Despite being one of the most critical pillars of public health, maternal health remains underfunded, underresearched, and persistently unequal. This article explores the systemic disparities that contribute to poor maternal outcomes in the United States, from racial and geographic inequities to the lack of targeted pharmaceutical development. It also highlights emerging innovations — from digital health tools and AI-driven diagnostics to new care models and global best practices — that show real promise for transforming maternal care. By examining cross-sector solutions, policy frameworks, and the growing investment landscape, the piece outlines a comprehensive agenda for progress. At its core, it argues that the tools for change exist — and now, the focus must turn to coordinated, equity-centered implementation. Maternal health is not a niche concern; it is a strategic, scalable opportunity for innovation and impact.
A Silent Crisis and Missed Opportunity
Throughout an era marked by revolutionary advances in medical science — from gene editing and precision oncology to real-time digital health monitoring and AI-driven diagnostics — maternal health remains stubbornly rooted in a different timeline. While pharmaceutical pipelines overflow with novel therapies for chronic diseases and rare conditions, few are designed specifically with pregnant people in mind. And while the digital transformation of healthcare promises to bring care closer to the patient, millions of women in both urban and rural settings still face barriers to receiving even the most basic maternal care.
The consequences of this persistent neglect are as staggering as they are unacceptable. The United States has the highest maternal mortality rate among high-income nations, with sharp disparities along racial, geographic, and economic lines.1-3 These outcomes are not random. They are the result of systemic underinvestment, outdated models of care, and a longstanding tendency to treat women’s health — and particularly maternal health — as a niche rather than a core focus of medicine and innovation.
This is not just a failure of public health but a missed opportunity for transformation. Despite representing half the population and a vast share of healthcare spending, women’s health remains underrepresented in drug development, clinical research, and investment portfolios.4,5 Maternal health is particularly overlooked, often excluded from large-scale funding and policy discussions that shape the direction of biomedical innovation.
Yet maternal health is uniquely positioned to benefit from the convergence of biopharmaceutical advances, digital health tools, and policy innovation. It sits at the intersection of primary care, mental health, chronic disease prevention, and health equity — an ideal proving ground for scalable, cross-cutting innovation. Elevating maternal health is not just the right thing to do — it is a strategic imperative for building a more responsive, inclusive, and resilient health system.
Maternal Health Today – Deep Disparities, Systemic Failures
Despite advancements in medical science, maternal health in the United States remains fraught with significant disparities and systemic shortcomings. These issues are particularly pronounced along racial, geographic, and socioeconomic lines, contributing to adverse outcomes for many women and infants.
Racial disparities are among the most alarming aspects of maternal health inequities. Black women, for instance, face a maternal mortality rate approximately 2.5 times higher than that of non-Hispanic white women. This stark contrast persists even when controlling for factors such as income and education, underscoring the pervasive impact of systemic racism and implicit biases within healthcare systems.6 Social determinants of health — including access to quality education, stable employment, and safe housing — further exacerbate these disparities, leading to higher rates of preterm birth and other complications among Black women.1,7
Geographic disparities also play a critical role in maternal health outcomes. Rural regions face unique challenges, with over one-third of U.S. counties classified as maternity care deserts — areas lacking hospitals or birth centers offering obstetric care and without obstetric providers. This situation affects more than 2.3 million women of reproductive age, predominantly in states like North Dakota, South Dakota, Oklahoma, Missouri, Nebraska, and Arkansas. Women residing in these areas are at a 13% higher risk of preterm birth compared with those with full access to maternity care.8 The closure of hospital obstetric units in rural communities has further limited access, compelling women to travel long distances for prenatal and delivery services, thereby increasing the likelihood of adverse outcomes.9
Clinical gaps in postpartum and perinatal care further compound these issues. Many women, particularly those enrolled in Medicaid, encounter challenges in accessing comprehensive maternal health services. The Centers for Medicare & Medicaid Services (CMS) has initiated the Transforming Maternal Health (TMaH) Model to address these gaps by enhancing access to midwives and doulas, improving prenatal care for chronic conditions, and reducing unnecessary procedures like cesarean sections for low-risk mothers.10 Nonetheless, significant work remains to ensure consistent and equitable care throughout the perinatal period.10
Despite decades of research and numerous recommendations aimed at improving maternal health, progress has been limited. In 2008, Fisk and Atun highlighted the scarcity of drugs under active development for maternal health conditions, representing less than 3% of the pipeline in cardiovascular health.11 More recent analyses indicate that this "drug drought" persists, with only a modest increase in the number of maternal health drugs in development.12 This ongoing neglect reflects broader systemic failures to prioritize and invest in maternal health, leaving critical needs unmet and perpetuating existing disparities.
Addressing these deep-rooted inequities requires a multifaceted approach that encompasses policy reforms, increased funding for maternal health research and services, and targeted interventions to eliminate racial and geographic disparities. Only through comprehensive and sustained efforts can the United States hope to improve maternal health outcomes and ensure equitable care for all women.
Innovation That Meets the Moment – Digital Tools and Tech Solutions
The persistent challenges in maternal health call not only for renewed investment, but also for the bold adoption of innovative technologies that can bridge longstanding gaps in care. Digital health tools — long heralded for their potential to transform healthcare — are beginning to make meaningful inroads in maternal health, offering scalable solutions to longstanding barriers in access, continuity, and quality of care.
Telemedicine, mobile apps, artificial intelligence (AI)-based monitoring systems, and wearable devices are increasingly being integrated into maternal care pathways, particularly for managing high-risk pregnancies and monitoring postpartum recovery. Remote monitoring tools can track vital signs such as blood pressure and fetal heart rate, enabling earlier interventions for conditions like preeclampsia or gestational hypertension.13 Mobile health platforms are being used to send reminders for appointments, provide access to culturally tailored educational content, and connect patients to community-based support networks.14 At the cutting edge of these efforts, AI-powered models are helping providers assess real-time risk levels and guide clinical decision-making based on individualized patient data.15
Outside the United States, promising innovations are also emerging, especially in low- and middle-income countries (LMICs) where digital solutions are being deployed to expand the reach of maternal care. In Uganda, a pilot program is using AI to enhance ultrasound scans, enabling frontline providers to detect complications early and refer patients for timely care. The technology, which guides users through image acquisition and automatically identifies anomalies, has helped increase early antenatal visits and reduce complications.16 These tools are designed with accessibility in mind, enabling use by healthcare workers with minimal formal training — an approach that holds lessons for underserved communities everywhere.
Domestically, community-based technology platforms are being leveraged to improve maternal and infant outcomes through real-time data sharing and community feedback. Dashboards that integrate clinical and social data are helping health systems and local organizations identify service gaps, improve coordination, and evaluate the impact of their interventions.17 These platforms are especially valuable in designing community-specific responses, where understanding neighborhood-level variation in health outcomes is key.
Recent studies have also demonstrated the promise of AI-driven maternal care solutions for early risk detection and intervention. A bibliometric analysis of emerging maternal health technologies confirms that Industry 4.0 tools — including AI, Internet of Things (IoT) devices, and data analytics — are being used to lessen the burden on clinical staff while maintaining high-quality monitoring of pregnant patients.18 The integration of these technologies is not a sci-fi dream — it is happening now, with demonstrable effects on maternal health indicators.
One notable example of institutional support for these innovations is the Enhancing Maternal Health Initiative from the Health Resources and Services Administration (HRSA). This multi-pronged program invests in workforce development, telehealth infrastructure, and cross-sector partnerships, while also encouraging the adoption of innovative care models and health IT solutions.19 It reflects a growing recognition that addressing maternal mortality and morbidity requires not only clinical care improvements but also systems-level innovation that reaches women where they are.
Taken together, these digital tools and technology-driven solutions offer more than incremental improvements — they represent a new architecture for maternal care, one that is data-enabled, patient-centered, and scalable across geographies and risk profiles. But for these innovations to reach their full potential, they must be supported by appropriate policy frameworks, reimbursement structures, and sustained investment in equitable implementation.
The Pharmaceutical Gap – Maternal Health in Drug Development
While technological innovation has begun to reshape maternal care delivery, the pharmaceutical sector continues to lag behind in meeting the specific needs of pregnant and postpartum individuals. Maternal health remains one of the most underrepresented areas in drug development, not only in terms of targeted therapeutics but also in the structure of clinical trials themselves.
One of the most persistent barriers to pharmaceutical innovation in maternal health is the routine exclusion of pregnant individuals from clinical research. Concerns about fetal safety and liability have long driven this exclusion, resulting in a near-total absence of safety and efficacy data for many drugs used during pregnancy.12 This leaves clinicians to make critical decisions based on limited evidence, often resorting to off-label use or withholding potentially beneficial treatments entirely. As early as 2008, experts were calling attention to this void: less than 3% of cardiovascular drugs under development at the time were being evaluated for pregnancy-specific applications, despite high maternal morbidity from hypertensive disorders.11 More than 15 years later, this fundamental disconnect remains largely unresolved.
This lack of targeted pharmaceutical development extends beyond safety data to the broader pipeline of therapeutics. There is a scarcity of new drugs designed specifically to prevent or treat common maternal health conditions, including gestational hypertension, preeclampsia, gestational diabetes, and postpartum depression. Despite clear clinical need, innovation in maternal vaccines and therapies tailored to physiological changes during pregnancy remains minimal.2,5 Postpartum mental health — an area with profound implications for both parent and infant — also remains dramatically underfunded relative to its burden of disease.
Advocacy is mounting for the safe inclusion of pregnant individuals in research protocols and clinical trials. Recent years have seen increased efforts to develop frameworks that allow for rigorous, ethical participation without compromising fetal safety. These include phased protocols, adaptive trial designs, and the establishment of pregnancy registries. Researchers and ethicists are calling for regulatory incentives to encourage pharmaceutical companies to include pregnant people in their studies, arguing that exclusion poses its own form of risk by perpetuating therapeutic uncertainty.7 A growing consensus holds that with appropriate safeguards, inclusion is not only possible — it is essential.
Emerging tools may also help mitigate the challenges historically associated with maternal clinical research. Pharmacokinetic modeling and simulation tools can be used to predict drug behavior in pregnant populations, allowing developers to refine dosage and safety parameters before entering large-scale trials. AI algorithms are increasingly able to identify adverse event patterns in real-world data and electronic health records, helping flag potential drug risks and optimize trial design. These tools, combined with longitudinal data from maternal health registries, could enable more targeted, evidence-based drug development while reducing risk to participants.
Ultimately, filling the pharmaceutical gap in maternal health will require both scientific ambition and structural change. Without dedicated funding mechanisms, clearer regulatory pathways, and a cultural shift within drug development toward inclusion and relevance, maternal health will remain an afterthought in pharmaceutical innovation. Yet with the right investment, maternal therapeutics could become one of the most impactful and socially urgent frontiers in modern drug development.
Data, Policy, and Investment – Building a Maternal Innovation Ecosystem
Transforming maternal health outcomes will require more than advances in clinical care or digital tools — it will depend on the development of an integrated ecosystem where data, policy, and investment work in concert to support scalable, equitable innovation. Encouragingly, new models of care, funding mechanisms, and public-private collaborations are beginning to lay the groundwork for such a system.
The Centers for Medicare & Medicaid Services’ TMaH Model represents a landmark effort to structurally improve care delivery for mothers across the country. By incentivizing care models that emphasize continuity, cultural responsiveness, and the inclusion of midwives and doulas, the TMaH Model seeks to reduce disparities and improve maternal outcomes, especially among those covered by Medicaid.10 Central to this model is a focus on whole-person care — addressing not just pregnancy-related complications but also chronic conditions, behavioral health, and social determinants of health.
Community-partnered models are also proving essential in addressing the unique needs of diverse populations. Programs like those profiled by the Commonwealth Fund demonstrate how partnerships with community-based organizations can fill gaps left by traditional healthcare systems, using data-driven dashboards and local outreach to ensure women receive timely, relevant, and respectful care.17 These models reinforce the idea that maternal innovation cannot be confined to clinical settings alone — it must be embedded in neighborhoods, homes, and support systems.
National quality improvement initiatives are amplifying these efforts. The Alliance for Innovation on Maternal Health (AIM) supports hospitals and states in adopting standardized safety protocols and best practices for childbirth. By collecting and analyzing outcome data, AIM empowers providers to identify preventable complications and implement evidence-based improvements in real time.20 These collaborative frameworks are key to turning pilot projects into sustainable, system-wide change.
Investment — both public and private — is also starting to align with the urgency of the maternal health crisis. According to McKinsey, closing the women’s health gap could unlock $1 trillion in global economic value annually by 2040, largely through reduced healthcare costs, increased workforce productivity, and improved population health outcomes.4 This economic case complements the ethical one: investing in maternal health is not only morally justifiable but fiscally responsible.
Philanthropic and venture capital (VC) interest in maternal health innovation has grown significantly in recent years, spurred by heightened public awareness, expanded Medicaid coverage, and new opportunities in digital health. VC firms are increasingly backing maternal health startups developing AI-powered diagnostics, culturally tailored apps, and postpartum care solutions.21 This influx of capital brings momentum but also a responsibility to ensure that innovation serves all communities, not just those with strong commercial market potential.
Policy innovation is also emerging at the local level. In Philadelphia, a pilot program known as the Philly Joy Bank is offering $1,000 in guaranteed monthly income to pregnant individuals in areas with high infant mortality rates. The initiative is rooted in evidence showing that economic insecurity is a major driver of adverse maternal and infant outcomes. By stabilizing income during a critical period, the program aims to improve birth outcomes, reduce disparities, and model the impact of upstream investments in maternal health.22
Together, these examples point toward a maturing maternal innovation ecosystem: one that is increasingly data-informed, equity-centered, and economically viable. Yet this ecosystem remains fragile, requiring continued policy support, cross-sector collaboration, and a commitment to scaling solutions that work. The next frontier in maternal health will be defined not only by what we invent, but by how we implement it and who benefits.
Global and Cross-Sector Models – Lessons from Abroad and Adjacent Fields
The maternal health crisis is global in scope, but so too is the potential for shared solutions. International and cross-sectoral models offer valuable lessons for transforming maternal care— particularly in how innovation can be scaled in resource-constrained settings, adapted for diverse populations, and embedded within broader systems of public health. Looking beyond U.S. borders and traditional maternal health paradigms reveals a wealth of strategies with proven impact and strong potential for adaptation.
The Pan American Health Organization (PAHO) has led a multi-country initiative to digitize maternal health systems across Latin America and the Caribbean, demonstrating how regional coordination and investment in digital infrastructure can significantly enhance care delivery. By integrating electronic health records, teleconsultations, and mobile monitoring tools into national maternal health programs, countries in the region have begun to reduce barriers to care while improving continuity across prenatal, delivery, and postpartum stages.23 Importantly, these efforts emphasize the importance of data interoperability, training for frontline health workers, and respect for patient privacy — components that are essential for successful digital transformation everywhere.
In LMICs, innovative models continue to emerge from necessity, often with fewer resources but greater ingenuity. The use of AI-assisted ultrasound in Uganda, for example, allows minimally trained providers to perform high-quality scans in remote areas, helping detect complications earlier and encourage timely antenatal visits.16 Similarly, community-based digital platforms in countries like India and Bangladesh have demonstrated success in tracking maternal and newborn outcomes, coordinating referrals, and educating pregnant individuals via mobile phones.6 These tools are not merely stopgaps — they are scalable innovations that demonstrate how technology can be adapted to improve care in any setting.
Beyond geography, maternal health can also benefit from strategies developed in response to other public health challenges. Programs designed to manage infectious diseases such as HIV, tuberculosis, and COVID-19 have pioneered approaches that are highly relevant to maternal care, including mobile testing, decentralized care models, and robust supply chain systems for reaching hard-to-access populations. The HIV field, for instance, has long leveraged peer navigators and community health workers to support adherence and retention in care — strategies now being replicated in maternal health to improve engagement during and after pregnancy. The rapid deployment of telehealth and home-based monitoring during COVID-19 similarly underscores the potential of virtual care models for routine and high-risk pregnancies alike.
These global and cross-sectoral examples demonstrate that innovation is not the exclusive domain of wealthy countries or high-tech industries. Rather, meaningful progress often stems from the pragmatic adaptation of tools and practices to the realities of everyday life. In many cases, the solutions developed in LMICs — where maternal health burdens are greatest — are also those most poised to drive transformative change in high-income settings. A truly global perspective invites the U.S. and other nations to look not only inward, but outward, borrowing successful strategies, sharing knowledge, and committing to a collective maternal health future that is inclusive, agile, and equity-driven.
What’s Next – A Policy and Innovation Agenda for Maternal Health
If maternal health is to be transformed rather than just improved incrementally, then bold policy action and targeted innovation must become central priorities across healthcare, life sciences, and government. The tools to improve outcomes exist. The data is clear. What’s needed now is the collective will to implement solutions that are evidence-based, community-informed, and scalable. The following agenda offers a strategic framework for moving from analysis to action.
Policy Recommendations
First, regulatory reform is critical to addressing the glaring absence of pregnant individuals in clinical research. Current restrictions often result in the exclusion of this population from drug trials, perpetuating a cycle of therapeutic uncertainty and risk.11 Incentives for the safe and ethical inclusion of pregnant participants — through adaptive trial designs, regulatory guidance, and risk-sharing frameworks — are urgently needed.2,5 A modernized regulatory approach must recognize that exclusion is itself a form of harm and build the necessary scaffolding to include pregnancy in mainstream clinical development.
Second, dedicated funding streams must be established to support maternal-specific innovation. This includes not only therapeutic development but also diagnostics, devices, and supportive care tools tailored to the physiological changes and complexities of pregnancy and postpartum recovery. Without targeted investment, maternal health will continue to be marginalized in biopharmaceutical research and commercialization.
Third, policymakers must prioritize the expansion of digital infrastructure, particularly in underserved and rural communities where gaps in connectivity limit the reach of telehealth and mobile care tools. Investments in broadband, device access, and digital literacy are foundational to ensuring that innovation is equitable in practice, not just in theory.14,17
Innovation Priorities
To accelerate meaningful progress, the life sciences industry must also reshape its R&D priorities. Maternal-specific active pharmaceutical ingredients (APIs), combination therapies, and non-invasive diagnostics represent high-need, low-supply areas that warrant focused development. These innovations should be informed by the biological nuances of pregnancy, rather than extrapolated from non-pregnant populations.
Emerging technologies also offer new pathways to de-risk and refine maternal drug development. AI-driven pharmacology modeling and digital twins can help predict drug interactions and optimize dosing with minimal risk to actual patients.15 These tools could become essential enablers of safe and efficient clinical research for maternal therapeutics.
The development of robust, privacy-protected real-world data platforms is another critical need. By integrating longitudinal health data from diverse populations, these platforms can improve post-market surveillance, enable earlier identification of complications, and support continuous learning within maternal health systems.4,13 Such infrastructures would also be invaluable in assessing the broader impacts of social, behavioral, and digital interventions.
Equity Imperatives
Finally, equity must be the guiding principle of all maternal health innovation. The communities most affected by poor maternal outcomes — Black, Indigenous, rural, and economically marginalized populations — must be centered in the design, implementation, and evaluation of any new program or product.5,6 This includes funding community-led initiatives, elevating lived experience alongside clinical expertise, and embedding cultural responsiveness into the DNA of maternal health innovation.
Support for locally tailored solutions — like those developed through partnerships with community health workers, midwives, and doulas — has already shown promise in improving engagement and outcomes.8,17 Sustained investment in these grassroots strategies will be essential to creating systems that are not only innovative but also just.
The next chapter in maternal health must be defined by coordinated action across policy, industry, and community. A maternal innovation agenda that embraces this holistic, equity-focused vision has the power to save lives, reduce disparities, and fundamentally reshape how societies value and support reproductive health.
Conclusion – A Call to Invest in Maternal Health
Maternal health is not a fringe concern or a siloed specialty — it is a foundational pillar of public health, economic stability, and social equity. It affects not only the individuals who give birth but also families, communities, and future generations. And yet, it continues to be underfunded, under-researched, and underprioritized in both policy and innovation.
We do not lack the tools to improve maternal outcomes. The technologies are emerging, the data is mounting, and the strategies — both domestic and global — are increasingly clear. From digital health platforms and AI-assisted diagnostics to equitable care models and maternal-specific therapeutics, the blueprint for transformation already exists.
What remains is the will: the political will to fund and legislate with intention, the institutional will to include pregnant individuals in research, and the collective will to center equity in every decision. The maternal health crisis has persisted long enough. It is time to act — not just with urgency, but with vision. An ecosystem that truly supports maternal health is within reach, but building it will require aligning science, policy, investment, and community around a shared commitment to care, justice, and innovation.
References
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