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Black midwives are going beyond conventional care to help communities confront the persistent U.S. maternal healthcare crisis. As pregnancy-related complications and mortality rates remain alarmingly high—particularly among Black women—midwives are increasingly spotlighted in an all-hands-on-deck approach to saving lives.
Dr. Kaytura Felix, a physician and distinguished scholar at the Johns Hopkins Bloomberg School of Public Health, spent over two decades studying structural racism and health inequities. As the crisis deepened, she began asking a different question: What is the Black community already doing to save Black mothers?
That search led her to Black midwives and inspired her multi-city research project, the Black Birthing Futures study, and her podcast, Deep Care. Her work arrives at a critical time. According to the American Midwifery Certification Board’s 2024 report, fewer than 10 percent of the nation’s 14,500 active midwives are Black. Financial barriers and systemic racism remain major hurdles to entering the field.
In this edited interview, Dr. Felix discusses her findings and the restorative power of community-based care.
Q: How did Black maternal health become your focus?
Felix: In 2023, I shifted from studying medical racism to looking at community solutions. Experts told me, “Look to Black community midwives.” As a physician, I initially thought midwifery was from another era. Then I shadowed a midwife’s postpartum visits. I watched a 10-day postpartum visit unfold entirely in a mother’s bedroom, wrapping care around her. It struck me that the midwife’s role extended to the whole family, which is vital since the majority of maternal deaths occur postpartum.
Q: What issues are driving this crisis?
Felix: Many Black Americans live in historically underinvested communities with more pollution and financial precarity. We enter pregnancy already “weathered.” Weathering occurs when the body runs on overdrive to stabilize itself against constant systemic challenges, accelerating aging. The body is often at capacity before pregnancy even begins.
Q: What is saving the lives of Black mothers right now?
Felix: Two things. First, doulas in hospitals, who reduce stress and help catch complications early. Second, community births in birth centers and at home. Midwives treat pregnancy as a physiological process rather than a medical emergency. They provide love, support, and vital education on nutrition and physical health.
Q: What are your goals for the Deep Care podcast?
Felix: Black women need to know all their birthing options. The barriers to midwifery are financial, but there is also a stigma within the Black community that we need to dismantle. Midwives are trained, educated and competent.
We need a bigger footprint for midwifery in this country, better transitions from community care to hospital care, and policies that support midwives. It is irresponsible to talk about the challenges without also advancing the solutions. We have only begun to scratch the surface.
