By Dr. Ja’Lia Taylor, NCNW Director of Policy, Telecommunications & Technology
In the United States, a country that allocates more financial resources to healthcare than any other developed nation, Black women remain three times more likely to die from pregnancy-related complications than their White counterparts, according to the Centers for Disease Control and Prevention Maternal Mortality Rates in the United States. In 2023 alone, the maternal mortality rate for Black women reached 50.3 deaths per 100,000 live births, while rates declined for almost every other racial and ethnic group.
More than 80 percent of these deaths were preventable said the CDC in Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 U.S. States, 2017–2019. These are not isolated medical anomalies. They are the result of delayed diagnoses, inadequate prenatal and postpartum care, systemic racism in healthcare delivery, and a lack of access to timely and culturally responsive services.
The Black maternal health crisis is not new, but the solutions must be urgent, bold, and data driven. One innovative intervention that shows promise is the use of telehealth technologies. When implemented equitably, telehealth can increase access to care, improve maternal outcomes, and help reduce the racial disparities that continue to place Black mothers at heightened risk.
Defining Telehealth
Telehealth is the use of digital tools such as video conferencing, secure messaging, mobile health apps, and remote monitoring devices to provide clinical services outside of traditional healthcare settings as defined by the Health Resources and Services Administration (HRSA), What is Telehealth? in 2021. These technologies enable virtual prenatal checkups, postpartum evaluations, behavioral health therapy, and chronic condition management without requiring physical travel to clinics or hospitals.
For many individuals, particularly those in medically underserved or rural communities, telehealth serves as a critical access point for essential services. In the context of maternal health, this access can mean the difference between life and death.
The Black Maternal Health Crisis: More Than Statistics
The racial disparities in maternal health outcomes are alarming. According to the CDC (2023):
- Black women are two to three times more likely to die from pregnancy-related causes than White women.
- Black infants are twice as likely to die before their first birthday compared to White infants.
- Black women frequently report that their symptoms are dismissed, and their pain is not believed by healthcare professionals in the 2019 article “Listening to Black women: Women’s narratives of racism and childbirth” in Birth.
Moreover, these disparities persist even when controlling for income and education. A study by the Commonwealth Fund in 2023 found that a Black woman with a graduate degree is more likely to die from childbirth than a White woman with only a high school education. This finding underscores the structural and institutional nature of the crisis, which extends far beyond individual choices or socioeconomic status.
Can Telehealth Be Part of the Solution?
Telehealth is not a cure-all. However, when deployed equitably and thoughtfully, it offers real potential to reduce disparities in maternal health outcomes for Black women.
1. Improving Access to Prenatal and Postnatal Care
Many Black women face barriers to receiving in-person care, including limited transportation, lack of paid leave, and childcare obligations according to an article in 2020 for Obstetrics & Gynecology. Telehealth reduces these barriers by allowing patients to attend appointments from home or work. For women in healthcare deserts or rural areas, this technology enables real-time access to providers, early detection of warning signs, and the delivery of vital health education.
2. Enhancing Postpartum Follow-Up
The postpartum period is one of the most dangerous times for Black mothers. Yet nearly 40 percent of all women miss their postpartum checkups recorded by the CDC. Research from Penn Medicine, in 2021, found that telehealth options significantly increased attendance at postpartum visits among Black patients. Virtual follow-ups make it easier for patients to ask questions, access urgent care, and receive ongoing support during recovery.
3. Addressing Mental Health Needs
Black women experience higher rates of postpartum depression but are less likely to receive treatment due to stigma, lack of culturally competent care, and provider shortages, according to an article in Primary Care: Clinics in Office Practice. Telehealth platforms can connect patients with mental health professionals who understand the cultural context and lived experiences of Black mothers, increasing the likelihood of engagement and follow-through.
4. Connecting with Culturally Aligned Providers
Telehealth can bridge the gap between patients and culturally competent providers. It gives Black mothers the option to seek care from practitioners who either share their background or have received specialized training in anti-racism and cultural humility. This can improve trust, communication, and patient satisfaction recorded the article “Racism and health: Evidence and needed research” in Annual Review of Public Health in 2002.
5. Expanding Access to Maternal Health Specialists
Through telehealth, patients can consult with OB-GYNs, lactation consultants, doulas, midwives, and high-risk pregnancy specialists regardless of geographic location. For women managing chronic conditions like diabetes or hypertension during pregnancy, these connections can be lifesaving, said the American College of Obstetricians and Gynecologists (ACOG) in 2021 Improving Access to Maternal Health Care in Rural Communities article.
Policy Support for Telehealth in Maternal Health: The Black Maternal Health Momnibus Act
The Black Maternal Health Momnibus Act, introduced by the Black Maternal Health Caucus, is a comprehensive legislative package aimed at addressing every dimension of the Black maternal health crisis. It includes provisions that:
- Fund community-based organizations implementing telehealth solutions
- Support broadband expansion in underserved communities
- Improve data collection on maternal health disparities
These investments are crucial for ensuring that telehealth can reach and benefit those who need it most insists the Black Maternal Health Caucus.
Medicaid Expansion and Coverage for Telehealth
While some states have expanded Medicaid coverage to include prenatal and postpartum telehealth services, others have not. This leaves millions of low-income women without access to even the most basic forms of care. Medicaid expansion remains one of the most effective policy tools for increasing maternal health equity, according to the Kaiser Family Foundation (KFF) 2023 Status of State Medicaid Expansion Decisions: Interactive Map. However, recent actions by the current administration suggest a lack of support for Medicaid. The push to cut $880 billion from federal spending has placed Medicaid under heightened scrutiny, as Medicare and Social Security have been excluded from potential reductions. The House Energy and Commerce Committee, which oversees Medicaid, has been assigned the task of identifying cost-saving measures. As a result, some Congressional members are revisiting proposals from the previous Trump administration. These include implementing block grants and per capita caps, ending funding for Medicaid expansion, lowering the Federal Medical Assistance Percentage (FMAP), and increasing work requirements. In addition, the methods states use to access federal dollars, such as state-directed payments and provider taxes, are being closely examined. Some lawmakers have even referred to these funding mechanisms as loopholes that need to be closed.
These proposed changes could have significant consequences for Black maternal health. Medicaid covers nearly half of all births in the United States and plays a particularly critical role for Black women, who are more likely to depend on Medicaid coverage.