For Black women, most pregnancy-related deaths happen weeks or months after childbirth

(NEW YORK) — Shalon Irving knew her newborn daughter Soleil for less than one month.

Three weeks after giving birth to Soleil, now 6, Shalon Irving, who is Black, died from complications of high blood pressure on Jan. 28, 2017 .

“My daughter had wanted a child more than anything on this earth,” Wanda Irving, Shalon Irving’s mother and Soleil’s grandmother, said in an interview with ABC News. “Soleil came to me and said, ‘Nonna, I want to die because I want to go where my mommy is. That’s the only way I’m going to get there.'”

Shalon Irving is part of a growing group of individuals, particularly Black women, dying from pregnancy-related complications several weeks or months after childbirth.

After her daughter’s death, Wanda Irving founded Dr. Shalon’s Maternal Action Project, an organization devoted to connecting Black women to resources and information about maternal mortality.

Data from the Centers for Disease Control and Prevention shows Black women die during and just after pregnancy at a rate 2.6 times that of white women.

A recent CDC report found the majority of maternal mortality cases — about 53% — occur after the first week of childbirth. Maternal deaths occur up to a year after delivery.

The causes vary based on race, with Hispanic and white women more likely to die from mental health conditions and Black women more likely to die from cardiac conditions, like the high blood pressure complications that killed Shalon Irving.

While every case is unique, CDC researchers estimated more than 80% of those deaths are preventable. Dr. Kamilah Dixon , a board-certified OB-GYN and maternal mortality expert at Ohio State University, said more awareness is needed.

“We still have to make sure that we are vigilant [even after childbirth],” Dixon told ABC News. “A lot of people think, ‘OK, we did it. All the risk is gone, and we don’t have to worry anymore.'”

One of the risks long after delivery is death from mental health conditions, which is the leading cause of maternal mortality overall, the CDC report found.

That includes deaths from suicide and accidental drug overdose. Blood loss is the second leading cause of pregnancy-related deaths.

The ongoing opioid addiction crisis in the U.S. contributes to the high rate of deaths from mental health conditions, said Dixon.

She said access to overdose-reversing drugs like Narcan is important to combat these deaths. Access to doulas and midwives could serve as mental and emotional support for individuals during pregnancy and after pregnancy.

Attention to cardiac health is key for Black women, who have the highest overall maternal mortality rates overall and are most at risk from heart conditions.

While the data doesn’t explain why pregnant Black women are more likely to die from cardiac conditions, CDC data from 2019 found Black Americans were 30% more likely to die from heart disease than their white counterparts.

Structural racism also plays a role in the stark inequities in maternal mortality, according to Dixon, who said differences between the types of conditions and issues affecting different demographic groups make it difficult to tackle the issue in a consistent way.

“I think it’s important to … understand what’s happening in particular communities so we can really target that,” she said, noting that different groups might need different types of interventions.

Still, big-picture policy changes can also play a role in driving change.

Congress passed a law in 2021 expanding Medicaid coverage for pregnant people from about two months to up to one year after childbirth, which will make resources more accessible to pregnant individuals.

“People need to know this is a problem we have here in the U.S.,” Dixon said. “I’ve had many patients in my office who’ve told me that they’ve chosen not to get pregnant because they don’t want to die.”

While pregnancy-related deaths are rare, individuals who want to become pregnant should be aware of the risks, according to David Goodman, Ph.D., a maternal mortality expert at the CDC.

“Be informed. Make sure that you are working with providers that you trust and have a relationship with,” Goodman told ABC News. “Don’t be afraid to walk away and find another provider as much as you are able.”

Home births are also on the rise, but Dixon and Goodman stressed that childbirths performed outside the hospital are riskier.

They said home births are unlikely to be a safe alternative for many pregnant people, who should consult their medical provider to discuss the options that might be safest for them.

In the meantime, families affected by pregnancy-related deaths, like Shalon Irving’s family, are taking their own steps to combat the problem.

Through the organization named for her late daughter, Wanda Irving helped create Believe Her , an app that provides maternal health resources for Black women and gives them a space to share their experiences.

Wanda Irving underscored that policy work is important, but she said lawmakers need to address structural racism to combat maternal mortality.

“Our whole system — everything — our foundation of America is built on racism, on the backs of Black and brown people. We need to recognize that, accept that and change it,” she said.

She added, “If we don’t start holding doctors accountable for the way that Black women are treated in the medical system, nothing is going to change.”

Aisha Bowen, M.D., is a resident physician in family medicine from Grant Family Medicine and a member of the ABC News Medical Unit.

Michal Ruprecht is a medical student at Wayne State University School of Medicine and a member of the ABC News Medical Unit.

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