Pregnant While Black: Advancing Justice for Maternal Health in America

by Monique Rainford

A tragedy is unfolding all around us and is receiving well overdue attention. Black women are three times more likely to die from pregnancy than their white peers. But Dr. Monique Rainford is working to better understand these disparities and do something about them. Pregnant While Black is a hopeful exploration of the issues pregnant Black women face in America . Within these pages, Dr. Rainford draws on over twenty years of experience working in obstetrics and gynecology to offer a primer on Black pregnancies and how to better care for them. She shares the successes and testimonies of Black women who have struggled during pregnancy and childbirth, anchoring the stories of these women with carefully researched facts. Despite medical advances over the last twenty years, for Black women, the overwhelming dangers of carrying and delivering children remain and it only seems to be getting worse. In Pregnant While Black , Rainford begins the work of "repairing the damage of the past" with an examination of the conditions that plague Black pregnancies. This important book carries the hopes and dreams of a generation looking to effect change, here and now.

Genres: Nonfiction, Science, Race, Feminism

245 pages, Hardcover

Published April 11, 2023

Reviews

[Jessica - How Jessica Reads · Rating 5 out of 5]

A heart-breakingly important read. So sad how many Black women die in childbirth. ☹️

The numbers/stats are a little much on audio — I had to rewind a couple times to relisten to some numbers.

But I still think everyone working on antiracism or in healthcare should read this!!!

[Robyn E · Rating 4 out of 5]

While I always knew that pregnancy, labor and postpartum all have risks associated, I was shocked to learn of the wide disparity between black women/babies outcomes vs all other races/ethnicities.

Did you know that the infant mortality rate for black American babies is more than double the rate for their white counterparts?

Did you know that black American babies fare worse than Jamaican babies born in Jamaica? Why is that? As the author states in the book, “poverty could never tell the entire story because poverty is definitely a factor in Jamaica, too.” Education & class do not lessen the maternal death rate.

This book offers a multitude of studies and statistics regarding black mothers/babies complications and mortality. The disparity is unacceptable, especially in an advanced and wealthy country as the US!

There’s so much more I could say….
I hope more people become aware of this (long overdue) urgent issue!
This must change.

RIP Dr Janell Green Smith who died January 2, 2026 due to childbirth complications during delivery of her 1st baby at 31 years old. She was a midwife and advocate for black maternal health. 💔😞

Format: audiobook

[Susannah Carter · Rating 2 out of 5]

Another read for class - similar to Under the Skin and Chasing the Scream, I just struggle with books that try to translate highly complex literature and statistics into easily digestible content for the everyday reader. So much of it reads as sensationalized. A really important topic, but I didn’t love the way it was written

[Kylene Jones · Rating 4 out of 5]

This was an amazing book. I already knew that our maternal mortality rate in America is bad and worse for POC but the stats are staggering. I also did not understand why. The last few years, I have been trying to become more socailly aware and the institutional racism is so hard for me to process. I have read several books on the subject and it breaks my heart. I am so ready for the day when people are people and it doesn't matter the color of their skin or who they love or if they are not able-bodied.

This book was well written and easy to read. Not easy reading though. The subject was tough but it was written in a way that most should be able to understand it. I am very glad I won this ARC from LibraryThing. Thank you for my book.

[Muthoni Ngocho · Rating 5 out of 5]

While I am no where near becoming pregnant , I do hope to become a mother one day.

Unfortunately, learning about the black maternal health crisis in detail and the disparities that black women are likely to face is part of the journey.

There is a ray of hope all the same , “the black martenal health momnibus act”, PREM-OB Scale (rigorously developed tool to quantify obstetric racism), Irth App( allows you to view and provide ratings of marternity and pediatric doctors and delivery hospitals)

[VLeighIsMe · Rating 4 out of 5]

Very informative but, as a black woman, very hard to get through. I had to take my time.

[Abigail Faulkner · Rating 5 out of 5]

Dr. Monique Rainford does an amazing job putting into word the disparities black women face in health care. As someone studying in social work, I think reading literature like this is imperative to being more culturally competent and to be able to better advocate and empathize with the new mothers I will come to work with. The research that she uses to further explain her arguments are all used well and answer questions that I would have about the studies as someone who has previously worked in research. She takes these complex ideas and does an amazing job of explaining all the layers of these issues without making you the reader feel dumb. It’s a difficult book to read, and it took me far longer then is typical for me to read it. That being said, I don’t thats a detriment here or a result of her writing skills. When it comes to writing, she clearly knows what shes doing. Furthermore, I don’t think reading a book about how America is failing black mothers and black babies should be an easy read. If your are going into any medical related field, do any field that works with pregnant women, this should be required reading.

[Rhiannon · Rating 5 out of 5]

I really appreciated Dr. Rainford's book highlighting the key facts and figures surrounding the black maternal mortality disparity. I am a social worker in a graduate program and have been drawn to this issue after it became more salient to me through work with clients; I've written research papers and made presentations displaying this topic. I thought "Pregnant While Black" was an eloquent, thorough, and comprehensive depiction of the maternal mortality disparity present within our country, complete with causes, (personal) anecdotes, and proposed solutions on all levels to address this inequity. I am very interested in working in this sector in my future social work career and Dr Rainford's book was very compelling in this country's urgent need for action and the implementation of change.

[Ren · Rating 5 out of 5]

This was a thoughtful and informative book on a major issue in the United States. This book did a wonderful job of sharing issues and information around maternal health of black women. The information in this book is relayed in a way that is accessible and clear. The use of stories makes this all the more real and emotional. Often books like this can be too caught up in the jargon, but this book was written so that even people without a medical degree can understand the nuances of this issue. Additionally, Dr. Rainford handles this with compassion. I would highly recommend this book to anyone wanting to learn more about this issue.

[Curtis · Rating 4 out of 5]

I had some awareness of the fact that Black women face a higher maternal fatality rate than their non-Black counterparts, but I did not know much more than that regarding this issue. Dr. Rainford does a fantastic job of comprehensively explaining the various factors that contribute to this unacceptable reality in a way that is easy to understand. Increased awareness around this issue is extremely important, and this book is an apt tool to help spread that awareness.

Note: I received a free copy of this book through the Early Reviewers program in exchange for an honest review.

[gelaine galupo · Rating 5 out of 5]

feels odd to rate this. started reading this because i was assigned excerpts of it to read in my maternal health class.

this was insanely well researched. i love the care dr. rainford puts into pairing key statistics and findings with meaningful experiences and stories she’s gathered in her time practicing. i liked this a lot, and i think the story of drs. shalon irving and sally ward will stick with me for a while.

[Lisa · Rating 5 out of 5]

An important book about a very important subject. Dr. Rainford shares stories and explains why pregnancy is so much more dangerous for Black mothers in the United States. She also tells us about programs that have been proven to improve the health of Black moms and infants.

[Karen E. Foster · Rating 5 out of 5]

This book is an interesting read on disparities among pregnant women of color. I learned so much regarding the advancement in the medical field, how Black women have overwhelming dangers of carrying and delivering children and it doesn’t seem to get better. We have taken so much for granted.

[Lily Snape · Rating 5 out of 5]

Super super informative and covers a large breadth of topics in Black Maternal Health. It is also EXTREMELY well researched and cited, but also has great anecdotes as well. I would definitely recommend to someone who does not have a lot of knowledge in the area.

[Brett Price]

Feels wrong to rate this. Important read, easy read. Doesn't read like a textbook.

[Myriam Coker · Rating 5 out of 5]

I read this for my patients

[Yadira Wood · Rating 5 out of 5]

Recommending this to all my medical colleagues. We can do so much better with information about what we’re not doing well.

[Katie Chignell · Rating 4 out of 5]

4⭐️ Another one I read for class. Overall, a very inspiring and well supported call to action to improve maternal health outcomes especially for Black mothers in the US. Writing style felt a little abrupt to me at some times, but another important read for anyone interested in healthcare.

[Erika Shira · Rating 4 out of 5]

It’s solid, has a lot of good information, and is written in a non-academic style with a personable and likable narrator. It’s unfortunately not queer-inclusive.

[Alyssa Crandall · Rating 5 out of 5]

Heartbreaking and infuriating but an extremely important read.

[Josia Klein · Rating 5 out of 5]

4.5 stars rounded up. Monique Rainford is a fantastic writer, weaving together statistics and stories to clearly portray the disparities Black women face in every piece of the U.S. healthcare system. She incorporates research and data to illustrate the problem but keeps the names and stories of real women at the forefront so that the reader isn't numbed or desensitized. All of these issues are written about with compassion and eloquence.

It took me a while to get through the book because it's just hard to read about how America is failing Black mothers and infants at every stage. Should be required reading for those of us working in healthcare or health policy.

[Griffin Wold · Rating 5 out of 5]

This is a detailed depiction of some of the many racial disparities Black women face while they are pregnant. She realizes that simply treating the symptoms will not cure it all, while still pointing out these injustices and things that can cause them as well as the effects these have on pregnant Black women. There are a lot of statistics, which both works well, but can also make it slightly inaccessible for some audiences who may not understand them.