Canadian linked-data study finds 66% higher severe maternal morbidity risk among Black birthing people

Researchers linked 2021 census self-reported race data to national birth, hospitalization, immigration and tax records across all provinces except Quebec for deliveries from 2012-2023. The analysis examined 108,805 births to Black people and 1,388,090 to white people, tracking 44 indicators of severe maternal morbidity including hemorrhage, preeclampsia, sepsis and cardiac events. Disparities persisted after adjustment for income, immigration status, and exclusion of sickle cell disease, HIV and preeclampsia, pointing to systemic factors rather than clinical case mix.

The findings align with U.S. CDC Pregnancy Mortality Surveillance and UK MBRRACE-UK reports showing Black women face 2- to 3-fold higher maternal mortality, yet this Canadian study adds population-level linkage that rules out income and immigration as sole explanations. It underscores how anti-Black racism in clinical decision-making, delayed recognition of symptoms and unequal postpartum follow-up produce measurable outcome gaps across every income stratum.

Next steps require mandatory race-disaggregated reporting in provincial perinatal databases, funded community co-design of care pathways, and antiracism training with outcome tracking. Without accountability metrics tied to funding, the 66% excess risk is unlikely to narrow.

Provincial health ministries should pilot race-stratified dashboards by 2026 and evaluate whether targeted quality-improvement bundles reduce the disparity within three years.