Maternal & child health policy crisis in the U.S.- systematic literature review

Despite global progress in reducing maternal mortality, the United States (U.S.) continues to face alarmingly poor maternal and child health (MCH) outcomes, ranking last among high-income countries. This systematic literature review examines the structural drivers behind these outcomes, including systemic racism, historical inequities, and the persistent neglect of key health determinants. Utilizing a root cause analysis (RCA) framework, the paper dissects the MCH crisis across distal, intermediate, and proximal levels to uncover the interconnected factors contributing to preventable maternal deaths, particularly amongst marginalized populations. By exploring barriers embedded in healthcare access, governance structures, and socioeconomic systems, the review demonstrates that the MCH crisis in the U.S. reflects broad institutional failures. The paper concludes by identifying actionable strategies for improvement and introduces a forthcoming honors thesis that will investigate how political leadership and regional characteristics influence maternal health outcomes across the U.S.