The black-white disparity in maternal mortality is widely acknowledged but little has been done to describe geographic variation in the disparity. We assessed the statewide variation between black and white maternal mortality ratios (MMRs) and the magnitude of the black-white disparity for each state.

Methods

Maternal mortality ratios were calculated nationally and for the 23 states with 10 or more maternal deaths among non-Hispanic black and non-Hispanic white subpopulations using CDC's 2013-2017 National Vital Statistics System. Maternal mortality ratios were defined as the number of deaths within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy from any cause related to, or aggravated by, pregnancy or its management excluding accidental or incidental causes per 100,000 live births.

Results

Nationally, the MMR among black women was 2.5 times higher at 48.2 deaths per 100,000 live births, compared with 19.1 deaths per 100,000 live births among white women. The MMR among black women was greater in every state examined, ranging from 1.3 times greater in Mississippi (23.2 deaths per 100,000 vs. 18.5 deaths per 100,000) to 4.3 times greater in New York (50.1 deaths per 100,000 vs. 11.5 death per 100,000).

Conclusions

The racial disparity between black and white women persists across all states examined. To address maternal mortality and morbidity, states must consider the role of structural, overt, and covert racism in maternal deaths.