It would be false to say President Joe Biden and Vice President Kamala Harris have not given the Black maternal health crisis any attention during their four years in office. But the question remains: Why are Black birthing people and their infants still in a health “crisis” at all?

As Harris leverages the support she needs for her presidential campaign—including Black women’s organizing prowess—she must seize on the opportunity to expand her approach to Black maternal health away from funding institutions and toward funding families.

In the weeks since the launch of her presidential campaign, Harris’ team has mobilized her large networks of Black women to get people registered to vote. Her speeches to large crowds of Black women voters have regularly mentioned Black maternal mortality. In 2021, she helped mark the inaugural White House Maternal Health Day of Action. As senator, Harris wrote in a column for Essence about helping to introduce the Black Maternal Health Momnibus: “Black women can’t afford not to be heard when their lives and babies are on the line.”

Since the 2020 election, the administration’s work on Black maternal health has focused on people with Medicaid and those seeking hospital births. It has incentivized medical providers to receive maternal-care-specific trainings and designated resources for more hospitals to be designated “birthing-friendly,” a designation similar to that of “baby-friendly,” which is awarded to institutions meeting specific guidelines that encourage breastfeeding and parent bonding, among other important recommendations for a baby’s long-term health. A “birthing-friendly” hospital must take part in evidence-based procedures and specific improvement programs for perinatal health. Such efforts also incentivized congressional members to take on the crisis through specific policy.

In 2022, the Momnibus Act of 2022 was announced as part of the Biden-Harris Blueprint for Addressing the Maternal Health Crisis. It eventually took shape as the “2023 Momnibus: Kira Johnson Act,” introduced by Rep. Alma Adams (NC-12) and Rep. Lauren Underwood (IL-14). It has since distributed nearly $220 million to varying hospitals and Medicaid expansion for those who seek to have doulas or postpartum support. The Momnibus/Kira Johnson Act also allocated funds to community-based organizations in targeted areas with specifically low Black birth outcomes. This direction has directly supported doulas and other birth workers to receive trainings and for Black birthing people to receive support with less barriers, regardless of where they give birth or if they are insured under Medicaid.

The likelihood of a Black mother dying in childbirth and an infant suddenly dying in the first 40 days of life have spiked during and since the pandemic. That is shocking. The majority of these governmental monies going to hospitals—the primary site of Black maternal death—has not lowered the mortality rates. The White House’s July 2024 “Blueprint,” released shortly before Biden stepped out of the race, has again outlined what the campaign will do to empower Black women to know and take care of their bodies outside of institutional settings where maternal deaths take place, as well as to provide adequate funding for postpartum doulas to support in the first 40 days of life. Poverty and other social determinants (systemic racism, lack of paid family leave in jobs where Black women work) are still not addressed.

Efforts to improve the Black maternal health rate cannot rely solely on funding institutions. They must work in tandem with helping families directly. A more grassroots approach that moves toward putting money in birthing people’s pockets directly, and into other community organizations that would shorten the distance and time between receiving in-home support, would be radical but is worth exploring as another approach to lowering the Black maternal and infant death rates.

At the time of this writing, the Harris campaign has not released specific plans about Black maternal health. But it has outlined a new proposal that would commit the child tax credit up to $4,500 per child and renewed a plan to give families of newborns a $6,000 tax credit. This would benefit Black women perhaps the most, as low socioeconomic status increases the risk of postpartum depression by 11 times. The Harris campaign still has the opportunity to roll out an official health-care plan aimed at lowering the child poverty rate and providing more free labor and postpartum support, both in home for low-risk birthers and for people who wish to birth in birth centers.

Harris’ attention to the Black maternal health crisis may renew as Election Day approaches. Whether or not any specific policies attend to the social determinants of poverty and systemic racism have yet to be determined. If her administration decides to invest in people over institutions, Black maternal health may improve to help the majority of Black women—who may be the most instrumental group organizing to get her elected.