Black people comprise a diverse range of nationalities, cultures, experiences, and perspectives, and therefore, cannot be considered a monolith. The Black-White maternal disparities, and differences in birth outcomes between US-born and foreign-born Latina and Asian women have been extensively documented. Black immigrants account for 10% of the total Black population in the United States (US) and have the highest birth rates of all immigrant groups in the country. Research focusing on the reproductive health of these populations is currently limited. Previous research has shown that foreign-born status has generally been associated with a reduced likelihood of adverse birth outcomes including low birthweight, preterm birth, and small for gestational age however, the pathways for the observed associations are yet to be fully understood. Most importantly, the majority of previous findings were not stratified by detailed maternal nativity (DMN).To address this research gap, this dissertation presents three studies seeking to provide an overview of variations in labor and delivery (L&D) care and pregnancy complications among Black women within the Black US Diaspora. The author defined DMN as the mother’s place of birth (i.e., US or not) and the mother’s specific country of birth. The first study was a systematic scoping review which utilized the Andersen Behavioral Model of Health Services Use as a framework to understand the contextual and individual characteristics associated with the access, utilization, and experiences of L&D care services among Black women in the US. The review included 27 articles which focused on issues including structural inequities, severe maternal morbidity, pregnancy complications, maternal death, birth plan decision-making, and alternative birthing methods. Only three out of 27 articles examined foreign-born women’s L&D experiences. These findings served as foundation informing the other two studies. The second and third studies used 2016-2020 Natality Birth Certificate Record Data to explore L&D characteristics and pregnancy complications among US-born, Caribbean-born and Sub-Sharan-African-born (SSA) Black women in the US. The second study examined associations between DMN and the following L&D characteristics: type of attendant at birth (i.e., physician or midwife) the place (i.e., health care facility or home), and the method of delivery (i.e., vaginal or cesarean). The findings revealed differences in L&D characteristics between US-born, Caribbean-born and SSA-born Black women and suggested the need for more research and healthcare policies that consider the specific needs and preferences of different groups of pregnant women based on their ethnocultural origins. The third study evaluated the relationship between DMN and three of the most prevalent pregnancy complications among Black women, gestational hypertension, eclampsia, and gestational diabetes. Consistent with prior studies, foreign-born Black women in the sample exhibited lower odds of gestational hypertension and eclampsia, but higher odds of gestational diabetes compared to US-born Black women. The collective findings of the present dissertation underscore the necessity of recognizing the heterogeneity within the Black Diaspora, highlighting the need for more granular data collection and analysis methods. Additionally, policies to increase access to quality care, cultural competence, interdisciplinary collaboration among maternity care providers and patient-centered L&D services are paramount to eradicate the reproductive inequities and adverse birth outcomes experienced by women across the Black Diaspora. Keywords: Detailed maternal nativity, Black women, Black Diaspora, US-born, Caribbean-born, Sub-Saharan African-born, labor and delivery, birth attendant, place of delivery, method of delivery, pregnancy complications, gestational hypertension, eclampsia, gestational diabetes.