This article examines how systemic racism drives higher rates of maternal mortality and complications among Black birthing people in the U.S. It reviews policy fixes—such as paid leave, telehealth expansion, and the Momnibus Act—alongside health-care reforms like diversifying the perinatal workforce and boosting midwife and doula access, and highlights community organizations leading local efforts.

• Black women die from pregnancy-related complications at 2-3x the rate of white women, mostly from preventable causes, regardless of income or education—wealthiest Black Californians face higher maternal mortality risk than poorest white Californians.
• The 1910 Flexner Report shut down all but two historically Black medical schools, creating today's shortage of Black physicians, while Black "granny midwives" who once attended half of U.S. births were sidelined to under 1% by 1975.
• The Black Maternal Health Momnibus Act bundles 12 bills to address these disparities, but only one component (Protecting Moms Who Served Act) has actually become law.
• Paid family leave and telehealth expansion (via CARES Act) have shown measurable success in narrowing racial gaps in postpartum care, yet the U.S. still has no national paid-leave guarantee.