Preeclampsia Risks and Health Disparities Impacting Black Women

Preeclampsia Claims a San Antonio Mother Amid Strict State Regulations

Preeclampsia affects between two and eight percent of pregnancies annually in the United States, carrying severe risks that disproportionately impact Black women and their babies. The condition involves complex vascular dysfunction, inflammation, and placental impairments that can interfere with fetal growth and threaten maternal survival.

Key Clinical Takeaways:
• Preeclampsia impacts up to 434,000 women yearly in the United States, serving as a leading cause of preterm birth and maternal and fetal deaths.
• Black women develop preeclampsia at a 60% higher rate than white women and face heightened risks of severe outcomes, including kidney damage.
• A recent study indicates that Black women reporting high levels of everyday racism face 50% greater odds of developing the condition.

The Death of Tierra Walker and the Legal Challenge in Texas

The lethal convergence of severe pregnancy complications and restrictive state legislation became the focal point of a lawsuit filed in September. Tierra Walker, a 37-year-old mother residing in San Antonio, died in December 2024 during the 20th week of her pregnancy. Throughout her illness, Walker experienced seizures, a blood clot, erratic blood pressure fluctuations, and severe pain radiating from her head through her chest to her left foot. These symptoms align with the clinical hallmarks of preeclampsia. Prior to her death, Walker repeatedly requested to terminate the pregnancy because of the profound physical toll it took on her body. Following an investigative report published by ProPublica in 2025, Walker’s family filed a lawsuit in September against Texas Attorney General Ken Paxton and others, alleging that the state’s abortion ban led to her death.

Clinical Realities and Growing Disparities Across Demographics

Preeclampsia frequently presents after the 20th week of gestation, though symptoms can emerge earlier and escalate rapidly. When the condition reaches a severe stage, standard medical recommendations often involve ending the pregnancy early through delivery or abortion. Known risk factors include pregnancy in one’s teens or after age 35, obesity, a history of hypertension, and previous pregnancy complications. Walker previously experienced preeclampsia during a 2021 twin pregnancy that ended in intrauterine fetal death at 25 weeks. Data released in July by the Centers for Disease Control and Prevention showed that one in ten birthing mothers experienced gestational hypertension in 2024, marking a 73% increase since 2016.

Systemic Stressors and the Biological Toll of Racism

Beyond traditional physiological risk factors, recent research points to systemic racism as a distinct driver of health disparities in preeclampsia rates. A study published in April examined more than 5,000 Black women and found that those reporting the highest levels of everyday racism experienced 50% greater odds of developing preeclampsia compared to women reporting the lowest levels. Similar elevations in risk were observed among women who reported facing institutional racism in employment or interactions with police. Dr. S. Michelle Ogunwole, an assistant professor of medicine at the Johns Hopkins University School of Medicine and lead author of the study, emphasized that Black women are not monolithic and experience varying degrees of societal stress. Preeclampsia also persists beyond delivery, with risks extending into postpartum weeks and raising the long-term likelihood of chronic hypertension and cardiovascular disease.

Infrastructure Gaps and Policy Shifts Threaten Maternal Health

Addressing preeclampsia requires comprehensive prenatal and postpartum care, including consistent blood pressure monitoring and early interventions. Medicaid serves as the largest single payer of maternity care nationwide, financing 41 percent of all births in the United States and 47 percent in rural areas as of 2023. At the same time, maternity care services face severe shortages. One in three United States counties, predominantly in rural and low-income regions, lacks a single obstetric provider or birthing facility, and projections indicate that 44 states will have an inadequate supply of OB-GYNs by 2035. As legal challenges surrounding state-level abortion restrictions proceed through the courts, public health experts continue to examine how intersecting legislative changes and safety-net reductions affect outcomes for pregnant individuals.

Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.