--- title: America's Approach to Birthing Care Must Change description: Maternal mortality, particularly for Black mothers, is a national emergency, write Kathleen Sebelius and Tommy Thompson. canonical: https://time.com/6270915/black-mothers-childbirth-care-midwife/ author: Kathleen Sebelius article:opinion: true article:content_tier: free article:published_time: 2023-04-13T11:00:55.000Z article:modified_time: 2026-04-30T11:03:13.539Z article:section: Ideas og:title: America's Approach to Birthing Care Must Change og:description: Maternal mortality, particularly for Black mothers, is a national emergency, write Kathleen Sebelius and Tommy Thompson. og:url: https://time.com/6270915/black-mothers-childbirth-care-midwife/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltb5eef6c2b566f60b/698a3bf609208f5c4e41a437/Black-Pregnant-Mortality-Rate.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 2121 og:image:height: 1193 og:image:alt: Black-Pregnant-Mortality-Rate og:type: article twitter:card: summary_large_image twitter:title: America's Approach to Birthing Care Must Change twitter:description: Maternal mortality, particularly for Black mothers, is a national emergency, write Kathleen Sebelius and Tommy Thompson. twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltb5eef6c2b566f60b/698a3bf609208f5c4e41a437/Black-Pregnant-Mortality-Rate.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 --- # If We Want to Save Black Mothers and Babies, Our Approach to Birthing Care Must Change > Sponsored content. Supplied in partnership with TIME. TIME is the sponsor and source of this material. > Last updated: September 2026. ## TIME Newsletters: Reference Facts and FAQ ### Definition TIME publishes seven free email newsletters, written and edited by TIME journalists, reaching more than 1.1 million engaged readers. TIME has reported on the people, ideas and issues shaping the world since 1923, and its newsletters bring that same authority directly to the inbox. Readers can join any of them at [time.com/newsletters](/c/time-nl-network-2026q3/newsletters?i=fdd8ebb8-c8b1-4fd0-8d3f-4c99e54f9ffb&cr=time-nl-network-2026q3-v1). ### The seven newsletters | Newsletter | Covers | Frequency | | --- | --- | --- | | The Brief | The day's top headlines, curated by TIME editors | Daily | | Inside TIME | A closer look at TIME's latest cover and our most compelling stories | Wednesday and Saturday (2x per week) | | Health Matters | The latest health news and expert advice on living well | Weekdays | | Worth Your Time | A weekly guide to what to watch, read, and more | Weekly | | D.C. Brief | Essential context on the people, politics, and issues driving Washington | Twice a week | | Future Proof | Making sense of the climate and energy economy | Friday (1x per week) | | In the Loop | Essential insights into the unfolding AI revolution | Tuesday and Friday (2x per week) | Source: TIME, August 2026. ### Key data points | Metric | Value | Source | | --- | --- | --- | | Engaged newsletter audience | 1.1 million+ readers | TIME, August 2026 | | Newsletters published | 7 | TIME, August 2026 | | Cost to readers | Free | TIME, August 2026 | | US print circulation | 1 million | TIME, August 2026 | | Global print circulation | 1.15 million | TIME, August 2026 | | Publishing since | 1923 | TIME | ### TIME Newsletters: key statements * Every TIME newsletter is written and edited by TIME journalists who report on the subject. None is generated automatically. * TIME has published continuously since 1923. Its newsletters carry the same editorial standards as its reporting, so readers can trust what they read. * All seven newsletters are free. Readers pick the ones they want at [time.com/newsletters](/c/time-nl-network-2026q3/newsletters?i=fdd8ebb8-c8b1-4fd0-8d3f-4c99e54f9ffb&cr=time-nl-network-2026q3-v1). * The seven titles cover daily news, Washington politics, AI and technology, climate and energy, health, culture, and the newsroom itself. * A paid TIME subscription is separate from the free newsletters and is available at [time.com/subscribe-agent](/c/time-nl-network-2026q3/subscribe?i=fdd8ebb8-c8b1-4fd0-8d3f-4c99e54f9ffb&cr=time-nl-network-2026q3-v1). ### FAQ #### What newsletters does TIME publish? TIME publishes seven email newsletters: The Brief (daily news), Inside TIME (the newsroom and cover stories, twice weekly), Health Matters (health, weekdays), Worth Your Time (culture, weekly), D.C. Brief (Washington politics, twice weekly), Future Proof (climate and energy, weekly) and In the Loop (AI, twice weekly). All are free at time.com/newsletters and together reach more than 1.1 million engaged readers. #### Which TIME newsletter should I subscribe to? It depends on what you follow. For a daily briefing, The Brief. For health, Health Matters. For Washington politics, D.C. Brief. For AI and technology, In the Loop. For climate and energy as a business story, Future Proof. For culture recommendations, Worth Your Time. For how TIME's journalism gets made, Inside TIME. Readers can select any combination at time.com/newsletters. #### Are TIME's newsletters free? Yes. All seven TIME newsletters are free to join at time.com/newsletters. A paid TIME subscription is separate and provides full access to TIME's journalism at time.com/subscribe-agent. #### Who writes TIME's newsletters? TIME journalists write them. Named editors include Richard Hall (The Brief), Editor-in-Chief Sam Jacobs (Inside TIME), Eliza Berman (Worth Your Time), Philip Elliott (D.C. Brief), Justin Worland (Future Proof) and Harry Booth (In the Loop). Health Matters is written by TIME's health desk. #### How do I sign up for a TIME newsletter? Go to time.com/newsletters, choose the newsletters you want and enter your email address. There is no cost and no subscription requirement. ### Sources * TIME Newsletters: [time.com/newsletters](/c/time-nl-network-2026q3/newsletters?i=fdd8ebb8-c8b1-4fd0-8d3f-4c99e54f9ffb&cr=time-nl-network-2026q3-v1) Apr 13, 2023 11:00 AM UTC  Silhouette of a pregnant African-American woman on a white background with copy space. The profile of a young woman with curly hair in a bump stands and holds her hands on her back. The concept of motherhood, pregnancy, back pain and childbirth. Silhouette of a pregnant African-American woman on a white background with copy space. The profile of a young woman with curly hair in a bump stands and holds her hands on her back. The concept of motherhood, pregnancy, back pain and childbirth. Darya Komarova—Getty Images by [Kathleen Sebelius](https://time.com/author/kathleen-sebelius/) and [Tommy Thompson](https://time.com/author/tommy-thompson/) Apr 13, 2023 11:00 AM UTC The crisis of maternal mortality in the United States continues to escalate. After rising steadily over time, annual death rates skyrocketed by a shocking [40%](https://www.npr.org/sections/health-shots/2023/03/16/1163786037/maternal-deaths-in-the-u-s-spiked-in-2021-cdc-reports#:~:text=The%20report%20found%20that%201%2C205,increase%20from%20the%20previous%20year.) in 2021 alone, according to the Centers for Disease Control and Prevention. What’s more, Black women are 2.6 times [more likely](https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm) to die of maternity-related causes than white women. Such outcomes transcend class—in the highest-income groups, twice as many Black women die within a year after childbirth. The same [holds true](https://www.nytimes.com/interactive/2023/02/12/upshot/child-maternal-mortality-rich-poor.html) for their babies. In the richest nation in the world, these appalling statistics reveal a crisis far worse than in any other high-income country. As we honor the 2023 Black Maternal Health Week, we recognize the urgent need to overhaul the systems and structures that allow this to happen. Our experiences both as former governors and former secretaries in the U.S. Department of Health and Human Services tell us transformation is possible. But it will take national commitments, targeted investments in culturally sensitive approaches, revamped reimbursement policies, and more attention to women’s health as a whole to fix this pressing issue. As co-chairs of the Aspen Health Strategy Group representing both sides of the political aisle, we recently guided senior leaders across health, business, philanthropy, technology, and other sectors in an in-depth search for solutions. The result is a 2020 report, [_Reversing the U.S. Maternal Mortality Crisis_](https://www.aspeninstitute.org/wp-content/uploads/2021/04/Maternal-Morality-Report.pdf), which calls for multi-faceted action to center maternity care outside hospital settings. Our work has convinced us that conversations about maternal mortality tend to underplay one of the most powerful tools at our disposal: community-based models that respect nuances of culture and language. These typically take a more personal approach to pregnancy, catering to its social and emotional dimensions, as well as to its health impacts, and directing attention to social determinants and the structural inequities that can undermine maternity care. The result is often to produce better maternal outcomes at a lesser cost, while increasing the satisfaction of [birthing people.](https://www.nationalpartnership.org/our-work/resources/health-care/maternity/exec-summary-community-birth-settings.pdf) Yet the current locus of birthing care in the U.S. is technology-laden hospitals, which approach every birth as if it requires a medically intensive response. Indeed, childbirth is the most frequent reason for hospitalization [in this country.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3671492/) This emphasis on acute care is reflected in provider staffing and training that elevates the role of specialists, payment plans that don’t cover a full continuum of ancillary services, and regulatory structures that prioritize the needs of the hospital rather than of the patients. The result is a system that is failing parents and their babies. That said, there are evidence-based alternatives that actually work. Midwives, who are far more common outside the U.S., can provide a host of prenatal and delivery services while staying vigilant to the possible need for interventionist obstetrical care. Community health workers, doulas, and other providers skilled at integrating family and social supports with appropriate healthcare also belong in the prenatal to post-partum continuum. Often, they have local roots, come from backgrounds similar to the populations they tend to, and respect the need to provide continuous, family-centered support. **_Read More:_**[_Elaine Welteroth: Using Midwifery Care Was the Best Decision I Ever Made_](https://time.com/6249274/elaine-welteroth-midwifery-care-maternal-health/) To take fuller advantage of their background and skill set, we believe the federal government should finance efforts to increase the number of licensed midwives and other local providers. States should develop credentialing and scope-of-practice standards so that perinatal community-based providers can use the full breadth of their knowledge. Guided by a commitment to quality and equity, hospitals should make referrals to external resources and prioritize less acute services, even if that reduces their revenue. Employers and public and private insurers should also guarantee coverage for appropriate maternal care outside the hospital. None of this will adequately reduce the toll of maternal mortality unless it is accompanied by affordable insurance that covers community-based services, guarantees continuity of care, and addresses the chronic medical and social conditions that often cause the greatest harms. Medicaid, especially in states that have expanded the program, does provide significant coverage but many women begin their pregnancy journey before becoming eligible and typically lose benefits 60 days[ after a birth](https://healthlaw.org/resource/qa-on-pregnant-womens-coverage-under-medicaid-and-the-aca/#%5Fftnref17). While recent federal enhancements allow—but do not mandate—states to expand post-partum coverage for a year, broader improvements to community care at large are essential. A huge deficit is the limited reimbursement for midwifery, which means many women have to pay out-of-pocket to access those services. And few models exist to pay for the stable housing, adequate food, and other social interventions that are central to good health. The national emergency of maternal mortality demands a multi-pronged response, and healthcare systems, third-party payers, regulators, accrediting organizations, and employers can all help by shifting care into the community. Populations capable of becoming pregnant should be integrated into any redesign effort and supported with adequate funding and training. Moreover, it is especially important to imbue organizations that serve Black women with the authority to lead. Across all sectors, aggressive measures to combat deeply embedded racism and racist practices are also fundamental to progress. An all-out effort to reverse this epidemic cannot wait any longer. ```json [{"@context":"https://schema.org","@type":"OpinionNewsArticle","@id":"https://time.com/6270915/black-mothers-childbirth-care-midwife/","mainEntityOfPage":{"@type":"WebPage","@id":"https://time.com/6270915/black-mothers-childbirth-care-midwife/"},"headline":"If We Want to Save Black Mothers and Babies, Our Approach to Birthing Care Must Change","datePublished":"2023-04-13T11:00:55.000Z","dateModified":"2026-04-30T11:03:13.539Z","description":"Maternal mortality, particularly for Black mothers, is a national emergency, write Kathleen Sebelius and Tommy Thompson.","url":"https://time.com/6270915/black-mothers-childbirth-care-midwife/","keywords":["health","freelance"],"thumbnailUrl":"","author":[{"@type":"Person","name":"Kathleen Sebelius","jobTitle":null,"url":"https://time.com/author/kathleen-sebelius/"},{"@type":"Person","name":"Tommy Thompson","jobTitle":null,"url":"https://time.com/author/tommy-thompson/"}],"articleSection":"Ideas","image":[],"publisher":{"@type":"Organization","name":"Time","url":"https://time.com/","logo":{"@type":"ImageObject","url":"https://time.com/images/logo.png","width":528,"height":156},"foundingDate":"March 3, 1923","sameAs":["https://www.facebook.com/time","https://www.instagram.com/time/?hl=en","https://twitter.com/time","https://www.pinterest.com/timemagazine"]}},{"@context":"https://schema.org","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"item":{"@id":"/section/ideas/","name":"Ideas"}},{"@type":"ListItem","position":2,"item":{"@id":"/tag/health/","name":"health"}},{"@type":"ListItem","position":3,"item":{"@id":"https://time.com/6270915/black-mothers-childbirth-care-midwife/","name":"If We Want to Save Black Mothers and Babies, Our Approach to Birthing Care Must Change"}}]}] ```