What Legacy Wants You to Know About the Black Maternal Health Crisis

As Medical Director of Obstetrics and Gynecology at Legacy Community Health, Dr. Erica Giwa works every day inside one of the most serious public health crises in the country. She sees firsthand how deeply the Black maternal health crisis affects mothers, babies, and entire communities — and why Legacy’s work must go beyond care to meet the moment.

“The reality is devastating,” she said. “In Harris County, Black mothers experience the highest maternal mortality rate in the country, and the majority of those deaths are preventable. These aren’t just numbers. They’re families changed forever.”

What the Data Shows

A report from Harris County Public Health documented a pregnancy-related death rate of 83.4 per 100,000 live births among Black women in the county between 2016 and 2020, the highest recorded for any county in the United States.

These numbers clarify why Legacy’s work must go beyond traditional care models.

That number is not improving nearly fast enough. Nationally, the CDC reported Black women had a maternal mortality rate of 50.3 deaths per 100,000 live births in 2023, far above White, Hispanic, and Asian women. Houston reflects the most severe end of a nationwide problem.

And it is not a problem that education or income can solve on its own. Black women in Harris County with college degrees still face a 60 percent higher risk of maternal death than White and Hispanic women who never finished high school. That statistic points to something structural inside healthcare itself, something Dr. Giwa understands well.

“The problem isn’t Black mothers,” said Dr. Giwa. “It’s the system around them. Too often their symptoms are overlooked, their pain is minimized, and their concerns aren’t acted on quickly enough.” Her job at Legacy, the way she describes it, is not just clinical. It’s corrective. “Our role is to catch problems earlier, act faster, and remove every barrier that keeps Black mothers from safe, respectful, and responsive care.”

Pregnancy-Related Deaths Are Preventable

A 2024 report from the Texas Maternal Mortality and Morbidity Review Committee found that 80 percent of pregnancy-related deaths in the state were preventable. Dr. Giwa builds her work around that number.

Legacy Community Health is the number one federally qualified health center (FQHC) in Texas by patient count, . It is also the top FQHC in the country for prenatal care by patient volume. The organization served nearly 200,000 patients last year across more than 60 clinics along the Gulf Coast, and provides care regardless of insurance status or ability to pay.

This commitment reflects Legacy’s belief in Health Beyond Care — supporting mothers medically and emotionally throughout pregnancy and beyond.

One of the programs Dr. Giwa is most emphatic about is Legacy’s Prenatal Navigation model.

“Prenatal navigation is one of the most powerful tools we have,” she said. “From the very first day, sometimes even the first pregnancy test, we assign a navigator who stays with the patient through pregnancy, postpartum, and into pediatric care.”

Navigators handle scheduling, bilingual support, transportation, childcare, and connections to community resources. The goal is continuity, making sure no one falls through the gaps between appointments or after delivery.

That last part matters more than most people realize.

“The postpartum period is one of the riskiest and most overlooked stages of maternal health,” she said. “We stay close during the fourth trimester because too many mothers are lost after delivery, not during it.”

Legacy’s postpartum support includes blood pressure monitoring, depression screening, lactation consulting, and continuity through the Ob2Pedi program that bridges obstetric and pediatric care.

Extra Care for Higher-Risk Patients

For higher-risk patients, Legacy pairs hands-on navigation with the Delfina Care platform, which supports remote monitoring of blood pressure, glucose, and weight between appointments, along with 24/7 doula access and virtual classes on nutrition, breastfeeding, and postpartum wellness.

Through its Delfina Care platform, Legacy has seen outcomes that include 48 percent fewer preterm births, 68 percent fewer NICU admissions, 44 percent fewer hypertensive disorders, and 58 percent fewer gestational diabetes cases.

“We are especially vigilant about high blood pressure and preeclampsia, because they remain leading causes of preventable maternal death,” Dr. Giwa said. “We don’t wait for problems to escalate. We act early, we monitor closely, and we make sure our patients know the warning signs.”

Black Maternal Health Is a Crisis With a Solution

When Dr. Giwa talks about maternal health, she comes back to the same point again and again: Black mothers deserve care that is safe, respectful, and responsive. Yet far too often, the system does not deliver that promise, which is exactly why Legacy steps in. It’s the reason Legacy designs care models that look beyond symptoms and address the full context of a mother’s life.

“Maternal deaths are preventable, and we know the solutions,” she said.

Black Maternal Health Week, observed April 11 through 17, was created to amplify the experiences of Black mothers. For Houston, this week is not just symbolic. Rather, it’s a moment to take stock of what is still being lost and what can be done right now.

If you are pregnant, planning to become pregnant, or supporting someone who is, Legacy Community Health offers free walk-in pregnancy testing, prenatal navigation, and full OB/GYN services across Houston. Care is available regardless of insurance or ability to pay.

Call (832) 548-5000 or visit legacycommunityhealth.org/services/obgyn-maternity to connect with a team that will see you, hear you, and stay with you.