their symptoms, and fails to provide the monitoring and intervention their pregnancies require.

Alongside maternal mortality, Black women carry disproportionate burdens of uterine fibroids, breast cancer, cardiovascular disease, and mental health conditions that are undertreated and under-researched. This hub covers each of these areas with the depth and directness that Black women deserve from health journalism.

The Black maternal mortality crisis is among the most documented racial health disparities in American medicine. ACOG, the American College of Obstetricians and Gynecologists, has identified implicit bias, undertreatment of pain, and failures in postpartum monitoring as primary drivers. Research published in the New England Journal of Medicine found that Black-physician-attended births had significantly better outcomes for both mothers and newborns compared to non-Black physicians attending the same births. Doula support — particularly Black doulas — has been shown to reduce cesarean rates and improve communication between patients and providers. The 12th month postpartum remains a critical window: Medicaid coverage extension to 12 months postpartum, passed in most states, has meaningfully improved monitoring of postpartum hypertension and hemorrhage.

Black women are three times more likely to develop uterine fibroids than white women, and more likely to develop them earlier, at larger sizes, and with more severe symptoms. Fibroids are the leading cause of hysterectomy in the United States, and Black women have disproportionately high hysterectomy rates — partly because they are less often offered uterus-sparing alternatives. Newer treatments including uterine fibroid embolization (UFE), radiofrequency ablation (Acessa), and the FDA-approved medication elagolix (Oriahnn) offer effective non-surgical options. If your provider's first recommendation is hysterectomy, ask explicitly about these alternatives. NHLBI research has established genetic factors that may explain increased susceptibility in Black women, opening doors for targeted therapeutics in coming years.

Black women are diagnosed with breast cancer at roughly the same rate as white women, but die from it at a 40 percent higher rate — the largest racial disparity in cancer mortality. Key factors include a higher incidence of triple-negative breast cancer (TNBC), which is more aggressive and has fewer targeted treatment options; later-stage diagnoses partly attributable to barriers in mammography access and provider follow-up; and evidence of systemic undertreatment. The American Cancer Society recommends annual mammography beginning at age 40 for average-risk women, but many guidelines have historically used 50 as the starting age — a recommendation that disproportionately disadvantages Black women, who are more likely to develop breast cancer before 50. ACOG and several leading oncology organizations now support earlier screening for Black women given the differential incidence of aggressive subtypes.

Cardiovascular disease is the leading cause of death for Black women in the United States, and Black women experience hypertension at some of the highest rates of any demographic group. According to the American Heart Association, Black women develop high blood pressure earlier in life and are less likely to have it well controlled. Stroke risk is substantially elevated. Contributing factors include neighborhood environments (limited access to healthy food, walkable streets, safe parks), chronic stress from racial discrimination — studied under the framework of 'weathering' by Dr. Arline Geronimus — and inadequate preventive monitoring. Home blood pressure monitoring and consistent primary care relationships are among the most evidence-supported interventions available.

The 'Strong Black Woman' archetype — the cultural expectation that Black women must be relentlessly resilient, prioritize others over self, and never show vulnerability — has documented negative health consequences. Research published in Health Psychology shows links between endorsement of this ideology and higher rates of depression, anxiety, and delayed mental healthcare seeking. Black women are significantly less likely to receive mental health treatment than white women, despite comparable or higher rates of psychological distress. The shortage of Black therapists — fewer than 5 percent of licensed mental health providers identify as Black — compounds the problem. Teletherapy platforms with filter options for culturally affirming providers have meaningfully expanded access in recent years.

Black women face higher rates of conditions affecting reproductive health including polycystic ovary syndrome (PCOS), endometriosis (frequently underdiagnosed), and premature ovarian insufficiency. Fertility treatment access remains limited by cost — insurance mandates for IVF coverage exist in only about a third of states, and treatment costs of $15,000-$25,000 per cycle are prohibitive without coverage. Research from the JAMA Network found that Black women undergoing IVF have lower live birth rates even after controlling for clinical factors, suggesting additional systemic variables in fertility care. Gynecologic care should begin with an annual well-woman exam that covers full reproductive health screening, including STI testing, cervical cancer screening, and contraceptive counseling aligned with your family goals.

Black women enter menopause on average 8.5 months earlier than white women and experience more severe and longer-lasting hot flashes, according to data from the SWAN (Study of Women's Health Across the Nation) cohort. Yet menopause remains profoundly under-researched and under-discussed, particularly for Black women. Hormone therapy, when clinically appropriate, can significantly reduce vasomotor symptoms and protect bone density. Cardiovascular risk during the menopausal transition is elevated and should prompt close monitoring. Black women approaching their mid-40s should proactively discuss menopausal transition symptoms with their provider rather than waiting for symptoms to become severe — many providers remain undertrained in recognizing perimenopause in Black patients.

Finding a provider who will listen — truly listen — is not a luxury. It is a health outcome. Research consistently shows that cultural concordance between patient and provider improves communication, adherence to treatment, and clinical outcomes. When searching for an OB-GYN, primary care physician, or mental health provider, consider using our provider directory, which lists verified Black and culturally affirming providers across the United States.

Questions worth asking a new provider: How do you approach pain management in your patients? What is your experience treating patients with [your specific condition]? What does your approach look like when a patient disagrees with a recommended treatment? Do you have experience with patients managing [fibroid, hypertension, etc.]? Red flags include providers who minimize your symptoms without investigation, suggest lifestyle change before completing a diagnostic workup, or resist providing second-opinion referrals.

If you are experiencing a pregnancy emergency — severe headache, vision changes, sudden swelling, chest pain, or shortness of breath — call 911 or go to the nearest emergency room immediately. These can be signs of preeclampsia or other life-threatening conditions. For mental health crisis support, text 988 or call the 988 Suicide and Crisis Lifeline. See our full crisis resources page.