Gendered Racism on the Body: An Intersectional Approach to Maternal Mortality in the United States

Scholars recognize sex and race as social determinants of health. However, demography research often ignores their derivatives (racism and sexism) and their contribution to racial inequality in maternal mortality. Based on weathering, the presence of both racism and sexism experienced in the United States likely leads to accelerated aging for women of color. Guided by intersectionality and weathering, this study examined the maternal mortality rates in the U.S. from 2015 through 2019 using formal demographic techniques. We measured maternal mortality rates two ways-using (1) maternal causes as an underlying cause of death and (2) as one of multiple causes of death. The Reproduction Rights Composite Index, created by the Institute for Women's Policy Research, served as a proxy for states-groups' support of women's health and gender equality. The overall maternal mortality rate was 59.4 (per 100,000 live births) using the underlying cause of death and 84.0 using the multiple cause of death for Black women, a 45% gap. This gap was greater for white women (83%), where the underlying cause of death maternal mortality rate was 24.2 while the multiple cause of death rate was 44.5. Controlling for age and women's reproductive rights' support, Black women's maternal mortality rates were typically double that of white women. Further, Black women's maternal mortality rates in their early twenties aligned with the maternal mortality rates of white women in their mid-thirties or older. Such findings reveal a complex relationship between gendered racism, weathering, and maternal mortality.