I used to be born and raised in Houston, Texas. It’s the town that formed me, the place the place my household constructed a life, and the place the place I believed I’d be most secure bringing a toddler into the world. Houston is residence to the world’s largest medical middle and is commonly held up as an emblem of medical excellence and innovation. It’s additionally the place I practically died giving beginning.
In November 2005, I walked into my OBGYN’s workplace for what I believed can be a routine prenatal checkup. I used to be shut to 6 months pregnant, college-educated, dwelling a solidly middle-class life, and insured twice over by way of each my employer and my then-husband’s employer. By each measure, I used to be thought of low danger. I had no prior historical past of hypertension or hypertension. I attended common prenatal visits. I had secure housing, dependable entry to wholesome meals, paid day without work, and entry to specialists. I used to be giving beginning in my hometown, surrounded by the medical establishments for which Houston is known.
Once more, I virtually died.
Within the weeks main as much as that appointment, my legs and ft had swollen past consolation, and my complications arrived each day, heavy and unrelenting. I informed myself this was being pregnant– the physique stretching and adjusting underneath the burden of recent life. I informed myself the complications have been migraines, one thing I had lived with lengthy earlier than I grew to become pregnant. However that day, my physician took my blood stress and instantly despatched me to the hospital.
I used to be experiencing preeclampsia, a pregnancy-induced hypertension that may escalate shortly and change into deadly with out intervention. Docs hoped mattress relaxation would purchase us time. At 25 weeks pregnant, my daughter’s organs weren’t totally developed, and each extra day inside my physique mattered. However my blood stress continued to rise, and with it got here the chance of stroke and dying.
I delivered my daughter weighing 1 pound and 1 ounce. She spent 4 months within the NICU, her physique sustained by machines that breathed for her till she may breathe on her personal. In the present day, she is a cheerful and wholesome 20-year-old, and the rationale I consider in miracles.
However Black ladies mustn’t need to depend on miracles to outlive being pregnant and childbirth.
What occurred to me was not an anomaly however a part of a sample that continues to position Black birthing folks in peril. In the present day, Harris County, Texas, which incorporates Houston, is without doubt one of the most harmful locations within the nation for Black ladies to provide beginning. Between 2016 and 2020, Black ladies in Harris County died from pregnancy-related causes at a charge of 83.4 deaths per 100,000 reside births, the best recorded charge for any racial group within the nation, in accordance with the Houston Chronicle. White ladies in the identical county died at roughly one-quarter that charge, a disparity so extreme that Harris County Public Well being has named Black maternal dying the county’s most pressing maternal well being menace.
This native emergency mirrors a nationwide one. In 2023, the maternal mortality charge for Black ladies in the USA was 50.3 deaths per 100,000 reside births, in comparison with 14.5 for white ladies, in accordance with the Facilities for Illness Management and Prevention. Schooling and earnings don’t shut this hole. Black ladies with faculty levels are nonetheless considerably extra more likely to die from pregnancy-related causes than white or Hispanic ladies who didn’t full highschool, a sample documented each nationally and inside Harris County knowledge.
None of that is by probability.
The CDC experiences that almost all pregnancy-related deaths in the USA are preventable. Analysis persistently factors to not biology, however to structural racism, persistent stress, environmental publicity, unequal entry to high quality care, and chronic bias inside medical programs as the first drivers of Black maternal dying.
Research have proven that many medical suppliers maintain false beliefs about organic racial variations, which results in Black sufferers’ ache being underestimated and their signs extra more likely to be dismissed or delayed in scientific settings, together with throughout being pregnant and postpartum care. These outcomes will not be about particular person habits. They’re the predictable results of programs that underestimate Black ladies’s vulnerability whereas overestimating our capability to endure hurt.
If schooling, proximity to care, or skilled experience may assure survival for Black ladies, then Dr. Janell Inexperienced Smith would nonetheless be alive. Dr. Inexperienced Smith was a 31-year-old Black nurse-midwife, educator, and maternal well being advocate who died in January 2026 from problems associated to childbirth after growing extreme preeclampsia. She returned to the hospital following a ruptured surgical incision and by no means made it residence. Her dying made a painful reality that’s unattainable to disregard. No credential, earnings degree, or skilled title can override a healthcare system that is still detached as to whether Black ladies reside or die.
This is the reason what is occurring in Houston can’t be understood solely as a healthcare failure. It’s a reproductive justice disaster. Reproductive justice was created by Black ladies within the mid-Nineteen Nineties, following the 1994 Worldwide Convention on Inhabitants and Growth in Cairo, by organizers who later fashioned SisterSong Ladies of Shade Reproductive Justice Collective. The framework moved past slim concepts of selection and entry, naming the correct to not have youngsters, the correct to have youngsters, and the correct to lift these youngsters in protected and sustainable communities. At its core, reproductive justice has at all times been about survival.
Over time, reproductive justice has been diluted and absorbed right into a mainstream reproductive rights motion lengthy dominated by white ladies and white-led establishments, narrowing its focus to authorized abortion entry and particular person selection whereas sidelining the structural racial and financial situations that form ladies’s lives. Students and advocates have warned that when reproductive politics middle on “selection” with out confronting race and sophistication, they privilege these whose decisions are already protected. The result’s a motion that mobilizes shortly round laws however struggles to rally round Black ladies’s survival, together with crises like maternal mortality and postpartum care.
So what does change require? It requires funding in Black-led maternal well being organizations, midwives, doulas, and community-based care fashions confirmed to avoid wasting lives. It requires necessary anti-racism and bias coaching for healthcare suppliers, not as a field to examine however as a situation of apply. It requires extending postpartum care past six weeks and treating being pregnant as a continuum, not an occasion. It requires lawmakers to fund maternal well being with the identical urgency they bring about to policing replica. And it requires reproductive justice actions to return to their roots by centering Black ladies’s survival as non-negotiable.
In Harris County, the information is unmistakable, the disparities are documented, and the losses are ongoing. What stays unresolved is whether or not Texas, and this nation, are keen to confront the reality that Black maternal dying shouldn’t be an accident. It’s the predictable end result of coverage decisions, racial indifference, and a failure to behave.
Till that adjustments, Houston will stay a spot the place giving life too typically means risking dying. That may be a ethical failure we are able to now not afford to excuse.
Josie Pickens is an educator, author, cultural critic, and abolitionist strategist and organizer. She is the director of upEND Motion, a nationwide motion devoted to abolishing the household policing system.
SEE ALSO:
Understanding The Black Maternal Well being Disaster
RFLC Needs To Finish The Black Maternal Mortality Disaster
