The blood clots that nearly killed tennis star Serena Williams shortly after she gave birth were a grim reminder that neither resources nor fame offer full protection from the risk of giving birth while Black. “No one was really listening,” wrote Williams, describing her frantic effort to get medical attention. Maternal and infant mortality rates are far higher in the US than in any other wealthy country, and Black women are three times more likely than white women to die from pregnancy-related causes. Health complications are unacceptably high among women of color—and the disparities have been widening for years. How did we get here, and where do we go from here?