The apparent rise and high levels of maternal mortality in the United States have been the subjects of considerable attention in the national press and in the realms of public health and clinical medicine in recent times. Although the attention is welcome to the long-neglected issue of maternal deaths, it is indeed frustrating for our nation that the problem continues to exist. The best information we have to account for maternal deaths, the Centers for Disease Control and Prevention’s Division of Reproductive Health’s Pregnancy Mortality Surveillance System, recently reported a pregnancy-related mortality ratio of 17 deaths per 100,000 births for the period 2015–2016.1 In addition to this high and unacceptable rate, there are persistent gaps in risk, with American Indian–Alaska Native and non-Hispanic black populations having 2–3 and 3–4 times the risks of other race–ethnicities, respectively. Health and medical care exist in the context of the larger society, and our failure to address the needs of women and the inequities borne by marginalized populations is a reflection of reconciling what we say we value and what we do to achieve our valued goals.
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