Pregnancy Complications Hit Black Canadians Harder, Says the First National Study

For years, Black women in Canada have described having their pain brushed aside during pregnancy and childbirth. And for years, the answer they heard was that Canada had no data to show the problem. That data now exists, and it backs them up.

The evidence comes from a study published October 5, 2026, in the Canadian Medical Association Journal. It is the first national, population-based analysis of racial gaps in serious pregnancy complications in Canada. Researchers examined 108,365 hospital deliveries to Black parents and 1,385,810 to white parents across Canada, excluding Quebec, between 2012 and 2023, as CBC News reported.

The bottom line. Black parents in Canada experienced severe maternal morbidity, the medical term for life-threatening complications, at a rate of 47.8 per 1,000 live births, compared with 27.7 per 1,000 for white parents. Once the researchers accounted for differences in demographics, income, and health, that gap meant a 66 percent higher risk. The authors stress that race itself is not the cause.

Key takeaways

The study covered 108,365 deliveries to Black parents and 1,385,810 to white parents in Canada, excluding Quebec, from 2012 to 2023.

Severe maternal morbidity occurred at 47.8 per 1,000 live births for Black parents and 27.7 per 1,000 for white parents.

After adjusting for demographic, socioeconomic, and clinical differences, Black parents faced a 66 percent higher risk.

Higher income was linked to better outcomes for white parents, while complication rates for Black parents rose with income.

In a 2025 national survey of nearly 2,000 Black women, girls, and gender-diverse people, about 42 percent said they had delayed or avoided care over fears of how they would be treated.

A severe headache, vision changes, chest pain, trouble breathing, heavy bleeding, or sudden swelling during or after pregnancy needs urgent assessment.

What does the study show about Black maternal health in Canada?

The researchers measured severe maternal morbidity, which covers complications serious enough to threaten a parent's life or long-term health. The most common were severe pre-eclampsia, severe hemorrhage, and sepsis. Pre-eclampsia is a dangerous rise in blood pressure during pregnancy, hemorrhage means heavy bleeding, and sepsis is the body's extreme reaction to an infection.

These pregnancy complications occurred at a rate of 47.8 per 1,000 live births for Black parents, compared with 27.7 per 1,000 for white parents. The gap showed up in every type of complication the researchers studied, and the McMaster University summary of the study lays out those findings in plain language.

Numbers like these have been missing until now. Giulia Muraca, a perinatal epidemiologist and associate professor of obstetrics and gynecology at McMaster University, is a co-senior author of the study. She told Medscape that Canada had lacked the kind of data other countries use to track these gaps. That is what makes this national picture of Black maternal health in Canada so important.

Why do racial gaps in pregnancy care persist?

The study did not look at causes, and its authors say plainly that being Black does not cause these complications. They describe race as a social category with no biological basis for these differences, and they point instead to structural and systemic factors, including anti-Black racism. The gap also held after the researchers accounted for other health conditions that occur at different rates in different communities.

Income makes the picture even clearer. Higher income was linked to better outcomes for white parents, yet complication rates for Black parents rose as income went up. Muraca described this to CBC News as a pattern of diminishing returns, where structural marginalization blunts the advantages that more money would normally bring.

Community research tells a similar story. In a national report released in 2025, the Black Women's Institute for Health surveyed nearly 2,000 Black women, girls, and gender-diverse people, as Global News reported. About 42 percent said they had delayed or avoided care because they feared how they would be treated. That kind of hesitation can widen racial gaps in pregnancy care, since many serious complications are easier to treat when a provider catches them early.

How does Canada's maternal health data compare with the U.S. and the U.K.?

Other countries started measuring this problem years ago. In the United States, the Centers for Disease Control and Prevention has long reported that Black women are about three times as likely as white women to die from a pregnancy-related cause. In the United Kingdom, the MBRRACE-UK national enquiry into maternal deaths found that Black women were more than twice as likely to die during or soon after pregnancy between 2021 and 2023.

Canada's new maternal health data tracks serious complications instead of deaths, so the numbers are not a direct match, although they point the same way. Severe bleeding is one of the most common of these complications, and treating it often depends on donated blood. That is one reason Canada's blood supply matters to every expectant parent.

What does this study mean if you are pregnant in Canada?

For Black Canadians who are pregnant or planning to be, this study confirms what many have described for years. It does not predict what will happen to you, and in every community, most births in Canada end safely. What it changes is the conversation, moving it from personal stories to documented evidence that hospitals and health systems now have to answer to.

Muraca told Medscape that closing these gaps will take support from governments, health-care partners, and Black communities, including partnering with those communities to design and evaluate services. As she told CBC News, universal health care has not yet meant universal access for everyone, which is worth remembering for anyone pregnant in Canada.

Which pregnancy warning signs need urgent care?

The most practical thing to take from this research is knowing when to act. Some symptoms always deserve prompt medical attention during pregnancy and in the weeks after birth. They include a severe headache that will not go away, changes in your vision, chest pain, trouble breathing, heavy bleeding, and sudden swelling, especially in the face or hands. If you notice any of these, call 911 or go to the nearest emergency department, and do not let anyone talk you out of being checked.

Learning these pregnancy warning signs before you need them makes it easier to act fast. Emergency departments across Canada are under real strain, as our explainer on the emergency room staffing crisis shows, yet serious symptoms in pregnancy are exactly what they are there for.

How can you make sure you are heard at prenatal appointments?

Being heard often starts long before an emergency. Care during pregnancy works best when it begins early and you trust the people providing it. These steps can help at prenatal appointments, especially if you have ever worried about being taken seriously.

Bring a support person. A partner, friend, relative, or doula can take notes, ask questions, and speak up alongside you.

Write your symptoms down. Record dates, times, and details, since a written record is harder to dismiss than a memory.

Ask for it in your chart. If a provider brushes a concern aside, you can ask them to document it in your medical record.

Seek a second opinion. You are entitled to another provider's view, and because specialist wait times in Canada can run long, it helps to ask early.

Look for culturally responsive care. Some Canadian communities have Black-led health programs, such as the Nova Scotia Sisterhood in Dartmouth. You can also search for providers near you who fit your needs.

Bring questions about everyday risks too, such as heat exposure during pregnancy. And if you are still waiting for a family doctor, a walk-in clinic can handle early concerns in the meantime. You are far from alone in that wait, as our look at Canada's family doctor shortage explains.

What are people asking about this study?

What counts as a severe complication during pregnancy?

Doctors use the term severe maternal morbidity for pregnancy complications serious enough to threaten a parent's life or long-term health. The most common include severe pre-eclampsia (dangerously high blood pressure), severe hemorrhage (heavy bleeding), and sepsis (an extreme reaction to infection). They can happen during pregnancy, during labour and delivery, or in the six weeks after birth.

Why do Black parents face higher risks during pregnancy in Canada?

The CMAJ study did not examine causes, and its authors stress that being Black is not the cause. They point to structural and systemic factors, including anti-Black racism, and note that the gap persisted after accounting for income, health conditions, and other differences. Surveys also show that many Black women delay care because they fear being dismissed.

What should you do if a provider dismisses your symptoms during pregnancy?

Ask the provider to record your concern in your chart, bring a support person to your next visit, and keep a written log of symptoms with dates. You are entitled to a second opinion. For warning signs such as a severe headache, vision changes, chest pain, or heavy bleeding, call 911 or go to the nearest emergency department.

Did the study include Quebec?

The study did not include Quebec. It used national hospital data from the rest of Canada, covering 108,365 deliveries to Black parents and 1,385,810 deliveries to white parents between 2012 and 2023. That makes it the first population-based national analysis of racial gaps in severe maternal complications, although Quebec's experience remains unmeasured in this research.

What is your next step?

Building a care team you feel safe with is one of the best things you can do during pregnancy. The Medimap Health Hub has more guides for every stage, and Medimap can help you find a family doctor or clinic near you, so you feel heard from the first appointment on.

Disclaimer. This article is for general information only and is not medical advice. Talk to a qualified health professional about your own situation. If you think you are having a medical emergency, call 911 or go to the nearest emergency department.