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Black people in Canada have an increased risk of severe maternal morbidity (SMM)—serious complications that can occur during pregnancy, labor or delivery, and postpartum—compared with white people, according to new research published in Canadian Medical Association Journal.

Severe maternal morbidity includes life-threatening conditions such as preeclampsia, hemorrhage, sepsis, heart conditions, uterine rupture, kidney failure and more.

Researchers conducted a study looking at the differences in SMM between Black and white people in Canada. The national study included data on almost 1.5 million births, including 108,805 to Black people and 1,388,090 to white people, from 2012 to 2023. Data were from Canada's 2021 long-form census, linked to national birth, hospitalization, immigration and tax information databases in all provinces and territories, excluding Quebec.

The rate of SMM was 47.8 per 1,000 among Black people compared with 27.7 per 1,000 among white people. After accounting for differences in sociodemographic and clinical characteristics, Black people had a 66% increased risk of experiencing SMM compared with white people. Rates were consistently higher among Black people across all types of SMM studied.

Importantly, differences in income and immigration did not explain the disparity. Black people had higher rates of SMM than white people across income levels and among both immigrant and nonimmigrant populations. The findings were also consistent when researchers excluded people with preeclampsia-related conditions, sickle cell disease and HIV—conditions that occur at different rates in Black and white populations and could potentially have contributed to the overall disparity.

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