The first-ever national Black Maternal Health Week, founded and led by the Black Mamas Matter Alliance, was created to give voice to an otherwise overlooked issue. The unfortunate reality is that Black mamas have borne the brunt of ill health for far too long. For decades, Black women have been more likely than white women to suffer poor maternal health outcomes. These racial disparities deserve national and global attention and action.

During Black Maternal Health Week, we raised awareness about the burden of maternal mortality and morbidity in the Black community and amplified the voices of Black mamas and Black women leaders on maternal health through webinars, online conversations, articles, and in-person events. We helped to galvanize local actors and community organizing on Black maternal health that I hope will continue in the weeks and months to come because there is much more work to do.

We cannot stop until we know that Black mamas are safe from the harm caused by racism, racial discrimination, and oppressive policies, and that they have the resources and support to thrive before, during, and after pregnancy. The path to realizing that goal is long and we are only at the beginning.

There are three key actions that can propel this movement for Black maternal health, rights, and justice forward: Listen to Black women, trust Black women, and invest in Black women.

Listen to Black women

Serena Williams wasn’t the first Black woman whose health-care providers wouldn’t listen to her. Black people’s historical and lived experiences with the medical-industrial complex is fraught with forced experimentation, lack of informed consent, abuse, and negligence. Unfortunately, modern health systems fail Black people and Black women in a variety of ways. We have less financial access to care and are more likely than white people to lack health insurance coverage. We receive lower quality care, less treatment for pain, and perceive racist interactions with providers. New evidence shows that, when it comes to maternal health, disregarding the voices of Black birthing parents is also a problem.

The 2018 report, Battling Over Birth: Black Women and the Maternal Health Care Crisis in California, by Black Women Birthing Justice shares the prenatal, birthing, and postpartum experiences of Black women in California. In it, focus group participants describe having their birth plans disregarded, having to fight with medical staff to have their needs met, and having care forced on them that they objected to or never consented to:

“That’s not what I wanted. It was like no choice for me. I literally—as soon as I walked in I was like laid on the table and they just gave me medicine. I have no memory of even—I know for a fact that I got at least three epidurals. But I never consented to any of them.” Cheyenne, 22, hospital, unplanned cesarean birth

“I didn’t want to put myself under more stress and be confrontational with people who were trying to help me, you know … I felt like I didn’t really have a voice throughout the process. You just go with it, you accept things for what they are, there’s no point in arguing.” Nadia, 22, hospital, vaginal birth

During Black Maternal Health Week, Twitter user @KemiDoll, a Black woman OB-GYN, shared her own experience of being ignored and mistreated by health-care providers. After telling a nurse she was in pain after her cesarean section, the nurse replied “Well, you don’t look like you’re in pain,” and proceeded to prod her in the affected area.

This #BMHW18 by @BlkMamasMatter is stunning in the visibility and clarity of the message. Why we ever thought racism was absent or just a small part of black maternal death is simply a product of said institutional racism. 1/

— Kemi Doll, MD MS (@KemiDoll) April 13, 2018

I was a board-certified OBGYN when I was 1 day post-op from my c-section, and in a great deal of pain. I told my nurse my pain score was a 7. She said “well you don’t look like you’re in pain.” Then mashed on my extremely sore belly and rolled her eyes when gasped and cried. 2/

— Kemi Doll, MD MS (@KemiDoll) April 13, 2018

This was not life and death, *not even close*, but the dismissal of my clearly reported symptoms is the common thread. I keep getting taken back to this moment reading these #BMHW18 stories. 3/

— Kemi Doll, MD MS (@KemiDoll) April 13, 2018

My husband had to go to the nurses station & advocate for me. I have never seen him (who is pathologically zen) so upset. I remember being grateful that he is white, bc if he looked like my 6’5″ dark skinned brother he would have been called “aggressive” and “intimidating.” 4/

— Kemi Doll, MD MS (@KemiDoll) April 13, 2018

What #BMHW18 is highlighting is the range of consequences Black mothers and soon-to-be mothers experience just trying to bring life into the world. And I am HERE FOR IT. Thank you thank you thank you. 5/5

— Kemi Doll, MD MS (@KemiDoll) April 13, 2018

While Doll acknowledges that this was not a life-or-death situation for her, we know that care provider disregard of patient concerns could mean life or death for someone else. We might ask ourselves if Shalon Irving and Kira Dixon Johnson would still be alive if providers had better listened to them and prioritized their care.

For this reason among others, “Listen to Black women” is the first recommendation in Setting the Standard for Holistic Care of and for Black Women by the Black Mamas Matter Alliance.

Trust Black women

Initiated in response to the 2010 anti-choice billboards erected in Georgia saying “Black children are an endangered species,” Trust Black Women has become a rallying cry for the reproductive justice movement and serves as an ever-important reminder of how we must approach Black women’s health, parenting, and leadership.

During Black Maternal Health Week, we witnessed a demonstration of the expertise, wisdom, and power of Black women leaders from various sectors who are concerned about Black maternal health and working to improve outcomes.

In the nation’s capital, Rep. Alma Adams (D-NC) and Sen. Kamala Harris (D-CA) introduced a resolution recognizing Black Maternal Health Week and calling out the role of structural racism, gender oppression, and health inequity in Black maternal health.

Black women state legislators also took up the cause for better Black maternal health on social media. We need more elected officials who are willing to speak up for Black women and maternal justice as these women are. Midterm elections are coming up. Vote wisely.

Online, our webinar on maternity care featured wisdom from five Black women care providers who described Black woman-centered models of care and shared best practices for providing Black mamas with the high-quality, holistic care they deserve. And on the ground in local communities, Black Mamas Matter Alliance partners and collaborators held events including self-care sessions, ceremonies to honor doulas, community dialogues, and Death by Delivery screenings. Each of these events centered Black women’s experiences and voices, and highlighted our leadership on creating change in our own community.

The Black Mamas Matter Alliance will build on this momentum and hold the first national Black Maternal Health Conference and Training Institute later in 2018.

Invest in Black women

While Black women have the expertise, experience, leadership, and knowledge to move the needle on Black maternal health, our work is often underresourced and unfunded. Throughout Black Maternal Health Week, we have encouraged investments in Black women-led efforts working to improve our community’s health.

In a 2016 interview with midwife Jennie Joseph, she describes doing her work to care for Black mamas “with few resources and without support.” Even so, an evaluation of Ms. Joseph’s care model and practice at Commonsense Childbirth reveals she is improving birth outcomes and eliminating racial disparities among her patients.

The Black Mamas Matter Alliance is a Black women-led effort and currently volunteer run. Our efforts to create a world where Black mamas thrive before, during, and after pregnancy are unsustainable without financial investments.

Black women’s work is valuable and must be valued financially. We need monetary resources to keep this work going and deserve to be compensated for our labor.

Doula care is one example of where investing money and shifting policy could make some difference. Black women’s doula work is often unpaid or undercompensated and would benefit from policy that expands their ability to get paid through health insurance. It could help thousands of women access meaningful, holistic care and compensate Black women for their care work.

Still, these gains would be short-term. Black maternal health is a problem that also needs long-term solutions. Those long-term investments include sustained time and attention on the issue.

Those of us who want to stop Black mamas from dying unnecessarily have to name racism as an important factor in Black maternal health outcomes and address it through strategic policy change and culture shifts. This requires us to step outside of a framework that only looks at health care and consider the full scope of factors and policies that influence the Black American experience. It requires us to examine and dismantle oppressive and discriminatory policies. And it requires us to acknowledge Black people as fully human and deserving of fair and equal treatment and act on that belief.

Do your part

Everyone has a stake in the health and well-being of Black mamas. This isn’t just a Black issue, it’s an American issue. We need average citizens, grassroots leaders, academics, policy makers, care providers, and the like to become activists wherever they can. We need you to join us. We can’t do this alone.

Join us in doing things differently. The status quo doesn’t serve Black mamas. We need you all to acknowledge racism wherever you see it and act to stop it. We need you to create space in rooms and at tables so Black women leaders can have a seat. And we need you to keep the conversation going. This is only the beginning of a movement that will last until Black mamas are fully loved, cared for, and have the resources and opportunities they need for total health and well-being.