What I’d Like Everyone to Know About Racism in Pregnancy Care

As a country, we struggle with the results of racism in all aspects of life. This includes unequal treatment based on race, or racial inequities, in pregnancy care.

More and more often, my Black patients say they’re afraid of birthing in the medical system. My Black ob-gyn colleagues have shared similar stories. They say their Black patients are voicing growing concerns and distrust in the care they need before, during, and after childbirth.

These patients are asking, “Will I be heard?” They fear doctors won’t listen to their concerns or will overlook potentially life-threatening symptoms.

These questions and fears are valid. If you’re pregnant, here’s what I would like you and your family to know about racism in pregnancy care—and what we’re doing about it.

Racism in pregnancy care is real.

Research shows women of color often do not get the same quality of care as White women.

In a 2023 survey, 1 in 3 Black, Hispanic, and multiracial mothers reported mistreatment during maternity care, compared to 1 in 5 mothers overall. About 4 in 10 Black, Hispanic, and multiracial mothers also reported discrimination during maternity care, compared to 3 in 10 mothers overall.

In another survey, pregnant women of color said more often than White women that health care professionals don’t listen to them. Black women also said about twice as often as White women that they felt pressured to have a cesarean birth.

Studies show health care professionals sometimes label Black women as “difficult” or “angry” when they speak up for themselves or they ask “too many” questions. That means some women of color have a hard time saying things like, “I’m afraid you’re not listening to me and that it could harm me or my baby.”

Racism happens at both the personal and societal level.

These surveys reflect one-on-one interactions between people. In other words, an individual doctor may believe something about Black women or other women of color and treat them differently than their White patients. The doctor may or may not be aware of their own bias.

Unequal treatment in medicine also stems from racism in our country’s health care system and other parts of society. Racism shapes the policies, funding, and systems that have served—or not served—our communities throughout history. This means that women of color may encounter barriers to resources that help ensure good health outcomes, including

• health insurance

• transportation

• nutritious food

• stable housing

• personal safety

Racism causes many harms.

Research shows higher rates of maternal mortality, or death related to pregnancy and childbirth, among women of color. Rates of maternal mortality are 3 to 4 times higher in Black women and 2 to 3 times higher in American Indian and Alaska Native women than in White women.

There are many causes of maternal mortality, including mental health conditions, heavy bleeding (hemorrhage), heart disease, and high blood pressure. Women of color are more likely than White women to have many of these health conditions.

How do we know that these higher rates of sickness and death are connected to racism? Because skin color itself does not change anything about a person’s health. And these statistics hold true even when you adjust for income and education levels. This means that it’s racism, not race, that leads to increased rates of sickness and death among women of color.

Many doctors and medical groups are working to address racism.

Ob-gyns know racism is a serious problem in pregnancy care. And we know that the death and harms racism causes are preventable. Groups of doctors and medical organizations are joining together to stop these harms. We are working to

• recognize our own prejudices

• learn from racial justice activists and scholars

• educate ob-gyns and medical students about racial bias and how to address it in women’s health care

• support research that’s done by and for women of color

• review the medical guidelines that doctors follow to ensure they address racism

Other groups are also working hard for system-wide change, such as the Black Mamas Matter Alliance and the National Birth Equity Collaborative.

In the meantime, there are some ways to get extra support.

It’s not up to you to solve the problems of racism in women’s health care. But there may be a few things you can do that may help.

First, consider bringing your partner or a family member or friend to your appointments. They can provide support and help you ask questions and get answers. This advice comes from the Centers for Disease Control and Prevention (CDC) HEAR HER campaign.

The CDC also suggests you and those supporting you understand the warning signs of urgent problems around the time of pregnancy. If you have any of these problems, you need to listen to your body and get immediate care.

The CDC has a guide for talking with your doctor about health concerns during or after pregnancy, with a sample script. If you feel your doctor may not listen to you, this guide may help with the conversation. (Also, this postpartum care checklist can help you remember important points to discuss after having a baby.)

Any time you have concerns about the quality of your care, tell your doctor. If you are concerned with the response, talk with the clinic director of the hospital department where your doctor works. You can also tell hospital staff that you want to speak with a patient advocate. This is a person trained to help others navigate the health care system. Sometimes they are called case managers or health navigators.

It’s also OK to think about switching doctors. Patient advocates, friends, and family may be able to help you find a different doctor. If you have health insurance, your insurance company may be able to help you find a new doctor too. It may not always be possible to switch doctors, especially if you have a high-risk pregnancy. But if you can switch, a new doctor may make a difference.

For extra support, you can consider hiring a birth or postpartum doula. Doulas work alongside doctors and nurses to help ensure your needs are being met. Doula support during childbirth is linked to higher levels of respectful care and patient satisfaction, according to the CDC.

It’s important to know that doulas may not be covered by insurance. Check with your insurance company or state Medicaid plan about coverage. If cost is a concern, you can consider asking doulas about payment plans or hiring a doula-in-training, who may offer lower-cost services.

Last but not least, if you need help with paying bills, transportation, housing, food, or other needs, talk with your health care professional or patient advocate. They can help connect you with a social worker or local organizations for support. The website www.findhelp.org also has a directory of local support programs by zip code.

There are no perfect answers.

I can’t tell my patients that racism in medicine isn’t real. It is. Even if you speak up for yourself, these risks are with us. But I can tell my patients that I will always listen to them, and more and more doctors are working to do the same.

Copyright 2026 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.