My doula clientʼs baby was born dead, and within minutes, my doula client was dead, too.
As her body went into shock while the staff was focused on her newborn, I saw her become anxious, then panicked, then disoriented, then vacant. The life left her eyes as I screamed her name.
Maternal mortality is a very real but overlooked justice issue. Culturally, we view dying in childbirth as a tragedy of a bygone era, not something that claims lives every day. In Nigeria, 75,000 people perish giving birth every year — thatʼs one death every seven minutes.
People assume that childbirth in the U.S. is markedly different from that in Nigeria and most of sub-Saharan Africa. And it is — our 2024 maternal mortality rate was 17.9 per 100,000 births. Although the U.S. rate is minuscule compared to Nigeriaʼs nightmare situation, it’s a crisis of another kind. Despite spending the most money on maternity care, our maternal mortality rate is the highest among high-income nations — and the only developed nation with an increasing rate. More women die from pregnancy-related causes in America than do in Iran. Only three women die per 100,000 births in Japan; in Iceland itʼs zero.
We also have outcome discrepancies from state to state: a mother giving birth in Louisiana is over four times more likely to die than one in California. And for every maternal death in the US, there are 70-80 patients who suffer a near-death event.
But the most appalling aspect of our maternal mortality crisis is racial: the Black maternal mortality rate is 50.3 per 100,000 births, about three times the rate of their white peers. Indigenous women die more than twice as often as white women.
And BIPOC women bear the brunt of obstetric violence, the abuse of pregnant or mothers giving birth by healthcare professionals. This includes but is not limited to non-consent, gaslighting, neglect, coercion, shaming, and physical violence.
A Crisis We Can No Longer Ignore
For most of U.S. history, maternal mortality was treated as a tragic and private matter, “one of the inexorable laws of nature.” Pregnancies were largely unavoidable due to a lack of birth control, and childbed fever claimed many lives before germ theory was understood. There was no federal public health effort to decrease U.S. maternal mortality until the early 20th century, when data collection began to save infantsʼ lives.
In the 1940s, with the advent of sulfonamide antibiotics and improvements in obstetric care, U.S. maternal deaths decreased sharply. Our national rate continued to decline until the late 1990s when it started rising again as a consequence of maternity care deserts, chronic health conditions, ingrained racial biases, unjust policies, and, more recently, the COVID-19 pandemic.
The maternal health crisis should startle us as Christians. God commands us to care for others and uphold the dignity of human life; moreover, Jesus himself held womenʼs experiences in high esteem. Throughout the Gospels, Jesus consistently saw, healed, restored, and dignified women who were often overlooked by society. From the woman at the well (John 4:1-26) to the woman who bled for 12 years (Matt. 9:20-22) to the woman caught in adultery (John 8:1-11), Christ consistently expressed concern for vulnerable women.
When Nicodemus asked Jesus what he must do to inherit eternal life, Jesus used the metaphor of childbirth to explain spiritual transformation (John 3:1-8):
“Very truly I tell you, no one can see the kingdom of God unless they are born again…unless they are born of water and the Spirit.” (vs. 3, 5)
Jesus likened salvation to perhaps the most visceral of womenʼs experiences: birth. As a newborn baby results from pregnancy and the delivery process, so would Nicodemus have to undergo the Spiritʼs conversion and be born anew.
In describing his impending death to his disciples on the night he was betrayed, Jesus employed birth imagery again, but this time from the mother’s perspective. John 16:21 says,
“A woman giving birth to a child has pain because her time has come; but when her baby is born she forgets the anguish because of her joy that a child is born into the world.”
Even on his way to Golgotha, Jesus stopped to address the women who were mourning and spoke about the suffering that awaited mothers in the coming judgment.
Despite being in a “huge crowd,” despite Simon carrying Romeʼs murder weapon just behind him, and despite having just been mocked, beaten, and spat on (Mark 15:17-20, Matt. 27:28-31), Jesus paused to tell the wailing women not to cry for him, but for their children (Luke 23:27-31).
“The time will come when they will say, ‘Happy are those who are unable to become pregnant, the wombs that never gave birth, and the breasts that never nursed a child.’” (v. 29)
In a few words, he addressed infertility, childbirth, breastfeeding, and the perpetual vulnerability of motherhood.
I find it particularly poignant that Jesus invoked childbirth during his Passion. The Latin passio means “to suffer,” and during Christʼs suffering, he referenced birth twice, both times from the motherʼs point of view. During his Passion, Jesus twice employed childbirth imagery to speak about suffering and hope. Jesusʼ attention to maternity amidst horrendous abuse suggests he valued mothers and recognized the magnitude of their experiences.
The New Testament continues to use birth imagery: “born of God” (1 John 4:7), “gave birth” (James 1:18), “newborn babies” and “spiritual milk” (1 Peter 2:2), and “new life” (Romans 6:4). The Early Church recognized the transformation inherent in the birth process as a powerful way to explain the paschal mystery and new life.
We, too, should follow Christʼs example (1 Cor. 11:1). As Christians, we are to imitate God (Eph. 5:1-2) and love our neighbors (Mark 12:30-31), all of whom bear Godʼs image (Gen.1:27). As Christians, we honor all life as sacred, and Jesus shows us that mothers are among those whose dignity and flourishing matter deeply to God. God the Father also demonstrates care for mothers. “The God who sees” helped Hagar when she was pregnant and on the run (Gen. 16:11-13), and the God who hears blessed Leah with children after listening to her cry that she was unloved (Gen. 29:33).
True religion, according to the Book of James, is to “look after orphans and widows in their distress” (1:27). Perhaps caring for orphans should include preventing children from being orphaned in the first place, and one way to do that is by ensuring mothers survive childbirth.
A Faithful Response
To that end, thereʼs plenty for the concerned Christian to do.
- Consider voting for Congress members who support the Momnibus Act, a comprehensive bill that simultaneously targets numerous components of maternal health.
- Advocate for the same conditions present in all countries that have fewer maternal deaths: universal healthcare and paid parental leave, robust support during the postpartum period, and integrated midwifery care.
- Get involved with the work of Black Mamas Matter Alliance.
- Contribute to SisterSongʼs Birth Justice Care Fund or a scholarship program to train Black midwives. Spread awareness regarding maternity care deserts.
- Because American postpartum care is lacking, parents need robust community and church support. If someone in your circle has a baby, consider bringing them a meal, doing their dishes, or taking their three-year-old to the playground.
- Ask your OBGYNʼs office if theyʼre open to partnering with local doulas to improve outcomes.
- Find out if your state has a Perinatal Quality Collaborative and think about how you might support them.
Six hundred forty-nine women in the U.S. died from pregnancy-related causes in 2024, and as someone who has seen maternal mortality unfold in real time, I assure you it ruins lives. It orphans children and leaves partners in anguish. It turns what is supposed to be a joyous event into a major trauma.
In the vein of “water, water everywhere but not a drop to drink,” too often American maternity care — like American healthcare in general — is “money, money everywhere but not to save a life.”
Given that Jesus repeatedly used childbirth imagery to speak about suffering, hope, transformation, and new life, Christians today might ponder the imagery in reverse: the spiritual phenomena of Christianity can inform our understanding of pregnancy and birth.
As people of faith, we know what it is to go through a trial, to long for a positive outcome on the other side, and to be made a new creation (2 Cor. 5:17). Our hearts should be tender toward a population so intimately familiar with the same.
I recall Christʼs words that he came to bring us life and life to the full (John 10:10), and a life cut needlessly short by maternal death is hardly a full life. Teresa of Avila reminds us that we are Christʼs hands and feet in the world — it is up to us to make “life to the full” possible for birthing people.
Halley Kim writes about faith and social justice, and she is working on her first book. In the past, she’s worked as a nurse, lactation consultant, doula, midwifeʼs assistant, pastoral assistant (UCC), and grassroots organizer. Her work has been featured in Baptist News Global and Feminism and Religion, as well as on numerous podcasts. She lives with her husband, three school-aged children, and a very spoiled dog in St. Louis, Missouri. Connect with her on Instagram, Substack, or HalleyKim.com.
