Maternal Health: A Strategic Imperative for Transforming U.S. Health Systems

Maternal mortality continues to rise in the United States. In 2023, the National Center for Health Statistics reported 18.6 maternal deaths per 100,000 live births; for Black women the rate was 50.3 — over three times that of white women (14.5) and higher than Hispanic (12.4) and Asian (10.7) women. The data presented depict system failure. Maternal outcomes are the benchmark of enterprise performance, revealing how well health systems can manage chronic disease, advance equity, and deliver coordinated, preventive care. This viewpoint calls for elevating maternal health from a siloed clinical program to a core strategic priority that advances quality, equity, workforce sustainability, and community trust. This article sets forth a leadership agenda that: embeds maternal metrics in executive dashboards with stratification by race, ethnicity, language, and geography; redesigns care pathways; strengthens workforce well-being and retention in frontline maternal care staff; and aligns incentives with value-based contracts to reward prevention and equity. Physician leaders should set the agenda now by breaking silos and making maternal health a systemwide imperative.