I barely survived giving birth to my daughter. In fact, both of us barely survived. My little one, just 25 weeks old and weighing only one pound at birth, is the greatest warrior I will ever know. And I am still dealing with the mental and emotional effects of my pre-term birth—often afraid that every time I have a headache I may be having a stroke, that my organs will shut down, or that I will die and leave the love of my life without a mother.

But I was lucky.

Although I was rushed to the emergency room with Pregnancy Induced Hypertension (PIH), I lived fifteen minutes away from one of the best medical centers in the city of Houston, and the nation overall. I was supported by my amazing family, and I had excellent medical insurance that would ensure that my daughter and I would receive expert care. I found out recently that many women living in Texas (and in southern states overall) are not nearly as fortunate as I was to survive a complicated pregnancy and birth, as Texas has the highest rate of maternal mortality in the developed world.

Because we know that maternal mortality is a grave issue affecting poor women without access to proper health care, we should also know that women of color, and particularly Black women, are disproportionately affected by it. In fact, and as advocate Elizabeth Dawes Gay notes, “Overall, the rate of maternal mortality among Black women is three times that of white women (28.4 per 100,000 live births and 10.5 per 100,000 live births, respectively).” Therefore, we must look at maternal mortality amongst Black women as both a reproductive justice issue, and a social justice issue.

Because Black mamas matter.

In June, a group of reproductive health and justice advocates came together in Atlanta to affirm just that. To gain further insight on the issue of Black maternal health, I spoke with three reproductive health advocates who attended the June meeting mentioned above: Elizabeth Dawes Gay, MPH (who is a reproductive justice advocate and freelance writer), Kwajelyn Jackson (who is the Community Education & Advocacy Director at Atlanta’s Feminist Women’s Health Center), and Pilar Herrero (who works with the Center for Reproductive Rights).

Here’s what I learned:

EBONY: What are some of the causes for the U.S. having such high rates of maternal mortality, and more specifically how/why do these statistics health issues affect Black women living in the south so severely?

EDG: Many things that influence pregnancy outcomes happen well before pregnancy happens, and before someone interacts with the health care system. Access to food, a living wage, safe housing, neighborhoods free from violence, political power, and social experiences that are influenced by race, gender, class, etc. all play a role in people’s ability to be healthy and maintain their ideal state of well-being.

KJ: One of the things we believe is contributing to the high maternal mortality in the south among Black women is the lack of health care access many women have before they even get pregnant, during their pregnancy and after they deliver. Georgia is one of several states in the south that has not expanded Medicaid under the Affordable Care Act, and several thousand people still have no access to affordable, comprehensive health care coverage of any kind.

PG: The data on maternal mortality tells us that the leading direct causes of maternal death include things like heart conditions, infections, severe bleeding, blood clots, pregnancy-induced high blood pressure, and stroke. However, there are also existing clinical solutions to these problems, so at least part of the answer involves ensuring that Black women have equal access to quality, life-saving care…Racism and poverty also undermine Black women’s health. Research shows that race impacts maternal health by acting as a stressor, and by limiting Black women’s access to the resources that they need to sustain their best health.

EBONY: Explain why these statistics on Black maternal mortality qualify as a human rights issue, a feminist issue and a racial justice issue.

KJ: For many of us, reproductive justice lives where human rights, racial justice, and reproductive rights intersect. So much of what we do centers how the many identities we hold affect the way we experience the world. Black maternal mortality is just as affected by our access to family planning and abortion, as it is connected to our ability to parent with dignity. For Black women, whose bodies are overwhelmingly policed that ability to have and parent the children and families you want, as well as the ability to choose whether and when to have children are core to our basic human rights.

EDG: Maternal mortality in the Black community is at its core tied to the experience of living while Black in the United States. It’s a very stressful and traumatizing experience. The murders of Black people by police and vigilante citizens is the most hostile way we observe racism in our country. But the persistent and perpetual devaluation of Black lives is also seen in how systems neglect our health, education, right to a living wage, right to justice…the list goes on.

EBONY: What can Black women do to advocate better for themselves with regard to pregnancy and childbirth, so that we can see statistics surrounding Black maternal mortality change?

PG:  In the context of maternal health, there are probably many ways that Black women can care for themselves and one another that fall outside the scope of law and policy- but as a lawyer, I am especially interested in changing the rules that influence maternal health. The Black Mamas Matter network was created, in large part, to do just that.

KJ: VOTE—and not just federally, but locally. There are so many policy decisions that impact our daily lives that are decided locally and not by the President. It is crucial to know what is happening and who decides, at the state legislature as well as county and city levels.

EDG: …One of the best things we can do for ourselves is to begin to provide each other with the kind of care that we want. If the medical establishment isn’t going to help us and will actually harm us, we have to take care of each other. We need more care providers who are looking out for our best interests and willing to provide holistic care.

As Pilar Herrero mentioned above, Black women have worked diligently as part of a multitude of human rights movement documented as part of this nation’s history. We cannot fight for the rights of others more than, or even before, we fight for our own rights to survive and thrive. It’s past time we change the narrative on Black women and maternal health.