Childbirth is Deadlier for Black Families Even When They’re Rich, Expansive Study Finds

February 12, 2023

In the United States, the richest mothers and their newborns are the most likely to survive the year after childbirth — except when the family is Black, according to a groundbreaking new study of two million California births. The richest Black mothers and their babies are twice as likely to die as the richest white mothers and their babies.

Research has repeatedly shown that Black mothers and babies have the worst childbirth outcomes in the United States. But this study is novel because it’s the first of its size to show how the risks of childbirth vary by both race and parental income, and how Black families, regardless of their socioeconomic status, are disproportionately affected.

“This is a landmark paper, and what it makes really stark is how we are leaving one group of people way behind,” said Atheendar Venkataramani, a University of Pennsylvania economist who studies racial health disparities and was not involved in the research.

The study, published last month by the National Bureau of Economic Research, includes nearly all the infants born to first-time mothers from 2007 to 2016 in California, the state with the most annual births. For the first time, it combines income tax data with birth, death and hospitalization records and demographic data from the Census Bureau and the Social Security Administration, while protecting identities.

That approach also reveals that premature infants born to poor parents are more likely to die than those born into the richest families. Yet there is one group that doesn’t gain the same protection from being rich, the study finds: Black mothers and babies.

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“It suggests that the well-documented Black-white gap in infant and maternal health that’s been discussed a lot in recent years is not just explained by differences in economic circumstances,” said Maya Rossin-Slater, an economist studying health policy at Stanford and an author of the study. “It suggests it’s much more structural.”

If anything, the study’s findings understate the dangers of childbirth in much of the United States, a variety of researchers said, because California’s maternal mortality rate has been declining over the last decade, as deaths have gone up in the rest of the country.