Abstract
The Black maternal mortality crisis reflects the persistence of institutionalized racism embedded in the U.S. healthcare system. In Texas, Black women account for just 11% of births yet represent 31% of maternal deaths—a mortality rate more than twice that of their white counterparts. This staggering disparity has persisted, even as statewide initiatives have improved maternal outcomes for non-Black women. This Comment situates the current crisis within a broader historical continuum: from the coerced medical experimentation on enslaved Black women by figures such as J. Marion Sims, through the codified racism of the Jim Crow era, to present-day inequities ingrained in the healthcare system, including implicit bias and inadequate access to culturally responsive care. Drawing on a comparative analysis of California’s effective interventions—including the California Maternal Quality Care Collaborative, mandated implicit bias training, and expanded support for midwives and doulas—this Comment argues that advancing maternal health equity in Texas requires a fundamental reimagining of maternal care. Specifically, I propose a three-part framework: implementing community-based participatory research that centers Black women’s lived experiences; enacting robust implicit bias legislation; and expanding access to alternative models of care, while reforming eligibility criteria for critical social support programs. Without urgent and systemic intervention, Texas will continue to abandon its most vulnerable mothers—perpetuating a preventable public health crisis rooted in centuries of medical exploitation, racial discrimination, and persistent structural and social inequities.
Last Page
298
First Page
249
Recommended Citation
Karah Renfroe,
Shattering the Silence: The Path to Maternal Equity in Texas,
28
The Scholar
249
(2025).
Available at:
https://commons.stmarytx.edu/thescholar/vol28/iss2/3
Volume Number
28
Issue Number
2
Publisher
St. Mary's University School of Law
Editor
Priscilla Okolie
ISSN
1537-405X
