You Belong Here

I haven’t been able to stop thinking about Adriana Smith since last week, when I first learned her story. Adriana was a Black woman, a 30-year old nurse and mother, was 9 weeks pregnant. She started experiencing severe head pain and headed to Emory University Hospital in Atlanta, GA. The pain turned out to be a blood clot that was diagnosed too late, with the heartbreaking outcome of Adriana being declared brain dead. This happened in February, and Adriana’s body is still alive.

Due to Georgia’s restrictive, anti-abortion fetal heartbeat law, which prohibits abortion in all cases after 6 weeks of gestation. Adriana is currently being used as an incubator for a child who may not survive once born or could be blind and unable to walk. This is the end game of laws like these: forcing women to give birth at all costs. Her family has no right to take her off the ventilator, with doctor’s citing Georgia’s abortion law. As not only a DEI practitioner, but birth doula, this is a chilling case.

The journey of bringing new life into the world should be filled with joy, support, and the highest quality care. Yet for too many Black and Indigenous women in our country, this sacred passage is marked by fear, dismissal, and tragically, sometimes death. The maternal health crisis affecting these communities isn't just a statistic—it's a profound injustice that touches families, communities, and our collective humanity.

A Crisis Hidden in Plain Sight

The numbers tell a story that should stop us in our tracks. Black women are three to four times more likely to die from pregnancy-related causes than white women. This disparity persists regardless of education level, income, or access to insurance. A Black woman with a PhD and comprehensive health coverage still faces significantly higher risks than a white woman without those advantages.

For Indigenous women, the reality is similarly devastating—they experience pregnancy-related deaths at more than twice the rate of white women. Behind each of these statistics is a mother who won't see her child grow up, a family forever altered, a community bearing another loss.

What makes these disparities especially heartbreaking is that roughly 60% of these deaths are preventable. This isn't about biology or genetics—it's about how our healthcare system responds to Black and Indigenous bodies and voices.

The Roots Run Deep

When we look closely at what's happening in maternity wards and birthing centers across America, we see patterns that reflect our broader social fabric:

Pain described by Black and Indigenous women is more likely to be dismissed or undertreated. Concerns they raise about their symptoms are often minimized or ignored, like in Ariana’s case, until situations become critical. Their preferences for their birth experiences may be overridden without proper discussion or consent.

These patterns don't exist in isolation. They grow from soil tilled by centuries of systemic racism:

• The historical abuses in medicine—from the exploitation of Black women's bodies in the development of gynecology to forced sterilizations of Indigenous women—have created generational trauma and understandable distrust.

• The chronic stress of experiencing racism throughout life—what researchers call "weathering"—takes a physical toll that can complicate pregnancy.

• Many Indigenous communities, particularly those on tribal lands, face significant barriers to accessing quality care, with some women having to travel hours for basic prenatal appointments.

• Hospital closures in rural areas and urban neighborhoods with predominately Black populations have created maternal health deserts precisely where specialized care is most needed.

• The lack of diversity among healthcare providers means many Black and Indigenous women never see a provider who shares their cultural background or lived experiences.

Bearing Witness, Taking Action

Understanding this crisis means opening our hearts to uncomfortable truths about our healthcare system and society. It means acknowledging that racism—both explicit and implicit—shapes health outcomes in profound ways. But awareness without action perpetuates the status quo.

Here's how we can channel our concern into meaningful change:

Educate Ourselves and Others

Learn about the history of reproductive justice and how it intersects with racial justice. Books like "Reproductive Justice" by Loretta Ross and Rickie Solinger or "Medical Apartheid" by Harriet Washington provide crucial context.

Follow organizations led by Black and Indigenous women working on maternal health issues. Their social media accounts and newsletters provide ongoing education directly from those most affected.

Share what you learn—not to center yourself, but to ensure these issues reach people who might not otherwise encounter them.

Support Birth Justice Organizations

Black and Indigenous women have long been leading the fight for equitable maternal healthcare. Organizations like Black Mamas Matter Alliance, Indigenous Women Rising, National Birth Equity Collaborative, and Ancient Song Doula Services are creating community-based solutions.

Support can look like regular donations, sharing fundraisers, attending events, or offering professional skills like grant writing or web design—always following their lead rather than imposing outside solutions.

Advocate in Healthcare Settings

If you work in healthcare, commit to ongoing anti-racism education and practice. Examine your own biases. Create protocols that protect vulnerable patients. Mentor students and colleagues from underrepresented groups.

If you're supporting a loved one through pregnancy and birth, be their advocate. This might mean helping them research providers with good track records for culturally responsive care, attending appointments to take notes, or ensuring their questions and concerns are properly addressed.

Push for Systemic Change

Individual actions matter, but they're not enough. We need policy change, expanded healthcare access, improved medical education, and accountability measures. Call your representatives. Support legislation like the Black Maternal Health Momnibus Act. Vote for candidates who prioritize health equity.

Hope on the Horizon

Despite the gravity of this crisis, there are reasons for hope. Community birth centers serving Black and Indigenous families are expanding. More hospital systems are implementing mandatory bias training. Doula programs are receiving insurance coverage. Medical schools are revamping curricula to address bias.

The maternal health crisis facing Black and Indigenous women isn't their burden to solve alone. It's on all of us to create a world where every birthing person receives care that is respectful, responsive, and results in healthy outcomes for parent and child.

This work isn't just about preventing tragedy—though that would be reason enough. It's about honoring the full humanity and dignity of every person bringing life into the world. It's about recognizing that safe, respectful maternal care isn't a privilege to be granted to some but a fundamental right that belongs to all.

The path to birth justice is long, but every step matters. When we stand as allies—listening deeply, amplifying voices, supporting solutions, and demanding change—we help create a world where all mothers and babies can thrive. Not someday, but now. Because every birth matters, and every mother deserves to be heard, protected, and celebrated on their journey.

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