Recently, the Leapfrog Group, an independent national nonprofit calling for better and safer patient care, released its 2025 Maternity Care Report. The report provides a comprehensive analysis of unique national data from hospitals representing 80% of inpatient beds in the United States—data not available from any other source. Leapfrog reports on key aspects of maternity care, including C-sections, episiotomies, and early elective deliveries, as well as the availability of patient-requested services such as doula support, certified midwives, and more.
The striking new findings from Leapfrog Group’s Maternity Care Report show that in 1 out of every five hospitals, Black patients are significantly more likely to have a C-section than white patients, even when treated at the same facility. Nationally, Black women are nearly three times more likely to die from pregnancy-related causes than white women, according to the CDC, making these hospital-level disparities even more alarming.
Additional key findings:
- C-section rates are rising again for low-risk, first-time moms.
- Midwife access is still lacking, especially in the South.
- 1 in 7 hospitals lacks a policy to prevent early elective deliveries, which can lead to worse outcomes and higher costs.
- The report encourages families to research their own hospitals and demand transparency about what services are offered and what risks exist.
Katie Stewart, Director of Health Care Ratings, The Leapfrog Group:
Why was it essential for Leapfrog to conduct this Maternity Care Report?
It is essential for Leapfrog to conduct this report to bring attention to critical trends in maternity care, especially areas where progress is stalling or worsening. For example, C-section rates for low-risk, first-time mothers are rising again after previously declining before the COVID-19 pandemic. The report also highlights racial disparities in C-section rates for low-risk, first-time mothers, revealing gaps in quality that urgently need to be addressed.
What was the intention behind this report?
The main goal of our survey aligns with our overall mission as a national nonprofit—to improve health care through transparency. That’s our intention and hope for this report. In our 25-year history, we’ve seen time and time again how transparency galvanizes change. One example of how Leapfrog’s reporting has spurred improvements nationally is seen in our 2025 Maternity Report. Episiotomy rates have improved by 73% since we publicly reported this data in 2012.
What does this report say about Black women who are mothers or who would like to be?
The report reveals troubling disparities for Black women in maternity care. Leapfrog data shows one out of every five hospitals reports a gap in C-section rates for low-risk, first-time Black mothers compared to low-risk, first-time White mothers. The report underscores the urgent need for changes ensuring all women receive safe and equitable care during pregnancy and childbirth. Black women who are pregnant or plan to become pregnant should be aware that not all hospitals are the same when it comes to quality and safety. Leapfrog’s resources are free and available here.
It can be very beneficial to bring an advocate to the hospital who can help on your behalf—a partner, doula, friend, or family member—who can support you throughout labor, delivery, and postpartum hospital care. Visit the Black Doulas Association or DONA to learn how doulas can help and connect with one in your area.
LaToshia Rouse, CD/PCD, Certified Birth and Postpartum Doula, Owner of Birth Sisters Doula Services.
How can hospitals improve care for Black Women and reduce unnecessary C-sections?
The statistics are clear: Black women in the U.S. are more likely to experience complications during childbirth, including unnecessary C-sections and complications from C-sections. Black women are far less likely to feel heard and supported in hospital settings. This does not lend to a setting that supports the physiological birth process. Feeling safe and being safe are necessary.
Clear, evidence-based protocols to guide labor management can help reduce unnecessary C-sections. Decisions should be based on the best evidence available and shared with the patient, who should provide informed consent. Hospital routines often prioritize speed and efficiency over physiological birth. Hospitals can support safer and healthier labor by encouraging movement, comfort measures, and patience. Partnering with doulas can improve all of these aspects.
How Doulas Are Changing the Game in Black Maternal Health
Doulas are trained professionals who provide emotional, physical, and informational support during pregnancy, birth, and postpartum. They’re not medically trained like doctors or midwives, but they are powerful allies for women navigating a system that often fails them. Research shows that having a doula can lower the risk of C-sections and reduce the use of unnecessary medical interventions. Why? Doulas help labor progress naturally and give people the tools and confidence to make informed decisions. Doulas help bridge the communication gap, ensuring that their clients’ voices are heard and that medical teams understand their patients.
Many doulas share lived experiences with their clients and offer culturally relevant support. That kind of connection can be life-changing, especially when dealing with trauma, fear, or mistrust of the healthcare system. Doulas are trusted coaches, educators, and non-judgmental supports that uplift Black families long after the baby is born.