The jaw-dropping statistics have made headlines for the past several years: Black women in different parts of America are two to four times more likely to die from pregnancy and childbirth complications than white women.
The hard questions are why this happens and how to change it.
A new documentary, "Birthing Justice," premiering this week on PBS, offers some answers, along with stories of joy, fear and hope. The film reveals the human lives and communities impacted by the crisis in Black maternal health.
Executive producer Denise Pines, the immediate past president of the Medical Board of California, said that when she first heard the grim statistics, she couldn't believe them. She did not personally know anyone who had lost a baby or had a close-call pregnancy or childbirth.
"How can this be happening?" she thought.
She and her business partners decided to explore the topic by filming what was happening on the ground in critical hot spots across the country. Missouri, which has one of the highest rates of Black maternal death in the country, became one of those locations.
In Missouri, Black women are four times more likely to die from pregnancy complications than white women. In St. Louis, Black babies are three times more likely to die before their first birthday than white babies.
Experts talked about why these disparities persist.
Kanika Harris, the director of maternal and child health for the Black Women's Health Imperative, said the biggest misconception is that something in the behavior of Black women -- their diet, exercise or habits -- makes pregnancy and childbirth more dangerous for them.
"There is nothing we are doing that is so different from anyone else in this country," she said. In fact, research that controls for income and education levels finds that Black women still die at higher rates from pregnancy complications than white women. The documentary cites multiple reasons: Black women are more likely to have undiagnosed conditions prior to pregnancy, are more likely to have their concerns and complaints ignored during childbirth, and are less likely to have access to postpartum care.
For all women, it's more dangerous to give birth today than it was 30 years ago: The overall maternal death rate in 1987 was 7.2 deaths per 100,000 live births; in 2021, it was 32.9. That's 10 times higher than many other high-income countries -- but still less than half of the rate for Black women in America, which reached 69.9 maternal deaths per 100,000 live births in 2021.
The most tragic part is that most of these losses are preventable. The Centers for Disease Control and Prevention compiled data from state committees that review these deaths and found that 84% of pregnancy-related deaths in the U.S. were preventable.
"There's something deeply wrong when in 2022, we can't keep our moms alive," said Dr. Joia Crear-Perry, founder of the National Birth Equity Collaborative, in the documentary.
The role that bias and racism in the medical system play in the disproportionate number of Black maternal deaths is underscored throughout the film. Olympic track-and-field star Allyson Felix appears in the film to share her pregnancy story. She was unexpectedly diagnosed at 32 weeks pregnant with severe preeclampsia -- a life-threatening complication -- which resulted in an emergency C-section.
In a 2018 magazine interview, tennis champion Serena Williams revealed that she also experienced severe health complications after giving birth because doctors neglected to listen to her about her existing medical conditions.
"Birthing Justice" director and co-writer Monique N. Matthews says she didn't want to make a film that just highlighted the scary headlines. As a Black woman, she said focusing on the terrible statistics makes her think, "So, I have to be scared to bring life into this world, too?"
She wanted to tell a story about Black maternal health anchored in resistance and fueled by joy.
"Black joy is a weapon and a tool," she said.
The documentary contains interviews with people on the front lines working on solutions. That includes Jamaa Birth Village in Ferguson, Missouri, and its founder, Okunsola M. Amadou, who has helped train more than 200 Black doulas in St. Louis.
The documentary's website, birthingjustice.com, offers resources for those who are pregnant, along with a section on policy and legislative initiatives that viewers can advocate for to address these problems.
The film tells a compelling story of an unacceptable problem facing pregnant women in America.
More importantly, it shares ways we can change the system to save mothers' lives.