New Report: Alabama’s Maternal Health Crisis Puts Black Moms at Risk

A new report from the ACLU of Alabama is highlighting the dangers of giving birth in the state and the racial disparities that prove Black women are being hit the hardest.

The organization’s new Moms Matter report calls Alabama the most dangerous state in the country for pregnancy and childbirth, highlighting a maternal health system where access to care, racial disparities and geography can determine whether someone brings a healthy baby home.

“Alabama must rethink how we approach maternal health, but that work shouldn’t begin in committee rooms in Montgomery,” Executive Director of the ACLU of Alabama JaTaune Bosby Gilchrist said in a statement. “It should begin in the living rooms and community centers where families have been navigating this reality every day.”

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According to the report, Alabama’s maternal mortality rate is 65 deaths per 100,000 births, nearly twice the national rate. For Black women, that figure climbs to 100 deaths per 100,000 births.

Those aren’t just numbers on a spreadsheet. They represent mothers, daughters, sisters and families left to deal with an outcome that should be far less common in a country with world-class medical resources like the United States.

The ACLU’s report is based partly on more than a year of community conversations about pregnancy and childbirth. Researchers held listening sessions in six Alabama communities – Selma, Montgomery, Tuscaloosa, Birmingham, Mobile and Anniston – and spoke with Alabamians about their experiences navigating maternal healthcare.

What they heard points to problems that start long before someone reaches a delivery room.

A mom in Alabaster told ALCU the hospital closest to her closed its OBGYN unit, forcing her to search for care farther away from home. “I am concerned about the hospital closures and lack of accessible care in Alabama. I live 30 minutes from my hospital,” she said. On average, pregnant people in Alabama face a 17-mile, 23-minute trip to the nearest birthing hospital.

The ACLU reports that 34% of Alabama counties are maternal health deserts, meaning residents in those areas lack adequate access to maternal healthcare. Hospital closures and shortages of providers can turn a routine prenatal appointment into a long-distance trip–or make getting care nearly impossible, especially in an emergency.

The Black women surveyed also echoed experiencing a problem with the healthcare system that has existed for generations: being heard when they say something is wrong.

“I’ve experienced discrimination in healthcare settings all my life,” one mom in Tuscaloosa said. “From withholding health information, being repeatedly dismissed, healthcare workers being aggressive and abrasive to me, etc. I have issues getting the help I really need.”

The report highlights discrimination in healthcare settings, barriers to mental healthcare and other systemic problems that can make pregnancy and the postpartum period more dangerous.

To address these issues, the ALCU recommends policies that improve maternal and reproductive healthcare, particularly for Black women and marginalized families, including supporting more accessible birthing options such as freestanding birth centers.

The ACLU also emphasizes community-driven policymaking, arguing that Alabama should build solutions around women’s lived experiences rather than leaving decisions solely to lawmakers and institutions.

The community findings aim to help shape policy recommendations aimed at improving maternal and infant health in Alabama. But the takeaway from the report is already pretty clear: Black mothers shouldn’t have to be lucky to survive childbirth.