Maternal Health Inequities During the COVID-19 Pandemic

Challenges, promising advances, and opportunities to promote equitable care.

A young mother holds her infant son, who has a pacifier in his mouth.

The COVID-19 pandemic has prompted dramatic changes to the delivery of maternal health care in the United States, but long-standing racial inequities persist as the pandemic continues to take a disproportionate toll on communities of color.

The Issue

Payers, providers, health systems, and communities lack data on maternal outcomes disaggregated by race and ethnicity, creating uncertainty as to how pandemic-related changes to maternity care may be affecting pre-existing inequities.

Key Findings

  • COVID-19 necessitated shifts away from traditional interventionist maternity care like Caesarean sections and labor inductions. The pandemic simultaneously increased patients’ and policymakers’ interest in alternative care models like birth centers and doula services. 

  • Expanding and diversifying the maternal health workforce is critical for promoting more culturally and linguistically effective care and addressing inequities. Pandemic-related staffing shortages have underscored this need.  

  • Though the pandemic has disrupted care delivery, stakeholders are optimistic that access to care could be strengthened by federal and state policies that ease restrictions on telehealth and expand health insurance coverage.


Throughout and after the pandemic, the United States has been and will continue being challenged to change maternal health care delivery and financing to ensure equitable outcomes. Researchers discuss multiple policy proposals that could innovate maternal health care and reduce existing disparities.

About the Urban Institute
The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.