Birth Equity

California Birth Equity Collaborative
Improving Care, Experiences and Outcomes for Black Mothers

The California Birth Equity Collaborative is a CMQCC quality improvement initiative to improve birth care, experiences and outcomes for Black mothers and birthing people in California. Our team is comprised of partnerships between CMQCC and participating hospitals and their local communities.



Since 1999, the reported maternal mortality data in California show a persistent 3-4x gap between Black mothers and mothers from all other racial groups. Between 1999 and 2006, maternal mortality rates nearly doubled in California, and CMQCC was founded in 2006 at Stanford University School of Medicine together with the State of California. Since CMQCC’s inception, California’s maternal mortality rate has declined by 55 percent while the national maternal mortality rate continued to rise. The expectation was that widespread adoption of CMQCC’s clinical safety bundles would reduce the gap in the number of maternal deaths among Black women. However, despite the reduction in Black maternal mortality rates, the difference in outcomes for Black mothers compared with all other racial groups has persisted.

Thus, CMQCC’s Birth Equity Collaborative presents an opportunity to develop QI tools to promptly evaluate and transform birth care, experiences, and outcomes through the integration of clinical and sociocultural interventions.

  • Data shows that even in the absence of risk factors such as maternal age over 35 years, lack of health insurance, inadequate or no prenatal care, and less than high school education, the U.S. system of health care is not protecting Black mothers and birthing people from experiencing higher numbers of deaths or life-threatening complications during pregnancy and childbirth.
  • Increasing evidence points to racism within and across multiple levels, and not race, as a key cause of these birth disparities.
  • Data also show variations in the maternal outcomes by race across hospitals in California, highlighting opportunities for advancing equity in quality improvement.
With our California Birth Equity Collaborative pilot, CMQCC aims to transform birth care for Black mothers and birthing people in California in partnership with participating pilot hospitals.