Maternal mortality rates are on the rise for all races in the United States and are strongly affected by the health of a woman before she conceives, a Texas advisory committee to the U.S Commission on Civil Rights reports.
The Texas Advisory Committee gathered testimony from October 2024 to February 2025 and released its report on August 6.
“The United States has one of the highest maternal mortality rates in the developed world, and Texas has one of the highest rates among the states,” wrote committee chair Merrill Matthews in the Executive Summary.
In June 2024, the Texas committee of liberal- and conservative-leaning volunteers decided to probe the role of racial disparities in maternal mortality rates, which the report says are now at 17.6 deaths per 100,000, nationally.
Rise in White Mortality
Black women in Texas are three times more likely to die during pregnancy and immediately after birth, but that statistic is improving, states the report.
“The gap between Black and White maternal mortality rates has narrowed in recent years, but troublingly, this is due to increased maternal mortality rates among White mothers, not improvements in maternal mortality for Black mothers,” states the report.
College-educated black women in Texas are as likely to die from pregnancy complications as black women without college degrees, says the report. Pregnancy-related mortality rates in Texas are highest for black women and Native American women. The rates were lowest among white and Hispanic women.
Big Role of Chronic Illness
The report used the World Health Organization’s definition of maternal mortality: deaths during pregnancy or within 42 days after a woman gives birth.
Preexisting health conditions before conception are a significant factor in explaining the racial disparities in mortality rates, accounting for nearly 80 percent of the gap between black and white mothers, the report says.
“In Texas, one in three pregnant women suffers from chronic conditions such as diabetes, hypertension, nicotine addiction, and/or obesity,” states the report. “When pregnancy occurs alongside these chronic illnesses, the likelihood of complications such as maternal morbidity or mortality significantly rises.
Obesity, hypertension, and diabetes are the most dangerous conditions for pregnant women, and they are more common among black women, the report states.
Socioeconomic Factors
The report found other factors that could be contributing to high maternal mortality include lack of transportation, childcare, and health-care access.
Texas has a large rural population, with 4.6 percent of pregnant women lacking access to a birthing facility within 30 minutes of home, the study finds. Postpartum care is an “essential part of addressing maternal mortality,” the report states. The Texas legislature extended postpartum Medicaid coverage to 12 months after birth starting in March 2024, though many mothers lack reliable transportation to take advantage of the care, the study states.
Violence, Mental Health Effects
The report found a major cause of maternal mortality is deteriorating mental health and rising incidence of domestic violence.
“Twenty-one percent of pregnancy-related deaths are from mental disorders, and 28 percent are due to violence, including suicide and homicide, often occurring in the postpartum period,” states the report.
It is important for health care providers to screen mothers for depression and domestic violence through all stages of pregnancy and beyond, the report states.
History of Mistrust
Given all the factors at play in the nation’s health care system, it is not surprising that maternal mortality rates are high, Matthews told Health Care News.
“Part of it has to do with U.S. racial history that has led some black women to mistrust the health care system,” said Matthews. “And black mothers tend to have higher uninsured rates, which discourages accessing prenatal care. As a result, maternal mortality among black and native Americans can be three times that of white and Hispanic women, negatively affecting the U.S. average.”
MAHA Limits
The Trump administration’s Make America Healthy Again program is unlikely to lower maternal mortality rates without additional efforts, says Matthews.
“Concerns about food dyes and fluoride in the water are things higher-income people worry about,” said Matthews.” Low-income, pregnant women’s primary challenge is access to affordable care, and I don’t see [Health and Human Services] Secretary [Robert F.] Kennedy [Jr.] doing anything about that.”
The most effective solutions may come from experimentation at the state level, “much as [Wisconsin and Oregon] experimented with welfare reform in the late 1980s and ’90s,” said Matthews. “Those efforts produced real results that the federal government later tried to imitate.”
Focus on Root Causes
It is important to view the issue of maternal mortality with a critical eye, says Patrick T. Brown, a scholar at the Ethics and Public Policy Center.
“It is true that maternal mortality rates are too high in the United States, but it’s always important to remember that overall statistics can paint a misleading picture,” said Brown. “The U.S. counts maternal mortality in different ways than most other countries, so we should never take the claim that it is more dangerous to give birth than in other developed nations at face value.”
“That said, we know there are certain preconditions that make it riskier to have a baby: diabetes, obesity, high blood pressure, and other underlying conditions can raise the risk of pregnancy [complications] and have little to do with the process of giving birth,” said Brown. “A concerted effort to address those, such as through better prenatal care and more focus on the root causes of poor health, will both improve outcomes for moms and babies and put the lie to the push that would use a ‘crisis’ in maternal mortality to advocate for legalized abortion.”
AnneMarie Schieber ([email protected]) is the managing editor of Health Care News
Internet info: Merrill Matthews et al., “Racial Outcomes in Maternal Mortality,” Texas Advisory Committee to the U.S. Commission on Civil Rights, September 2025: https://www.usccr.gov/files/2025-09/tx-sac-report-on-maternal-mortality.pdf
AnneMarie Schieber is a research fellow at The Heartland Institute and managing editor of Health Care News, Heartland’s monthly newspaper for health care reform.
