Thompson and Johnson: New Hampshire Is Ranked No. 1 — But Black Mothers Still Aren't Safe

By Camilla Thompson and Tanisha Johnson, InDepth NH

Above, Tanisha Johnson is pictured. Courtesy photo

New Hampshire recently received the 2025 March of Dimes Report Card, and on paper, the state appears to be a national leader. We rank first in the nation for the lowest preterm birth rate and first for the lowest infant mortality rate. In a country where maternal health outcomes continue to decline, these achievements should not be overlooked. They show what is possible when a state invests in the well-being of families.

But as a state and as a community, we must confront a harder truth: these positive outcomes do not reflect the experiences of Black mothers and birthing people in New Hampshire.

Behind the Rankings, Stark Disparities Persist

A closer look at the data reveals a pattern that cannot be ignored.

According to the March of Dimes:

• Black mothers in New Hampshire are 2.3 times more likely to receive inadequate prenatal care than white mothers.
• Black infants in NH die at a rate 1.4 times higher than the state average.
• Nationally, Black women are 3–4 times more likely to die from pregnancy-related causes.
• The U.S. preterm birth rate for Black mothers (?14%) is nearly double that of white mothers.
• Families insured by Medicaid face significantly higher risks of complications and adverse outcomes compared to those with private insurance — further exposing inequities tied to income and access.

These disparities exist not because of individual behavior, but because of structural barriers: unequal access to care, implicit bias in clinical settings, a lack of culturally concordant providers, and the cumulative stress of navigating racism long before labor begins. These factors shape who is heard, who is believed, and who receives timely, appropriate care.

New Hampshire Cannot Lead Without Leading in Equity

If we want to remain a national leader, we must also lead in protecting the families at highest risk. That means:

• Expanding access to prenatal, labor, and postpartum support
• Ensuring Black women and birthing people are centered in maternal health policy
• Strengthening Medicaid coverage, doula reimbursement, and maternal mortality review systems
• Investing in community-based and Black-led support networks

This work must be structural, not symbolic.

As Camilla Thompson, Maternal Health Director at BLM NH, states:
“Equity is not a side project; it is the foundation. New Hampshire cannot lead the nation unless it leads in protecting the lives of those most at risk. If our systems do not work for Black mothers, then they do not work.”

Why BLM NH Leads This Work And Why We Will Not Stop

Every February, BLM NH hosts the only statewide conference focused exclusively on Black maternal health. This annual event brings together families, doulas, midwives, nurses, physicians, policymakers, and advocates from across New England to foster solutions and build accountability. We created this conference because Black voices needed a place to be heard, respected, and centered.

This year, BLM NH will launch a Maternal Health Toolkit designed to help families:

• Advocate for themselves during pregnancy and labor
• Understand their rights within hospital systems
• Identify warning signs and high-risk symptoms
• Prepare questions for medical providers
• Connect with doulas, lactation support, and local resources

Advocacy should not depend on privilege. This toolkit helps close that gap.

We work directly with hospitals and clinicians across New Hampshire to improve communication, address implicit bias, and support culturally informed care. Change requires partnership and we are committed to creating the dialogue needed to move systems forward.

Our partnership with NHPQC ensures that the experiences and safety of Black birthing people are included in statewide quality improvement initiatives, data reporting, and maternal health priorities.

Research demonstrates that doula support improves outcomes, reduces preterm births, and enhances the birthing experience; particularly for Black mothers. BLM NH continues to advocate for expanded doula reimbursement, more BIPOC doula training opportunities, and equitable access for Medicaid-covered families.

As Tanisha Johnson, Executive Director of BLM NH, often says:
“Rankings cannot be our measure of success. Safety, dignity, and equity for Black mothers must be.”

Changing outcomes means changing systems and that includes changing laws.

BLM NH strongly supports the WELLS Act, which strengthens patient protections, improves hospital accountability, and requires racial bias training. This legislation directly addresses preventable harms disproportionately affecting Black mothers.

As the 2026 legislative session approaches, several Legislative Service Requests (LSRs) are already in development that will impact maternal and reproductive health. While bill numbers are not yet assigned, BLM NH is monitoring proposals expected to include:

• Protections for reproductive autonomy, including safeguarding access to contraception and abortion care
• Bills proposing limitations or restrictions on reproductive health services, which could disproportionately harm low-income and Black families
• Efforts to strengthen maternal health data transparency, including race-based data collection
• Legislation affecting Medicaid coverage, postpartum supports, and insurance access
• Proposals that impact the doula workforce, licensing, or reimbursement pathways

Some of these bills will strengthen maternal health. Others may threaten access to care, widen racial disparities, or limit critical reproductive freedoms.

BLM NH will be advocating vigorously; supporting the legislation that protects families and opposing the policies that endanger them.
Because policy is not abstract: it shapes who lives, who thrives, and who is left unprotected.

New Hampshire can model what maternal justice looks like. But we cannot celebrate being number one while Black mothers are still being left behind. Our work continues until every birthing person in New Hampshire is heard, believed, supported, and safe not just in statistics, but in lived experience.

Author Bios

Camilla Thompson is the Maternal Health Director for Black Lives Matter New Hampshire, where she leads statewide efforts to improve maternal care access, equity, and outcomes for Black birthing people. She specializes in community-centered maternal health advocacy and systems change.

Tanisha Johnson is the Executive Director of Black Lives Matter New Hampshire and a leading advocate for racial and reproductive justice in the state. She works to strengthen community partnerships, advance policy change, and ensure that Black families are protected, supported, and heard across New Hampshire.

This article first appeared on InDepthNH.org and is republished here under a Creative Commons license.