Ndidiamaka Amutah-Onukagha’s life’s work underscores a critical reality: that racism and implicit bias drive adverse health disparities for women.
Black women are three times more likely to die from pregnancy-related causes than white women. In midlife, Black women are also more likely to reach menopause at an earlier age and experience a longer duration of symptoms.
It shouldn’t be this way. Amutah-Onukagha envisions a world that improves health care for Black women, who have historically been underserved, throughout their lifespans.
“Out of pain, opportunity is born,” she said in a 2022 TEDx Talk. “We are overdue in the race for solutions.”
Amutah-Onukagha educates on the systemic factors driving inequitable outcomes for Black women and champions efforts to reduce health disparities as a maternal advocate. She is the founder of Tufts University’s Center for Black Maternal Health and Reproductive Justice and a professor in the Departments of Public Health and Community Medicine, Obstetrics and Gynecology, and Medicine at Tufts University School of Medicine. She also holds a PhD in child and maternal health and is the founder of the Annual Black Maternal Health Conference at Tufts.
In an interview with Flow Space, Amutah-Onukagha discusses her center’s mission today and why the menopause care space must not leave out the lived experiences of Black women in midlife.
This interview has been edited for length and clarity.
Flow Space: Your work has advocated for high-quality, equitable, and respectful care for Black women. What issues are at the top of your mind and driving you in 2026?
Amutah-Onukagha: As we move into 2026, Black maternal health remains at the core of my work and continues to be a critical entry point for understanding broader inequities in women’s health. The challenges Black women face during pregnancy and childbirth often reflect gaps in care that begin much earlier in life and persist well beyond the postpartum period. Addressing these issues requires a long-term, preventative approach that supports women before, during, and after pregnancy.
How is your center addressing these gaps?
At the Center, we are building on our leadership in Black maternal health by expanding our focus to women’s health more broadly, particularly for communities of women who experience persistent inequities. By applying what we have learned from maternal health to earlier and later stages of life, we are advancing a whole–life span approach that prioritizes prevention, coordinated care, and long-term health outcomes. Our goal is to ensure that all women receive the support they need at every stage of life, not just in moments of crisis.
Where are you seeing progress in Black maternal care, and where is true progress lagging?
I am encouraged by increased attention to maternal morbidity and mortality, stronger data, and more meaningful conversations around quality and accountability in care. Community-informed models are gaining traction, and we are beginning to see greater recognition that improving maternal outcomes requires continuity of care across the life course. Still, progress is uneven, and sustained investment and implementation remain major gaps.
You mentioned advancing a whole-life span approach. What needs to happen to improve care for Black women in midlife navigating perimenopause and menopause? How can the menopause space be more inclusive for women in midlife?
We must first acknowledge that Black women experience perimenopause and menopause differently, often with more severe symptoms and less access to appropriate care. Improving care requires better research that includes Black women, more culturally responsive provider training, and clear clinical guidelines that reflect racial, social, and economic realities.
The menopause space also needs to move away from a one-size-fits-all narrative. Inclusion means centering diverse voices, addressing comorbidities that disproportionately affect Black women, and recognizing how stress, racism, and structural inequities shape midlife health.
Equity in midlife care is not optional; it is essential.
What topics around midlife may be coming up at the Black Maternal Health Conference this year?
This year, I anticipate important conversations around menopause equity, chronic disease management in midlife, mental health, and the long-term impacts of reproductive health. We will also see more discussion on how midlife health intersects with caregiving, economic security, and workplace policies, especially for Black women who are often navigating multiple roles with limited support.
Where are you seeing the private sector step in to address disparities in maternal health outcomes?
The private sector is beginning to play a more meaningful role, particularly through investments in Black-led startups, femtech innovations, and community-based care models. We are seeing companies focus on improving access to culturally competent care, remote monitoring, and patient education. That said, private-sector involvement must be aligned with community needs and public accountability. Profit cannot come at the expense of trust or equity.
What are we not talking enough about?
One pressing issue is the need to protect and expand reproductive autonomy while also addressing the full continuum of Black women’s health. We cannot silo maternal health, midlife health, or aging; they are deeply connected. To truly advance equity, we must invest in Black women’s health across the lifespan, listen to Black women, and build systems that honor their dignity at every stage.
link