By Jordan Meadows
Staff Writer
A fundraiser was held in Durham highlighting the human toll behind North Carolina’s maternal and infant health disparities, as participants walked past signs bearing the names of Black women who died from pregnancy-related causes.
The event was organized by MAAME, a Durham-based nonprofit that provides doula support and maternal health services, works primarily with Black mothers and families. The organization’s name is both as an acronym and as a word meaning “mother” in the Twi language.
At the event, attendees like Durham resident Laura Gonzalez Dutor described how doula care helped ease anxiety during pregnancy by providing additional guidance and advocacy alongside medical providers.
“I knew that there was always going to be someone, in addition to my partner, that would be able to advocate for me and just help me make informed decisions,” Gonzalez Dutor said.
Research indicates that doula care—trained, non-clinical professionals providing continuous physical, emotional, and informational support to families before, during, and shortly after childbirth—is associated with lower rates of cesarean sections, fewer birth complications, and improved infant health, particularly among low-income mothers.
Despite these benefits, access remains uneven, with private insurance rarely covering doula services and Medicaid coverage limited within North Carolina.
Across the United States, maternal mortality rates remain higher than in other wealthy countries, and Black women face significantly greater risk. According to federal data, Black women nationwide die from pregnancy-related causes at roughly three times the rate of white women. In North Carolina, that disparity persists, with Black women accounting for a disproportionate share of maternal deaths.
Although Black residents make up about 22% of the state’s population, Black women represented approximately 43% of pregnancy-related deaths between 2020 and 2022.
Between 2019 and 2021, North Carolina’s rate rose sharply from 22 to 44 deaths per 100,000 live births. Earlier reviews by the state’s Maternal Mortality Review Committee found that nearly 80% of pregnancy-related deaths were preventable.
However, North Carolina reported a decline in infant mortality from 6.9 deaths per 1,000 live births in 2023 to 6.3 in 2024, marking the lowest rate ever recorded in the state. Health officials attributed the 8.7% decrease in part to a 14.9% drop in neonatal deaths, meaning more infants are surviving the first 28 days of life. Expanded Medicaid coverage and improved access to prenatal and postpartum care have been cited as contributing factors.
Nevertheless, Black infants in North Carolina are still nearly three times more likely to die before their first birthday than white infants.
“We are not making progress where we need to on unacceptable disparities,” said Dr. Kelly Kimple, acting director for NCDHHS' Division of Public Health.
These disparities are particularly visible in rural areas, where access to maternal care is often limited. Hospital closures, provider shortages, and longer travel distances can delay or prevent timely care. State and federal initiatives have increasingly focused on expanding the maternal health workforce in these regions, including training nurse midwives and improving telehealth access for mental health and substance use treatment.
Wake County generally has greater access to hospitals and providers than rural counties, though disparities by race and income persist. State funding initiatives and federal grants have directed resources to urban centers like Raleigh, Durham, and Chapel Hill, while also attempting to extend services into underserved communities statewide.
North Carolina expanded Medicaid eligibility in recent years, resulting in more than 700,000 additional residents gaining coverage. The state also extended postpartum Medicaid coverage from 60 days to one year, a move aimed at addressing complications that often arise after childbirth.
Public health campaigns such as “I Gave Birth” and the state’s Perinatal Health Strategic Plan have sought to improve awareness and care coordination.
Federal funding has also played a role as more than $4 million from the U.S. Department of Health and Human Services has been allocated to North Carolina through multiple programs, including maternal mental health services, workforce training, and initiatives designed to improve care quality in birthing facilities.
