When Marlee James learned she was pregnant, she was determined to give birth at home. She had heard stories from Black women in her family of being ignored by doctors and needing to advocate for themselves before receiving adequate care. And in her work as a therapist, she had researched institutional racism and understood the harm it could cause in hospital settings.

“My overall feeling about it was just kind of a general mistrust,” James said.

Based on the statistics, James had reason to be concerned: The maternal mortality rate for women who are Black is more than 50 deaths per 100,000 live births, more than three times the rate for women who are white, Hispanic or Asian, according to the U.S. Centers for Disease Control and Prevention. In Minnesota, where the maternal mortality rate

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