The United States continues to face a critical and persistent maternal-health crisis, with significant disparities in outcomes, particularly for Black mothers. As joint research from the Institute for Economic Mobility and the McKinsey Health Institute reveals, Black mothers are up to five times more likely to die from pregnancy-related causes than women in other OECD countries, and up to four times more likely to face complications as women of other races in the US. While awareness of this problem has grown, the healthcare industry is now challenged to move from acknowledging the data to implementing meaningful, sustainable actions that save lives. This requires a shift in strategy: rather than treating maternal health as a single episode of care, viewing it as a continuous journey connected to a woman’s overall health and the social implications that shape it.
In this landscape, Joy Rhoden, senior vice president of Health Outcomes and Care Transformation at the American Hospital Association (AHA), is a leading voice for change. Representing nearly 5,000 hospitals and health systems, the AHA plays a central role in mobilizing the healthcare field to systematically reduce health disparities. Rhoden’s work focuses on empowering member hospitals and the healthcare field at large with tools and strategies to address disparities and improve care delivery and the patient experience.
In a conversation with McKinsey Senior Expert Fadesola Adetosoye, Rhoden discusses what separates leading health systems from those struggling to make progress on maternal health. She outlines the vital role of leadership, data-driven interventions, and authentic community partnerships. Her passion is evident as she makes a powerful case for why valuing maternal health is not just a moral imperative but an economic one with profound implications for families, communities, and the national economy. An edited version of the conversation follows.
Three traits for maternal-health progress
Fadesola Adetosoye: What separates health systems that are successfully progressing on improving maternal health from those that may be struggling to move from awareness to action?
Joy Rhoden: The health systems that are making real progress share several common characteristics:
- Leadership: There is a strong leadership commitment from both the clinical and administrative sides. When leaders clearly articulate that maternal health is a quality and safety priority—not a side initiative—it sets the tone from the very top. This includes engaged boards who see the quality dashboards, look at the maternal-health “swim lane,” and ask probing questions of senior leadership.
- Data: They demonstrate a willingness to look beyond national statistics and understand their own performance. We know the headline story—that Black women are dying at three times the rate of their White counterparts—but leading organizations should know their own story. What is the experience of moms coming into their hospitals? Then they can use those internal insights to design targeted interventions.
- Humility: They approach the work with humility and person-centeredness. They understand that there are people behind that data. They are willing to move outside institutional walls, partner with communities, and deliver culturally responsive care.
Health system innovation and accountability
Fadesola Adetosoye: How can health systems innovate better, and how can they do a better job of holding themselves accountable for results?
Joy Rhoden: I don’t think we need an entirely different set of metrics; hospitals are already collecting many of the right data points. The key is the self-interrogation of that data. How do you make it actionable? Also, we should look at the experiences of women in our hospitals and health systems: Are they feeling heard and respected? The challenge is disaggregating that data across different demographic factors—race, ethnicity, insurance type, age, employment status, and educational level. These are factors that, frankly, should not impact outcomes, but we know that they do.
The responsibility is to slice and dice the data in ways that may reveal uncomfortable truths, and then implement codesigned actions with the community. A compelling example is the work Cedars-Sinai did in Los Angeles.1 Admittedly, this one is a soft spot for me—it’s where my only child was delivered. They looked at their maternal-health data and found that eligible Black women were not being offered low-dose aspirin for preeclampsia prevention at the same rate as their White counterparts. In response, they launched a full-blown educational campaign for patients and partnered with trusted community messengers like the March of Dimes. They educated pharmacies and built an alert into the electronic health record to help providers identify eligible patients. As a result, the utilization of low-dose aspirin for Black moms more than tripled [essentially closing the treatment gap]. That’s a powerful example of using data to guide interventions.
The promise—and caution—of AI
Fadesola Adetosoye: There is a lot of conversation right now around artificial intelligence. What is the opportunity for AI within health systems, specifically regarding maternal health?
Joy Rhoden: It should be top of mind for every hospital or health system CEO. Otherwise, you’re not reading the tea leaves. At the AHA, we have a strategy group focused on innovation, and embedded in that work is assessing the promise of AI to advance things like predictive analytics—predicting who is likely to return to an emergency department [ED] setting, for example—and looking at population health metrics.
On the clinical side, we see a lot of use of ambient AI, which can record conversations so providers can be more present with the patient. However, one of the tensions for our members is separating the hits from the hype. We want to use technology appropriately because, if it’s not deployed responsibly, it could exacerbate disparities. It should act as an enabler to augment care, particularly in rural areas where ensuring access to specialty care at tertiary centers is critical.
Shifting from ‘healthcare’ to ‘health’
Fadesola Adetosoye: We often talk about maternal health as if it’s a single episode. But the journey for a mom doesn’t stop at delivery. How are leading health systems thinking about this issue?
Approximately 50,000 women experience severe maternal morbidity each year. That’s a staggering figure.
Joy Rhoden: Maternal health doesn’t start with pregnancy or end with delivery. It’s crucial to move further upstream. How do we help young women interested in becoming moms enter pregnancies with the right health posture? We’re seeing more women entering pregnancy with chronic conditions. Health systems are responding by shifting the conversation from healthcare to health. And we can’t do it alone. The medical-care dollar cannot be split in all these different ways. We must enter into effective partnerships to address housing stability, food insecurity, interpersonal or domestic violence, and transportation needs. All of these issues are tied to health and live largely outside the healthcare system.
On the back end, after a mother gives birth, the focus often shifts entirely to the baby. We cannot forget moms. A big role we can play as hospital leaders is to educate all the touchpoints moms might have in the postpartum period—her partner, family, emergency medical services [EMS] first responders, pediatricians who see the baby for follow-ups, ED providers, et cetera. Are they all fully educated on the potential postpartum signals?
Morbidity, defined by health conditions caused or worsened by pregnancy, is real. The last US data I saw indicated that approximately 50,000 women experience severe maternal morbidity each year.2 That’s a staggering figure.
Fadesola Adetosoye: Thinking about the maternal-health journey holistically, how should hospital systems solve for the unique needs of Black women during their maternal journey?
Joy Rhoden: Having a team that is culturally aware and culturally informed—to respond to the unique needs of Black mothers—is vital. Concordant studies show that when patients connect with their provider on a cultural level, it leads to higher patient satisfaction and better treatment adherence. For example, research shows that health outcomes for Black newborns improve substantially when they are cared for by Black physicians. But the reality is, we can’t produce enough Black ob-gyns and pediatricians to take care of all Black mothers and babies.
Consequently, it’s important that we build the skill sets of other care team members so that they understand the broader bio-psycho-social context of their patients. Because biases are inherent: We all have them, and they become a problem when inserted into the care plan. Leading health systems are also expanding the definition of the maternal workforce to include doulas and community health workers. They are trusted voices who can help moms navigate the healthcare environment, translate medical terminology, and advocate for themselves. That is really where the secret sauce lies. But hospitals can’t solve this alone; they must work with assets communities already possess.
A compelling example of this comes from Akron, Ohio, where Summa Health partnered with Project Ujima and the Minority Behavioral Health Group because their traditional prenatal care models were not working for Black moms and low-income patients. Through weekly group prenatal sessions with a consistent care team and access to Black ob-gyns, certified community health workers, and health counseling, they saw phenomenal results: increased breastfeeding rates and decreased preterm birth rates and infant mortality.3
At the AHA, we’ve begun the Better Health for Mothers and Babies Initiative. We’re able to catalog innovative practices across the country and present them to our nearly 5,000-member hospitals and health systems. We aim to reduce preventable maternal morbidity and mortality by understanding our data, looking at disparities, centering on patients and communities, and engaging the workforce.
The economic imperative
Fadesola Adetosoye: Closing the Black maternal health gap is not a health imperative alone. It impacts the economic fidelity of families, communities, and society writ large. How does that lens change the conversation you have with health system leaders?
Joy Rhoden: You’re spot on. The moral case has been made. Now, when talking to hospital CEOs, we’re leaning into the economic imperative. As this health gap is a growing burden on the GDP, we’re releasing a report soon on the economics of disparities. A recent national study estimates that these disparities cost the US hundreds of billions [$451] of dollars annually and, if left unaddressed, are expected to keep growing.4 It’s a problem we can’t afford to ignore.
The conversation has to shift to focus on health as our outcome. When you start to value maternal health economically, you see it as a community stabilizer. It impacts job participation, workforce participation, and the ability of families to remain intact and contribute. When we don’t address these poor outcomes, the long-term consequences include increased utilization in the ED, longer hospital stays, and increased caregiving needs. Those are massive added costs to the system.
Policy, payment, and practical solutions
Fadesola Adetosoye: Looking five years ahead, which policies or actions do you think will have the greatest impact on improving Black maternal-health outcomes?
Get outside of your institutional walls ... so that solutions are cocreated with a cultural lens.
Joy Rhoden: Coverage is foundational. It is the entry point into coordinated care versus fragmented care, so ensuring the gains we’ve made remain intact is vital. I am very encouraged by the expansion of Medicaid up to one year postpartum across most states.5 But coverage doesn’t equate to access; we also have to solve the access problem and ensure we have providers willing to care for these patients.
Beyond policy, low-tech, high-impact ideas are being tested. For example, many hospitals are piloting visible, neon-colored wristbands that signal to an ED or EMS provider that a mom is in the immediate postpartum period. Other health systems are providing wallet cards for moms to present at the ED, or giving blood pressure cuffs at discharge for home monitoring. We sometimes think solutions have to be highly technological, but these low-cost interventions hold incredible promise. However, payment practice is often far out. So we need payment reform and policies that spur these right behaviors.
What’s next?
Fadesola Adetosoye: If you could have every hospital CEO commit to one action in the next 12 months, what would it be?
Joy Rhoden: Get outside of your institutional walls. Go into the community—not once, not twice, but consistently. Talk to Black moms and the people who live in those communities. Listen, learn, and take those learnings back to your leadership teams. But more importantly, invite those same voices into the conversation so that solutions are cocreated with a cultural lens. The humility required in this work cannot be overstated. You don’t build trust by only showing up with an ask. You have to show up and show yourself as being trustworthy.
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