Fighting for Black maternal health amid federal rollbacks

RALEIGH, N.C. — Black maternal health is more than a statistic — it’s a call to action for mothers, daughters and communities fighting to be seen, heard and cared for. With potential government shutdowns threatening critical programs, the conversation around Black maternal health has never been more urgent.

North Carolina state Sen. Natalie Murdock, who represents Durham and Chatham counties and has championed maternal health legislation since entering the General Assembly, emphasized a stark reality: even in areas with world-class hospitals, access remains a defining barrier.

“We have access to Duke Hospital, Rex, UNC, WakeMed — some of the best health care providers in the world,” Murdock said. “But if you cannot get access to them, that is an issue we’re seeing with communities of color, especially Black women.”

Progress through policy

North Carolina made significant strides through Medicaid expansion, extending postpartum coverage from 60 days to 12 months — a critical window for addressing complications and ongoing health needs. The change followed advocacy from leaders like Murdock, who shared data showing the life-saving benefits of extended care.

She also cited the “Save More Ta-Ta’s” legislation, filed by the state Senate minority leader Sydney Batch and breast cancer survivor. The bill addresses a gap affecting women of color with dense breast tissue, who often need additional screenings not covered by insurance. Early detection remains key, yet cost barriers continue to block access.

Beyond genetics: systemic inequities

Karida Giddings, access to health care coordinator for North Carolina Black Alliance, offered perspective on the systemic causes of health disparities.

“We’re looking beyond just the genetics,” Giddings said. “We’re looking at the systems built around us that are really creating the root causes of the disparities we see.”

Those systems include limited access to healthy foods, a shortage of culturally competent providers, and health professionals who fail to listen to Black women’s concerns — leaving many communities to fall through the cracks. Data shows that in some states, Black women die at rates three to four times higher than white women during pregnancy and childbirth.

Community-based solutions

Both Murdock and Giddings underscored the critical role of community-based organizations in closing care gaps. Groups such as MAAME and Equity Before Birth have stepped in to provide doula support, blood pressure monitoring and postpartum follow-up care.

These organizations saw increased funding following the social justice reckoning after George Floyd’s death, and North Carolina funded two such groups with state dollars for the first time. Yet, that progress remains fragile.

The federal threat

With Medicaid rollbacks and government shutdown threats on the horizon, uncertainty looms. The anti-diversity, equity and inclusion backlash has already resulted in multimillion-dollar research grants being withdrawn, including one from the University of North Carolina at Chapel Hill.

Murdock warned that without reliable data, it becomes difficult to justify grant applications or target interventions effectively. Meanwhile, rural hospital closures add another layer of risk. The potential loss of Siler City Hospital, for instance, could turn a 15-minute drive to deliver a baby into an hour-long journey — a potentially deadly delay.

Resilience and resistance

Despite the challenges, both Murdock and Giddings expressed confidence in the resilience of Black communities.

“Black people as a whole will do what we have to do to survive,” Murdock said.

Giddings added:

“When you asked me what it looks like, it looks like Black women doing what they’ve always done — leading, organizing and building bridges, standing in the gaps in ways that our system has yet to really do.”

The bottom line

The state’s maternal health crisis serves as a stress test for the systems communities have built to protect themselves. While the political climate presents challenges, advocates, legislators and grassroots leaders continue to lay a foundation for progress.

“We are resilient people,” Murdock said. “When we weather this political storm of violence that is self-inflicted, I do think we’ll come out better on the other side.”

Black maternal health is not just a health issue — it’s a justice issue, a community issue, and a reflection of our values as a society.