What Black Expectant Mothers Should Expect—and Demand—in Care

When Knowledge Is a Lifeline: What Black Expectant Mothers Should Expect—and Demand—in Care

On January 2, the maternal health community lost Dr. Janell Green Smith, a certified nurse midwife and tireless advocate for Black maternal health. She died after delivering her first child. She was 31 years old.

This is not just a tragedy. It is a warning.

Black women in the United States are far more likely to die from pregnancy-related causes than white women. This gap shows up at every income and education level. It shows up in hospitals with the newest equipment. It shows up even when the patient is informed, trained, and deeply connected to care—as Dr. Green Smith was.

So we need to say this plainly: pregnancy is not safe for Black women in the same way it is for others. And pretending otherwise costs lives.

This is about vigilance. It is about knowing what questions to ask, what care to expect, and when to push back. Not because Black mothers should have to fight for safety but because, right now, too many still do.

The Care You Should Expect Every Time

Start here. These are non-negotiables. If they are missing, something is wrong.

You should be listened to.

Your concerns should never be brushed off as anxiety, stress, or “normal pregnancy stuff.” Pain, shortness of breath, headaches, swelling, bleeding all deserve full attention.

You should receive clear explanations.

Your provider should explain what they are checking for, why it matters, and what comes next. If you leave confused, the job is not done.

You should be monitored closely before and after birth.

Many maternal deaths happen after delivery, often weeks later. Postpartum care is not optional. It is essential.

You should be treated with dignity.

No eye-rolling. No rushed visits. No minimizing your voice. Respect is part of medical care.

If any of this feels shaky, trust that instinct. Your body knows when something isn’t right.

Questions Black Expectant Mothers Need to Ask

These questions are not about being difficult. They are about staying alive.

During Pregnancy

• What warning signs should I watch for between visits?

• How do you track high blood pressure, preeclampsia, or blood clots?

• If I report pain or symptoms, what is your process for follow-up?

• Who do I contact after hours if something feels off?

During Labor and Delivery

• Who will be making decisions if complications arise?

• How do you handle emergencies, and how quickly can you act?

• Will my support person be included if I cannot speak for myself?

After Birth (This Is Critical)

• What symptoms require immediate care after I go home?

• When is my first postpartum check, and can it be sooner than six weeks?

• What is your plan if I experience severe headaches, chest pain, or heavy bleeding?

If a provider resists these questions, that resistance is information. Pay attention.

Bring Support With You—Everywhere

You should not navigate pregnancy alone.

Bring an advocate.

A partner, friend, doula, or family member can help ask questions and speak up when you are tired or overwhelmed.

Write things down.

Keep a simple list of symptoms, dates, and changes. Documentation matters.

Say it again if needed.

If something is dismissed, repeat it clearly: “This does not feel normal for me.” That sentence is powerful.

This will allow you to be prepared in case something goes wrong.

Why This Burden Exists (And Why It’s Not Your Fault)

Let’s be clear: Black women are not dying because they don’t care for themselves.

They are dying because:

• Symptoms are underestimated

• Pain is dismissed

• Concerns are delayed or ignored

• Systems are built without Black bodies in mind

Education alone does not fix this. Awareness alone does not fix this. Accountability is what fixes this.

That is why organizations led by and for Black women matter so much.

Trusted National Resources for Black Expectant Mothers

These organizations provide education, advocacy, and support. Share them. Use them. Bookmark them.

• Black Mamas Matter Alliance. Focuses on policy, education, and community-centered care.

• National Birth Equity Collaborative. Works to end racial inequities in birth outcomes through research and systems change.

• SisterSong. A leader in reproductive justice and advocacy for Black women and birthing people.

• March of Dimes. Offers information on pregnancy risks, warning signs, and postpartum health.

These groups do more than share information. They push systems to do better.

What We’re Asking You to Do

This is not a moment for passive concern.

If you are pregnant or supporting someone who is:

• Ask the questions.

• Expect full answers.

• Seek second opinions when needed.

If you are a provider or administrator:

• Examine your response patterns.

• Believe Black women the first time.

• Build systems that catch problems early—not after it’s too late.

If you want to help:

Support Black maternal health organizations in your city or state. Donate if you can. Volunteer if you’re able. Share trusted information widely.

Not because tragedy should be leveraged but because prevention is an act of love.

A Final Word

Dr. Janell Green Smith dedicated her life to safer births for Black women. Her death reminds us that knowledge alone does not guarantee protection in a broken system.

So we keep speaking.

We keep asking.

We keep insisting on care that matches our worth.

Because Black mothers deserve to live.

And their children deserve to grow up with them.