As a Black woman born and raised in the United States, I have always been aware of how blessed I am to have experienced two healthy pregnancies with no complications (other than having to deliver each of my babies almost one week past my due date). While reading Pregnant While Black: Advancing Justice for Maternal Health in America by Dr. Monique Rainford, I was made aware that this is not the case for far more Black women than I could have ever imagined. The American health-care system has a problem, and Black women are paying the highest cost.

Pregnant While Black is a resounding call to action that expresses the experiences of Black women in the United States with compassion, conviction, and love. This book is not just a collection of statistics and heartbreaking recollections of families across the nation, it is a passionate and empathetic exploration of the racial disparities that plague American maternal health care, written by a woman who understands and deeply relates with the challenges faced by Black women.

Dr. Rainford has extensive background as an OB-GYN and brings an invaluable perspective to the critical issues that have disproportionately affected Black pregnant women. She is a board-certified obstetrician and gynecologist with more than twenty years’ experience, a graduate of the University of Pennsylvania and Harvard Medical School, and she is currently an assistant professor at Yale Medicine. In her book, she delves into the heartbreaking statistics surrounding maternal mortality and infant mortality rates in the Black community, which are truly alarming. Dr. Rainford notes that Black mothers are more likely to die during childbirth, and their babies are more likely to experience adverse outcomes compared to other racial groups due to racism. She also points out that Black women are three times more likely to die from pregnancy than their White peers. Detrimental outcomes like these, while stark, are essential for us to confront head-on.

Implicit and explicit biases in health care are the headliners of these disparities, and Dr. Rainford does not shy away from discussing them. Her accounts of medical professionals making racial assumptions and failing to provide unbiased care are disappointing and disturbing. But if we want to be a part of the change that must take place in this country, these issues are necessary for us to understand. Black women are often subjected to lower-quality care, reduced access to crucial resources, and receive critical misdiagnoses due to these biases.

One of the book’s vital contributions is its discussion of the difficulties faced by Black women who seek fertility assistance. The topic of infertility is not being openly discussed as options for Black women in a timely manner, if at all, leading to missed opportunities for natural conception. Dr. Rainford underscores the importance of knowledge of and access to resources such as pre-conception counseling, and genetic counseling during traditional child-bearing years to promote opportunities for motherhood. Additionally, mental health support should be available for those who have experienced miscarriages and are looking to heal and try again.

The historical mistreatment of Black women in health-care settings has led to a justified mistrust that many still carry today. Dr. Rainford highlights the significance of ensuring that Black women have access to Black health-care providers who understand their unique experiences and challenges. She writes, “The physician and healthcare workforce need to match the population. Increasing efforts should be made to increase the percentage of Black physicians….” Unfortunately, the shortage of Black OB-GYNs, particularly available through Medicaid plans, exacerbates this issue.

One of the most devastating statistics is the higher rate of stillbirth among Black women. Black women are twice as likely to experience stillbirth than other racial groups. Sadly, racism negatively impacts babies before they’re even born. Systematic racism, stigma surrounding mental health issues, and the fear of biases from health-care providers can all contribute to these tragic statistics that are increasingly impacting the Black community.

The rate of cesarean sections among Black women are also higher than other races, which emphasizes the importance of timely interventions and proper care. Not only is this procedure more dangerous, but it is often unnecessary. The postpartum period is another critical phase where Black women face higher risks, and this is an aspect of maternal health that should be prioritized in health-care reform.

Furthermore, the COVID-19 pandemic has disproportionately affected pregnant Black women, who are more likely to contract the virus and experience severe complications. These challenges require immediate attention to protect the health of mothers and their unborn babies.

In the book’s final chapter, titled “The Ray of Hope,” Dr. Rainford states, “The morbidity and mortality rates for Black women will improve if their health needs are addressed before they get pregnant…[if] they receive compassionate and medically sound prenatal care…[if] their concerns are addressed appropriately as soon as they are raised….”

Pregnant While Black doesn’t just highlight the problems within the American health-care system, it also examines potential solutions. Dr. Rainford emphasizes the need for unbiased prenatal care for high-risk pregnancies, the importance of early intervention to prevent critical conditions like preeclampsia, and the benefits of having a health-care team that understands the specific needs of Black mothers and infants.

Although I did not experience any complications with either of my pregnancies, I am aware of the dangers of being pregnant or requiring any type of medical assistance while being a Black person in America. Dr. Monique Rainford offers an essential and compassionate exploration of the racial disparities in maternal health care and clearly outlines the roles all of us can play in demanding change in the health care Black women receive in the US. We must advocate for better health-care opportunities and resources for Black women, and for society to confront the biases and systemic racism that have devastating consequences for Black mothers and their babies. Dr. Rainford’s work is a vital resource and a testament to the strength and resilience of Black women who have bravely faced the challenges on their paths to motherhood while providing an example of bravery and undying resolve for us all.