Working Together to Reduce Black Maternal Morbidity and Mortality

June 20, 2025

PSO News

Canada Lacks Race-Based Pregnancy and Birth Data

In the United States, Black women are about three times more likely to die from pregnancy-related causes than White women¹. But what about in Canada? Unfortunately, we don’t know—because Canada does not systematically collect race-based data from individuals to inform analysis on pregnancy and birth outcomes. Without these data, we can’t fully understand the inequities or implement and monitor effective solutions. As one advocate states: “It is a massive barrier: If the crisis can't be proven, it is made invisible”².

What Ontario Data Tell Us

While national data are lacking, some insights have emerged from Ontario. A recent study³ found that Black individuals were overrepresented in maternal deaths, whether in the early (within 42 days) or later periods (43 to 365 days) after childbirth. However, the findings must be interpreted cautiously due to significant gaps in race-related data.

Other Ontario studies^4,5 that looked at perinatal outcomes found that Black individuals faced higher risks of a range of complications, including:

Gestational diabetes

Preeclampsia

Placental abruption

Preterm birth (<37, <34, and <32 weeks)

Spontaneous preterm birth

All caesarean deliveries

Emergency caesarean deliveries

Low birth weight (<2500g, <1500g)

Small-for-gestational-age infants (<10th percentile, <3rd percentile)

Low 5-minute Apgar scores (<4 and <7)

Admission to neonatal intensive care

Hyperbilirubinemia requiring treatment

Congenital heart disease

The outcomes from these studies highlight the urgent need for comprehensive, race-based data collection across Canada to allow us to measure and advance equity in care and outcomes.

What can we do?

BORN Ontario

Improve how we collect and use sociodemographic (SD) and social determinants of health (SDH) data.

Partner with Black-led and Black women-led organizations working in perinatal, maternal, and reproductive health.

Use data to support Black pregnant individuals with informed decision-making and self-advocacy.

Provide culturally relevant resources on key health issues (e.g. pain management, prenatal care, fibroids, sickle cell disease, preeclampsia, and mental health).

Support provincial efforts to give patients and healthcare providers personalized health information (i.e. the new digital Ontario Perinatal Record).

Connect with organizations developing telehealth and digital health platforms to improve healthcare experiences for women of colour (this aligns closely with the Prenatal Screening Ontario Info Line and community engagement will help enhance this resource to better serve Black women).

Healthcare providers:

Acknowledge privilege and systemic inequities.

Reflect on personal biases and assumptions and how they may affect your interactions with pregnant and birthing women and individuals.

Engage with curiosity and compassion to better understand patients’ lived experiences and their unique needs.

Educate patients and families about warning signs for perinatal complications (e.g. severe headache, extreme swelling of hands/face, difficulty breathing, heavy bleeding or discharge, and overwhelming fatigue) and when to seek emergency care.

Support timely diagnosis and treatment of perinatal complications during and after pregnancy.

Hospitals and healthcare systems:

Invest in ongoing implicit bias and anti-racism training for leaders and frontline staff.

Promote racial concordance by recruiting and retaining more healthcare professionals from populations underrepresented in health professions

Collaborate with Black-led organizations to:

raise awareness and share information about how to prevent, spot, and treat health problems during pregnancy.
support care providers in helping Black pregnant people make informed choices and have control over their care⁶.
implement and normalize race-based data collection* to better track and respond to inequities.

*Organizations like Parkdale Community Health Centre in Toronto wood are already collecting demographic and social determinants of health (SDH) data on populations existing at varying intersections of identity (e.g., unhoused, recent immigrant and/or refugee status), including race and ethnicity. Insights shared by these organizations highlight key structural and accessibility barriers—for instance, unhoused individuals face multiple barriers to receiving relevant prenatal education and/or care.

Researchers:

Co-design with Black communities by including their knowledge and lived experiences in every step—designing the study, choosing the right questions, understanding the results, and sharing results in meaningful ways⁷.

Evaluate care models that aim to improve care outcomes, reduce inequities, and close outcome gaps.

Policy-makers:

Amplify Black voices by partnering with and funding Black-led initiatives to center Black voices in perinatal care.

Implement policy changes grounded in an equity-focused framework—one that directly addresses Black maternal and perinatal health inequities and improves outcomes.

Pregnant individuals and their families

Trust your instincts. If something feels wrong or is concerning, talk to your healthcare provider about it.

Know the urgent warning signs for perinatal complications (e.g. preeclampsia, preterm labour, placental abruption), including: severe headache, extreme swelling of hands/face, difficulty breathing, heavy bleeding or discharge, overwhelming fatigue, and more.

Share recent pregnancy history at every medical visit—up to a year after delivery/childbirth.

Connect early with healthcare providers and social support systems before, during, and after pregnancy.

Seek resources and support from Black-led organizations:

On April 15, 2025, five members of BORN’s Internal Health Equity Advisory Group — Annabel Cope, Tavleen Dhinsa, Danna Hull, Ian Joiner, and Alicia St.Hill — participated in the Toronto Black Maternal Health Week Policy and Research Day, following the successful acceptance of their poster submission.

During the event, they had the opportunity to network with health leaders, clinicians, and individuals, all focused on leveraging their position to advance Black maternal health. They listened and engaged in discussions during two panel conversations: the first focused on the current state of Black maternal health, highlighting evidence and lived experiences; the second explored opportunities for innovation to drive meaningful change and reduce disparities in care.

They heard a clear message: urgent action is needed to improve Black maternal and perinatal health outcomes. 

Learn more about what sparked TBMHW - Check out this episode of Healthcare Change Makers. Dr. Tunde-Byass and Jennifer talk about why there is limited data about Black maternal health in Canada, what data is available, and what healthcare organizations can do today to better support Black families and patients. They also share a bit about their own career journey, including launching Canada’s first racially concordant mentorship program.