On all fours in an inflatable pool in my living room, I could feel my baby’s head crowning. I reached down to touch him, stunned at the quiet instinctiveness my body seemed to possess. Before I could even think about what to do next, my body summoned one last great push, safely delivering my son into my husband’s waiting hands. We sat there in awe, just the three of us—no doctor, no midwife, no doula—soaking in what suddenly felt like the perfect birth.

My husband and I always knew we wanted a home birth. Aromatherapy, candlelight, and the comfort and safety of my own home always sounded far superior to a sterile hospital delivery room filled with strangers in scrubs. But what we didn’t initially plan was that we’d have a completely unassisted home birth, without a trained birthing professional like a doctor or midwife present to help coach us through the delivery of our first child.

From almost the moment I found out I was pregnant, I worried. Every mom-to-be worries—Will I have pregnancy complications? Will my child be healthy? Will I poop during labor?—but with my being a black woman in America, the realization quickly set in: Being pregnant meant putting my well-being, even my life, on the line in a way that white moms, statistically, don’t have to.

Shockingly, the United States is the most dangerous developed country in the world to have a baby. Women in the U.S. are three times more likely to die during childbirth than women in Canada. To put it in perspective, that’s a higher maternal mortality rate than in Kuwait and Kazakhstan. Immediately after birth, complications like postpartum hemorrhage can threaten a new mother’s life, and after leaving the hospital, many more women face health complications that can be life-threatening, according to the Centers for Disease Control and Prevention. Some estimates say 60 percent of these deaths are preventable.

That’s enough to keep any pregnant woman up at night, but for black women, the stats are even more chilling. Black women in the United States are three to four times more likely to experience pregnancy-related death than white women. The prevailing theory as to why this gross inequity exists? Black women are often ignored and dismissed when it comes to health issues, including ones that can turn fatal.

Even Serena Williams isn’t immune to the deadly bias. The day after giving birth, she was having trouble breathing. With a history of pulmonary embolism, she notified her care team right away, telling them she needed a CT scan. But Williams’ request was initially downplayed; nurses thought her pain medication might be making her confused, she told Vogue. Her persistence is what ultimately saved her life. When she finally did get the scan, it revealed blood clots had indeed settled in her lungs.

Not all black women are as lucky. Kira Johnson, a 39-year-old woman in Los Angeles, died just hours after giving birth to her second child. After a routine C-section, Johnson began complaining of excruciating abdominal pain and started losing color, her husband told People. He noticed blood in her catheter, but it was hours before her health care professionals took any action, he said. Another surgery revealed Johnson had massive internal bleeding. She died from the complications.

This racial bias weighed heavily on my mind—with stories like Johnson’s and Williams’ happening more often than I could stomach, how could I feel safe having a hospital birth? My husband’s own grandmother died while pregnant in the hospital. She was just 35.

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