Health research about immigrants often groups together all immigrants from Africa. However, there is great variation within Africa in socioeconomic and historical factors. This study’s objective is to describe and compare maternal and birth characteristics by African regions of origin for women giving birth in the U.S. 2016-2018.

We use a restricted national birth certificate file with “mother’s birth country.” African countries are grouped by region (North, West, East, Central, and Southern), based on United Nations classification. Health outcomes include mother’s age, education, marital status, and trimester prenatal care began. Infant characteristics include gestational age, birth weight, and delivery method. We also compare Black and white African-born women.

There were 11,226,459 singleton births, with 203,373 for mothers born in Africa. Overall, compared to US-born women, woman from Africa were 1.4 times more likely to be married and at least 1.4 times more likely to have an Associate degree or above (except Central Africa), but 1.7 times less likely to initiate prenatal care within the first trimester. There was African regional variation in maternal education, delivery methods, and preterm birth. Caesarean section (CS) rates were very high for West Africa (38.1%). Among women from Southern Africa, the preterm birth rate was higher for Black than white women (12.5% vs. 6.7%).

When all of Africa is grouped together, top sending countries dominate the data, and regional differences are masked. While generally immigrant women have good birth outcomes, these data show some concerning trends for adequate prenatal care, preterm births, and CS deliveries.