Our nation’s history of anti-Black racism is deeply ingrained into every facet of U.S. society, especially within our institutions and systems. Our health-care system is not exempt from this stark reality and has a painful legacy of racism that continues to harm Black communities to this day.

We know that interpersonal and structural racism within medicine has led to devastating inequities in care provision, patient experience, and health outcomes for Black communities. Black people face increased barriers to accessing and utilizing health care; are more likely to face social, political, and economic challenges that adversely impact health, such as poverty, housing, and food insecurity; and Black people commonly experience discrimination and bias from their providers and within the medical institutions that serve them.

These inequities are compounded by the COVID-19 pandemic’s heightened effects on Black communities versus white, ongoing police violence against Black people like George Floyd, Breonna Taylor, and others, and is in relationship with and reflects the ongoing abuses we historically faced during slavery and segregation, as well as today’s mass incarceration crises.

This may be most evident in the maternal health sector, where Black women and birthing people face unimaginable, deathly threats to their autonomy, health, and safety every single day. Pregnancy and birth should be a time of joy and excitement for all who want to be parents—but for too many Black women and families, it becomes a horror.

This Black History Month, at the precipice of a critical election year, we must shine a light on the Black maternal health crisis and fight for the healthy futures of Black women and families.

As a Black mother and reproductive health, rights, and justice advocate, I know firsthand how critical this fight is and how cruel and brutally violent our health systems can be for Black women. Throughout different stages of my life, I have navigated the health-care system knowing that at any given moment my pain could be ignored, my questions could go unanswered, and my concerns could be met with disregard. I want to say explicitly that this type of harm occurs at every level of the health-care structure—from community health centers largely serving Medicaid or uninsured patients to the tallest, most glittering state-of-the-art medical facilities in New York City, specifically Manhattan, who serve the rich and famous.

This is the depth and breadth of racism—it knows no bounds. Black women like me have had our pain, humanity, and autonomy diminished for centuries. Why are we constantly being told that we are not the authority on our own bodies? As a mother of Black children, I know the most important thing I can do for my family and my community is to encourage us to honor our own experiences and speak truth to power. You know when something is wrong, and when you’re not being treated with the dignity you deserve. Speak your mind, even if your voice shakes.

Listening to our bodies can quite literally save our lives. In my position at Planned Parenthood of Greater New York, I lead the very important work that encourages providers to identify and examine the racial biases that occur within themselves and the systems they operate in and change them. This process of learning, unlearning, and rebuilding is the only way we change the systems around us and create a better world—for Black women and everyone.

We’ve all heard the statistics. Black parents are three times more likely to die from pregnancy-related causes than their white counterparts, and in New York state, the pregnancy-related mortality ratio is on average 9.2 times higher for Black parents compared to white parents. A 2021 maternal mortality report by the Centers for Disease Control and Prevention shows that the parental mortality rate (or number of maternal deaths per 100,000 live births) had worsened in the United States by 89 percent since 2018, and the maternal death rate for non-Hispanic Black women was 2.6 times higher than the rate for non-Hispanic white women from 2019 to 2021.

The most prevalent contributing factors associated with parental mortality rates include quality of care, underlying chronic conditions (such as high blood pressure, infection, or heart disease), and severe bleeding. We live in one of the wealthiest nations on Earth, with ample resources for all who need them, yet we continue to see Black women and families sidelined in health care. Providing care with a culturally humble lens and being responsive to the lived experiences of patients ensures that Black birthing people are heard and affirmed when receiving care. The moment we start considering people’s experiences and histories and their intersections with broader oppressions, we are able to approach the critical issue of parental mortality more holistically and compassionately, with an eye toward justice.

Black parents deserve to be seen, embraced, and supported during our pregnancies, birthing experience, postpartum period, and at all stages of our reproductive lives. We deserve access to the social, economic, and environmental resources necessary to build strong, healthy, safe families and communities. There is no reason why Black women should have to worry about whether our health-care providers will ignore our concerns, diminish our pain, and risk our lives just because of our race.

We need swift and immediate action for birth justice—and by committing to a future where Black pregnant people, mothers, and families flourish, everyone else does, too. When we take care of Black women, we take care of our communities at large. We need greater access to support like midwives and doulas, cultural humility and antiracism training for medical professionals, and bold, visionary policy changes that allow for greater paternity leave, prenatal care access and postpartum support, and greater awareness and resources for mental health struggles while pregnant and afterward.

Every family has the right to thrive and live with dignity and opportunity. This begins with safe, healthy, compassionate pregnancy and birth. And we cannot continue to leave Black women behind. Join me this Black History Month and always to fight for the care and compassion Black women deserve—our lives depend on it.