The most comprehensive study yet of maternal health in Canada has found Black Canadians face a much higher risk of serious complications during pregnancy, labour, delivery and postpartum than white people — underlining the urgent need for better data tracking and tools to eliminate systemic anti-Black racism in our health-care system, researchers and advocates say.
The research, published Monday in the Canadian Medical Association Journal (CMAJ), looked at more than 108,000 in-hospital deliveries to Black people, and more than 1.3 million in-hospital deliveries to white people across the country between 2012 and 2023.
Researchers found that severe maternal morbidity, encompassing complications such as pre-eclampsia, hemorrhage and sepsis, occurred at a rate of 47.8 out of 1,000 live births for a Black parent compared to 27.7 out of 1,000 live births for a white parent.
Even when researchers accounted for other factors like age, immigration status or other health conditions, Black people still had a 66 per cent higher chance of experiencing these potentially life-threatening complications.
The data lines up with what advocates have been saying for years — that Black women have their pain dismissed and routinely face barriers when navigating maternal care.
“It’s huge to finally have this, you know, so-called proof and evidence that we’ve been told that we need to have in order to really prioritize Black communities and reproductive health,” said Cheyenne Scarlett, co-founder of the Black Birth Project, a non-profit aimed at improving reproductive outcomes for Black people in Canada.
She told CBC News that she has first-hand experience with the cracks in Canada’s maternal care: She once went to the ER with an ectopic pregnancy, and says she was sent home without receiving proper treatment.
“This report is not at all shocking to me,” she said.
Official data shows Black women in the U.S. are three times more likely to die in pregnancy or childbirth than white women. They are twice as likely in the U.K., while a 2021 study from The Lancet found that Black women had a 43 per cent higher risk of miscarriage.
But similar long-term demographic data has been lacking in Canada until now, despite years of calls for it.
“As Canadians … we’ve been able to distance ourselves from the very real reality of the fact that although universal health care is so important, it still doesn’t mean universal access for everyone,” Giulia Muraca, associate professor of obstetrics and gynecology at McMaster University, told CBC News.
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The higher rates of complications for Black people persisted when researchers controlled for conditions that occur in different rates in Black and white populations, such as sickle cell disease, with authors noting in the study that the consistent disparity “suggests broader structural influences on maternal health.”
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And while a higher income correlated with an improvement in maternal outcome for white parents, the study found that rates of severe complications increased for Black parents along with their income — an example of a “diminishing returns” phenomenon, Muraca suggested, in which those who experience structural marginalization don’t receive the same advantages of an increased income.
The study didn’t look at causes, but its authors stress that these differences don’t stem from race itself.
“Being Black is not the cause of these differences,” Muraca said. The evidence that Black patients are experiencing “less equitable outcomes,” she said, should prompt us to start examining “inequities in access … differences in communication, in escalation of care, in differences in treatment, for example.
“These are things that we can start to now collect routine data on and hold institutions accountable for.”
The struggles Black people face in Canada just trying to access health care is something that community organizations have been studying independently for years.
“So me, as a Black woman, when I go into the hospital, when I’m in front of a practitioner, how are they responding to me?” Kearie Daniel, executive director and founder of the Black Women’s Institute for Health, said. “Are they going to see my pain the same way that they’re seeing someone else’s?”
A national survey released by the Black Women’s Institute for Health in 2025 looked at the experiences of nearly 2,000 Black women and girls with Canada’s health-care system. It found that 42 per cent avoid seeking medical care because they were afraid of how they might be treated.
When it came to maternal care, some women reported fearing their children might be taken from them after staff summoned social workers with no justification, Daniel said. Others dealt with miscarriages at home rather than risk poor treatment at the hospital. Many reported their pain was ignored.
“They’re giving birth in the emergency bathroom, in the waiting room, they are being turned away,” Daniel said.
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She said during her own pregnancy, her mother kept stressing she needed to dress well when going to the hospital, concerned that she wouldn’t be taken seriously.
“Having to go into a system that really isn’t seeing your full humanity when you’re depending on them to do so for your survival and the survival of your baby is just so — ‘demoralizing’ is not the right word. It’s not a heavy enough word to really articulate just how excruciating it is.”
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Research has shown that Black people in Canada often suffer higher risks of negative health outcomes, including with breast cancer and during the COVID-19 pandemic. Enduring disparities have their roots in historical injustices that shaped modern medicine, according to a recent report set to publish this fall in the Canadian Ethnic Studies journal.
To ensure equitable maternity care, what’s needed now, Daniel said, is real action from governments and health-care organizations.
Better staff training is important, but it must be paired with the tracking of race-based data along with other socioeconomic differences, she said, to monitor if interventions are actually improving health outcomes for Black people.
Although some regions began tracking race-based health data after the pandemic, it’s still fractured across the country.
“There has to be accountability,” Daniel said. “We are dying as a result of not having that.”
Canada’s health-care system also needs to work with community organizations to create truly informed care, advocates say.
Althea Jones founded Ancestral Hands Midwives in 2024, meant to help Black people get better pregnancy care. She said it’s frustrating to have to prove what community members have known for years, but she’s still hopeful this study might lead to more funding for interdisciplinary, Black-led care.
“I think people need care that reflects them,” she said. “They need to be seen and heard.”
Jenelle Ambrose Dash, chair of the Black Maternal Health Collective Canada, echoed the call. Every April, her organization runs Black Maternal Health Week in Toronto, bringing together groups like Ancestral Hands to share research and educate others.
She added that there needs to be more funding for health care in general, noting that the current “overwhelmed” system only exacerbates inequity.
When she heard about the CMAJ study, she saw her own story — a previous traumatic experience with pre-eclampsia — reflected in the data. She’s determined to ensure that no Black parent has to go through what she did.
“There are real people behind the numbers,” she said.
“I hope that something will be done coming out of this study. We’re well past the point of awareness. We are looking for accountability now.”
