We Shouldn’t Have to Be Willing to Die to Give Birth in the U.S.

I still recall the visceral reaction I had to hearing Serena’s birth story back in 2018. It was the first time the realities of birth and the maternal health crisis landed on my radar. I remember thinking: If that could happen to Serena Williams, what makes any of us safe? I packed the thought away in the back of my mind, where it stayed until I found out I was pregnant for the first time in 2021. Suddenly, it was my turn to face the fears that had been planted years before.

Between Serena’s first birth experience and mine, more than 3,400 mothers died during or after childbirth in the U.S. That’s 3,400 prayers never whispered into tiny ears—3,400 parents who won’t be able to watch their beautiful babies grow up. This should not be the norm in the country with the largest economy in the world. According to the World Health Organization, the U.S. has the highest maternal mortality rate of all industrialized nations. Yet the majority of maternal and infant deaths in the U.S. are preventable. Why then, with all the advancements in modern medicine and technology, are the numbers only getting worse? Why aren’t more resources going toward saving our mothers, especially now when more of us are being forced into a broken maternal health-care system due to a rollback in reproductive rights? Why aren’t we all talking more about solutions?

While we were both marginally aware of the ongoing maternal health crisis before having children, we were admittedly living under the misguided illusion that our privilege might insulate us from the threat of becoming statistics. We couldn’t have been more wrong.

Having babies in America was a wake-up call for both of us. Like many parents, and first-time parents at that, we never anticipated the harrowing experiences we’d have on the road to becoming mothers. We have both accomplished a lot in our lives and careers—from Grand Slams to history-making career appointments—needless to say, we can do hard things. But nothing made us feel as disempowered as being pregnant and Black in America, left to rely upon a medical system that is statistically failing people who look like us. The CDC reports Black women are three times more likely to die during and after childbirth than white women. Giving birth shouldn’t have made us fearful for our lives, but we both were. And the overall picture isn’t good for any of us. Many people still think of the maternal health crisis as a far-away problem. It is not. Nearly half of mothers in this country label their births as traumatic.

Serena’s near-death experience in the hospital during childbirth has been well documented. Last year, in an op-ed for TIME, Elaine shared her demoralizing experiences with doctors that led to her life-changing decision to have a home birth attended by Black midwives. Midwifery is the default birth-care model used within and outside of hospitals in other high-income countries with better birth outcomes including the U.K., France, and Canada—yet it is not covered by most insurance providers in the U.S., and midwifery-assisted home birth is outlawed in some states.

Read More: The History That Explains Today’s Shortage of Black Midwives

Sharing our stories was important for raising awareness. But we didn’t want to stop there. We want to be part of creating solutions that change not only the conversation but also the standard of birth care in this country. We both feel that the current discourse around maternal health is missing a necessary call to action and an accessible entry point to work together toward improving birth outcomes in real time.

What began for Elaine as a birthday fundraiser on Instagram in December 2023 has inspired a new movement for maternal health called birthFUND. In just 16 hours, that birthday fundraiser raised nearly $16,000 to cover the cost of birth care for two families at Kindred Space LA, the Black-owned midwifery practice that Elaine worked with for her own delivery. Since then, by enlisting a high-profile funding circle of families like Serena and her husband Alexis Ohanian, John Legend and Chrissy Teigen, Kelly Rowland, Ashley Graham, and Karlie Kloss, as well as strategic corporate partners like SoFi, birthFUND has quickly grown into a coalition that is committed to expanding access to midwifery care for families across the country who can’t afford to pay the out-of-pocket costs.

Expanding access to midwifery care—which the World Health Organization reports could avert more than 80% of all maternal deaths, stillbirths, and neonatal deaths—is one critical step in the direction of progress. Midwives are clinically trained professionals who attend low-risk births and deliver safe, holistic, culturally conscious maternal health care that contributes to better birth outcomes in high-income countries all over the world. Yet, in the U.S., midwives are often not fully covered by insurance, and for decades have been the victims of an effective propaganda campaign that has led to widespread stigma and distrust in the same holistic model of care that quite literally birthed our nation. Since the advent of modern obstetrics replaced midwifery as the default form of birth care in America in the early 20th century, the health care system has created monetary incentives for medical interventions during birth that can have adverse effects. While the demand for midwifery and out-of-hospital births began to steadily rise in the U.S. during and after the pandemic, it’s still out of reach for many families.

Read More: If We Want to Save Black Mothers and Babies, Our Approach to Birthing Care Must Change

Choosing birth care is a deeply personal decision. We are not here to stoke arguments over the best way to give birth or to fuel fear-based, anti-doctor narratives. Our goal with birthFUND is to help remove financial barriers to quality care and to expand life-saving access to both education and choice. No matter where or how they decide to give birth, parents deserve access to safe, dignified care. Right now, that human right is out of reach for far too many.

As isolating as our birth experiences felt, they were reflective of a widespread crisis. Whether due to unwarranted medical interventions, racial bias, or gross negligence before, during, and after childbirth, the outcomes in the U.S. are staggering—and all too often, fatal. Our birth experiences are proof that no one is insulated from falling through the cracks of a broken system. And while even wealthy Black women are currently dying at similar rates to poor white women, we need to be careful not to frame this as just a Black woman’s problem. Because it isn’t. Nor is this a poor people’s problem. Charles Johnson, whose wife Kira died in 2016 following a scheduled cesarean section, said it best: this crisis of care is “a human rights issue.” It impacts us all. And it’s taking too long to fix what’s broken.

We are ready to tackle this issue, head on. And we hope families—and companies—all over the country will join us.

Elaine Welteroth is a mother, journalist, TV host, and founder of birthFUND, a network of families committed to expanding access to safe and affirming birth care across the country by matching individual funders with families in need of quality birth support through midwifery options.

Serena Williams is a mother, entrepreneur, 23x Grand Slam-winning athlete, and founder of Serena Ventures.

Contact us at letters@time.com.