April 8, 2025
Bridging The Gap: Addressing Black Maternal Health Disparities Through Self-Advocacy
Black Mamas Matter Alliance is more than just a campaign. It’s a movement
By Ayanna Alexander-Laine
This April, we recognize Black Maternal Health Week (BMHW), a time to amplify the stories and challenges of Black mothers across the country. Held annually from April 11–17 and founded by the Black Mamas Matter Alliance, BMHW is more than just a campaign. It’s a movement.
And for me, it’s deeply personal.
Despite all the accolades—Olympian, academic, entrepreneur—none of them shielded me from the all-too-common challenges Black mothers face in our healthcare system.
I was healthy, strong, and deeply in tune with my body. Yet still, I encountered the kind of maternal health adversity that far too many Black women experience. That’s when it truly hit me: If someone with my level of access to care could still face these disparities, what about the countless Black women who don’t have those same resources?
This is not just a medical issue. It’s a systemic one — rooted in implicit bias, structural racism, and a long history of disregarding Black voices in clinical spaces. While many solutions are needed to address this crisis, one tool continues to stand out: self-advocacy.
Why Black Maternal Health Week Matters
Black Maternal Health Week was launched in 2018 by the Black Mamas Matter Alliance to build awareness, activism, and community-driven solutions around Black maternal health. It intentionally aligns with National Minority Health Month and begins on April 11, the International Day for Maternal Health and Rights — a global day of action to end preventable maternal mortality.
The Black Mamas Matter Alliance is bringing some much-needed awareness to the persistent and alarming disparities in maternal mortality in the U.S.– disparities that have gone unaddressed for far too long. In 2021, the maternal mortality rate for non-Hispanic Black women was 69.9 deaths per 100,000 live births — a staggering figure that is 2.6 times higher than that of non-Hispanic white women, whose rate was 26.6.
This data is not just numbers but reflects lives lost, families forever changed, and a healthcare system that continues to fail Black mothers. What makes this data even more concerning is that the mortality rates increased across all racial and ethnic groups between 2020 and 2021, highlighting the deepening nature of the crisis. Organizations like the Black Mamas Matter Alliance play a critical role in not only raising awareness but also advocating for systemic changes that center Black voices, protect Black mothers, and promote equity in perinatal care. Their work is not just timely; it’s lifesaving.
This year’s theme, “Healing Legacies: Strengthening Black Maternal Health Through Collective Action and Advocacy,” emphasizes the leadership of Black-led perinatal, maternal, and reproductive health organizations as a foundation for driving systemic change. It’s a powerful reminder that healing is both individual and collective.
Why Self-Advocacy Matters
Self-advocacy, at its core, is about recognizing your worth and speaking up for your needs–even in environments where you’ve been taught to stay quiet. For Black women, self-advocacy can be a literal lifesaver. It’s about asking the hard questions, requesting second opinions, and trusting your intuition when something doesn’t feel right.
Unfortunately, the burden of advocacy often falls on the patient. Healthcare providers are on the front lines, responsible for delivering immediate and adequate care, but implicit bias creeps in, often silently and dangerously. This bias can affect how symptoms are interpreted, how pain is managed, and how urgently care is administered. It’s a matter of life and death.
That’s why self-advocacy is essential. For Black mothers navigating this system, it can start with a few foundational steps:
● Know your rights. Every patient has the right to be heard, respected, and fully informed. You have the right to ask questions, decline procedures, request a different provider, or seek a second opinion at any time.
● Bring a third party/support person with you to appointments. Whether it’s a partner, trusted family member, doula, or friend, having someone present to advocate alongside you can help ensure your concerns are addressed. They can take notes, ask clarifying questions, and speak up if you’re being dismissed or overlooked.
● Document your experience. Keep a record of your appointments, symptoms, and any care concerns. Having detailed notes not only empowers you but also provides a reference point if you feel your concerns aren’t being taken seriously.
● Listen to your gut. If something doesn’t feel right, say so. Use clear, assertive language: “I’m concerned about this symptom and need you to take it seriously,” or “I’d like to revisit this decision and understand all of my options.”
● If a provider refuses a test or treatment you’re requesting, ask them to document that refusal in your medical chart. This not only shows that you’re serious about your concerns—it can also prompt them to reconsider, or at the very least ensure there’s a record that you advocated for yourself. That documentation can be important for future care or if any issues arise.
● Choose culturally competent providers whenever possible. Seek out OB-GYNs, midwives, or birthing centers that demonstrate an understanding of racial disparities in maternal health and a commitment to addressing them.
Another element of self-advocacy is to do research ahead of time on your provider/practice. While it’s not your job to be the expert, familiarizing yourself with basic birth plans, medical terms, and common interventions can help you feel more in control. Knowledge is power and confidence.
While it’s unjust that so much of this responsibility falls on the shoulders of women, these tools can serve as a shield and a voice when navigating a system that too often asks us to be silent.
This is also why cultural sensitivity and anti-bias training must be more than a checkbox; they must become standard practice in every healthcare setting. Providers need the tools to recognize disparities and the courage to address them head-on.
The Role of Doulas and Midwives
Equally essential in improving outcomes is the presence of doulas and midwives. Black mothers who work with these birth workers often experience better outcomes across the board. Why? Because doulas and midwives offer more than support—they offer protection. They help amplify the mother’s voice, serve as advocates in moments of vulnerability, and bridge the communication gap between patient and provider.
Doulas, in particular, offer continuous physical, emotional, and informational support throughout pregnancy, labor, and the postpartum period. They’re not medical professionals, but they play a crucial role in helping mothers make informed decisions and feel empowered in the process. For Black mothers, who are more likely to be dismissed or ignored in clinical settings, that reassurance and representation matter. It builds confidence. It builds trust.
Research also confirms that doulas provide more than just emotional support; they contribute to tangible health improvements. Mothers supported by doulas are significantly less likely to experience complications and more likely to have healthy birth weights and begin breastfeeding successfully.
Midwives are trained medical professionals who provide holistic reproductive care and often practice in community-based or birthing center settings that prioritize respectful, personalized treatment. Their care model is centered around listening, education, and shared decision-making—all key components in creating safer and more affirming birth experiences for Black women.
Together, doulas and midwives offer a powerful combination: emotional grounding, medical guidance, and a commitment to advocacy. In many ways, they restore what traditional healthcare settings sometimes stripped away: dignity, agency, and respect.
In essence, they provide a critical additional layer of care — before, during, and after birth. And for Black women navigating a healthcare system that too often fails them, that support can be transformational. It can mean the difference between trauma and healing, between being heard and being harmed.
When Data Meets Lived Experience
Through my academic research, I’ve examined how implicit bias affects care delivery and maternal health outcomes. I’ve studied how artificial intelligence if left unchecked, can reinforce these same disparities. I’ve examined how certain leadership models can help healthcare professionals rebuild trust with marginalized patients.
But beyond the data, what continues to drive me is the storytelling.
We need more stories. We need more voices. We need to make the invisible visible.
Because statistics can be dismissed, but stories? They move people. They inspire action. They can lead to change.
Looking Ahead – A Call to Action for Leaders
As we recognize Black Maternal Health Week 2025, I encourage everyone, patients, providers, policymakers, and allies, to engage with this issue both intellectually and emotionally.
Listen to Black mothers. Amplify their experiences. Champion culturally competent care. Support and fund doulas, midwives, and community-based birth workers and advocate for the policies that reflect our lived realities, not just data points.
We also need to advocate for more cultural sensitivity training for healthcare providers. Cultural sensitivity isn’t just a box to check; it’s a critical tool in closing the gap in maternal health outcomes for Black mothers. Too often, providers are unaware of the implicit biases and systemic inequities that shape their patients’ experiences and outcomes.
By fostering cultural awareness and humility, providers can begin to recognize how historical mistrust, communication gaps, and unconscious bias contribute to disparities in care. This kind of training and reflection is essential to delivering equitable, respectful care. When providers are equipped with the knowledge to understand cultural context and the awareness to challenge their own assumptions, they’re better positioned to listen, to act with empathy, and to respond in ways that affirm the dignity and needs of women. Ultimately, cultural sensitivity is not about being politically correct–it’s about being clinically effective and morally accountable.
This mission is deeply personal for me — but it’s not mine alone. When we advocate for better care for Black mothers, we’re building a more equitable healthcare system for everyone.
We owe it to ourselves, our families, and the generations to come.
Ayanna Alexander-Laine
Ayanna Alexander-Laine is a distinguished professional with a multifaceted career in athletics, healthcare, and venture capital. Ayanna currently serves as a General Partner at Freedom Trail Capital. She competed in the triple jump at the 2012 Olympics, won two Commonwealth Games medals, and became a 16-time national champion. Currently, Ayanna is a Ph.D. candidate in Business Administration, focusing on health equity, Black maternal health, and the ethical implications of AI in healthcare. Her influential research, published in the International Journal of Management and Humanities, addresses Black health disparities and implicit bias training. Additionally, Ayanna is producing a documentary on Black maternal health disparities and is dedicated to expanding VC opportunities for underrepresented groups.
