Pregnancy is oftentimes a death sentence for Black moms and their babies. For decades, Black mothers and their needs during pregnancy have been ignored and pushed aside.

This can no longer be considered simply an issue for Black mothers, but a crisis: Their lives are on the line as they try to bring life into this world.

We must center Black mothers and their experiences at the forefront of systemic change, unconstruct racial biases that can lead to difficult pregnancies, pass the Black Maternal Health Momnibus Act nationwide (you can track the progress here) and invest in community organizations and policy changes to bring widespread attention to the Black maternal health crisis and the effects it has on the Black community.

Taking my health into my own hands

I had the opportunity to give birth to four healthy children, but during my pregnancies, I also experienced systemic and institutional racism that is all too common in the maternal health field.

In a time that is meant to be the most exciting and transformative time in a woman’s life, for many Black women, that is not their reality.

My second pregnancy was more complicated than my first—but I was determined to give birth to two healthy twins. I did my research on the complications that could arise during birth and asked questions that would help guide me in the right direction if anything was to go wrong. When I brought up these questions and concerns to my doctor, I felt like he did not want me to be a part of the conversation about my own health. You see, my twins were a rare and dangerous twinning pair called monoamniotic monochorionic twins. Because MoMo twins represent between 1% and 5% of all identical twins, the research is limited. I thoroughly read all of the studies around the risks and experimental treatments in preparation to have an educated conversation with my admitting hospital doctors, only to be met with dismissive answers that didn’t address my questions and a “we know what’s best for you” attitude.

During my third pregnancy, when it was time for me to give birth to my youngest child, my new obstetrician was not interested in answering the questions I had or making me feel better or at ease, so I made the decision to kick him out of the delivery room.

I felt this was the right decision for me, even after months of setting the stage for my expectation of open communication in labor and after drafting a birth plan that literally just said, “My only expectation is open communication and a thorough explanation of why a procedure is being suggested.”

This, however, was not how things played out at all. My new doctor, a different doctor than the one who saw me with my twins, was once again dismissive of my desires to continue to labor unassisted with ruptured membranes (my water broke), even with regular temperature checks to ensure I did not develop an infection. After arguing with him—through contractions—I asked him to leave.

I felt confident enough to do this, but this is often not the case for other Black mothers in the delivery room. They don’t get the opportunity to take their health into their own hands as their concerns are often ignored, and are not given the same advice about their health as white mothers.

My experience and the experience of other Black mothers led me to become a doula and join MomsRising, where I advocate for issues that affect the most vulnerable moms.

Black moms are dying at the highest rate in the developed world

According to The National Institute for Health Statistics, the maternal mortality rate jumped significantly in 2019, with 754 women dying during pregnancy or within 42 days of giving birth, compared to 658 women in 2018.

Black women had the highest rate of maternal mortality than any demographic, with 241 Black women dying in pregnancy, childbirth, or after giving birth, which means Black women are 3 to 4 times more likely to die from childbirth than white women.

Seeing this data in writing makes the situation more real for others, but this is the reality that Black moms have to deal with when wanting to start or expand their family.

Read more: Having more Black doctors and midwives could be the key to reducing Black maternal mortality rates

The importance of uncovering the root cause

If we want to reduce the mortality rate for Black mothers, we have to look at the underlying causes that are at the root of the problem and change the narrative around how society views Black mothers.

Institutional racism is an underlying factor that Black mothers experience—resulting in the fact that they are treated differently than white mothers and are put in dire situations which can lead to death. Black mothers are not seen as equal to white mothers, and the biggest hurdle they will continue to face is the ways in which society and the medical field view them.

The stress, anxiety and other external psychological factors that Black women are predisposed to make them more physiologically vulnerable to premature birth, premature membrane rupturing and long-term health problems arising from their pregnancy.

Black maternal health disparity is a societal problem

Black maternal health is not a personal problem that falls on the shoulders of Black mothers and the Black community, but it is a societal problem that requires broad policy solutions.

To combat the stark reality of what maternal health looks like for Black mothers, we must support the community-based organizations that support Black pregnant mothers.

Investing and supporting these organizations will be the foundation of changing the narrative and the reality of Black motherhood.

We must understand and recognize how they play a critical role in the Black community and it has been proven they can determine black maternal health and they are the key to solving the crisis.

Read more: If we want to end racial disparities for moms and babies, we need to invest in our children—today

How to actively support Black mothers

At MomsRising, we are advocating for Congress to pass The Black Maternal Health Momnibus Act, which will fill gaps in existing legislation and offer much needed investment in addressing Black maternal health during pregnancy and postpartum so that the safety and health of mothers and their babies are prioritized throughout their entire journey.

We are bringing the real voices of Black families to lawmakers so they understand the need for the act that is critical in saving Black mothers and their babies.

While we address Black maternal health, we also cannot forget the ways in which breastfeeding plays into fully addressing the crisis. In the US, 4 out 5 mothers start out breastfeeding, but less than half are still breastfeeding at 6 months postpartum. Additionally, 60% of pumping parents don’t have access to adequate time or private, non-bathroom space to express breastmilk and society does not give them the support they need in order to breastfeed.

Black maternal health is an issue we can no longer ignore, as Black mothers and Black communities are on the line. To address the issues that exist that hinder Black mothers and put their health at risk, we must support the community organizations that support Black mothers.

We must push Congress to pass The Momnibus Act so there are adequate policies in place that protect Black women during and after pregnancy.

To get involved, you can reach out to your Members of Congress in the House of Representatives and the Senate to let them know why Black maternal health matters to you.

You can also join the community-based organizations who are leading the charge on supporting Black mothers and stay up to date on The Momnibus Act.