GEOFF BENNETT: For too many American women, giving birth can be deadly.

The U.S. has the highest rate of maternal mortality among developed nations.

Over 1,200 women died of maternal causes in 2021 alone.

But, for some, the risk is even higher.

Black women are three times as likely to die from labor complications.

Amna Nawaz reports on the people who are working to help them have safer pregnancies.

WOMAN: Hi.

DR. DOEE KITESSA, University of Maryland School of Medicine: Hi.

How are you today?

WOMAN: I'm good.

AMNA NAWAZ: Dr. Doee Kitessa is on a mission.

DR. DOEE KITESSA: Take a look at where your blood pressure was today.

AMNA NAWAZ: The obstetrician/gynecologist is an attending physician at the University of Maryland Medical Center in Baltimore.

DR. DOEE KITESSA: I went into medicine to improve health.

And so, when you see disparities, I want to make it better.

Particularly, as a Black woman, this is something that is near and dear to my heart.

AMNA NAWAZ: More than 60 percent of the city's population is Black, which Dr. Kitessa says plays a crucial role in the quality of prenatal and postpartum care Black women often receive.

DR. DOEE KITESSA: So I think race plays a couple of factors.

They have less access to quality education because of issues like redlining, for example, that historically has been present in the United States, particularly in Baltimore.

It affects housing.

It affects income.

And that is going to impact their health outcomes in terms of access to care.

AMNA NAWAZ: Another critical component she's seen in the health care system, patients not being heard and their pain dismissed.

DR. DOEE KITESSA: What ends up happening is, Black women feel that their concerns are not listened to, or when they come in, in labor, their pain is dismissed, or, when they come in just with a complaint of pain, that it might not be fully evaluated, that it's explained away from other reasons, rather than being listened to and fully evaluated.

KRYSTLE CARTER WORD, Patient: They were relatively dismissive of what I was saying.

They were saying, well, fibroids are common.

AMNA NAWAZ: Krystle Carter Word struggled to get doctors to take her concerns seriously when she had trouble trying to conceive.

KRYSTLE CARTER WORD: They were seeing just a patient based on whatever demographic I fit in, and because fibroids are higher for African American women, and lots of women do conceive with them.

AMNA NAWAZ: Research has found that, by the age of 50, 80 percent of Black women are likely to have fibroids.

KRYSTLE CARTER WORD: What I have learned is, sometimes, fibroids can impact your ability to conceive, and, other, times it can't.

So, Dr. Kitessa, who I worked with here at University, was able to help me identify that as a potential issue.

And that is what I really liked.

It felt like a decision that I was very much in charge of, and, after I had the fibroids removed, I was able to conceive twins.

AMNA NAWAZ: But Black women are at higher risk for other health complications as well.

DR. DOEE KITESSA: Black people have higher rates of high blood pressure.

In pregnancy, high blood pressure can manifest as preeclampsia, which is a disease of pregnancy which there are higher rates in Black women, diabetes in pregnancy.

And it's not something inherently about Black people that -- or genetically that causes them to have these conditions more.

With fibroids, we don't necessarily really know why.

Some of the ideas about things like diabetes and high blood pressure is this idea of weathering, that the chronic stress of racism over time is changing our bodies at the cellular level.

AMNA NAWAZ: Despite growing awareness of these issues and medical advancements over time, the numbers of Black women dying in childbirth have continued to climb.

A long-term study out this summer showed that the largest jump in deaths was among American Indian and Alaskan Native mothers and that the maternal mortality rate in the U.S. more than doubled with Black mothers.

MARY KATHERINE, Patient: The nurse on labor and delivery tells you describe your pain, and you start crying, telling her exactly how much pain you're in, and she tells you to shut up because she is typing.

AMNA NAWAZ: Black women like Mary Katherine (ph) have been sharing their stories on TikTok and other platforms to raise awareness and create a community of support.

MARY KATHERINE: Please help you, because you feel like you're dying, she tells you she feels like you're faking for pain medicine.

ELAINE WELTEROTH, Journalist: I think that these stories tell us that this crisis is real.

AMNA NAWAZ: Journalist Elaine Welteroth had her own bad experiences while pregnant, even early on during routine checkups.

You talked about going doctor to doctor, trying to feel safe and to feel heard.

Give us a sense of what you were running into.

ELAINE WELTEROTH: I had a doctor interrupt me in the middle of a question, telling -- closing her laptop, standing up and walking out of the room to tell me and -- and told me on the way out that I was asking too many questions.

And it made me feel incredibly small and belittled.

AMNA NAWAZ: She eventually sought support from a Black-owned birthing center, working with a midwife and doula to deliver her son.

ELAINE WELTEROTH: We are living in a maternal health crisis in this country and across the world.

AMNA NAWAZ: Welteroth now uses her platform to advocate for change, and hopefully save lives.

ELAINE WELTEROTH: I shouldn't feel like one of the lucky ones because I survived my birth experience in the richest country in the world.

But I do.

AMNA NAWAZ: But experts worry, for women already at higher risk during pregnancy, the Supreme Court's decision to overturn Roe v. Wade could be potentially more deadly.

What kind of impact do you think the Dobbs decision, the overturning of that, could have on maternal mortality?

DR. ALLISON BRYANT, Mass General Brigham: I think it's only going to be worsened by the Dobbs decision.

So, I think, in those states in which individuals are sort of having to carry pregnancies that they either did not desire to carry or really their clinicians thought they were not healthy enough to carry, that's only going to exacerbate the inequities that we see in severe maternal morbidity, as well as mortality.

AMNA NAWAZ: After years on the front lines of the fight to save lives, Dr. Kitessa is now preparing the next generation of doctors to carry forward her work.

DR. DOEE KITESSA: We should be appalled by anyone dying in pregnancy.

My mission as an OB-GYN and being an educator is, I want to fundamentally change how we provide care to Black women, how we provide care to other women from marginalized communities, and addressing a lot of these issues that we've talked about related to unconscious bias, related to structural racism, related to trust, related to recognizing patients' humanity.

AMNA NAWAZ: Krystle Carter Word, meanwhile, is settling into motherhood.

KRYSTLE CARTER WORD: I'm learning something new every day.

I am learning that I am not actually in charge.

I can make a schedule, I can make a plan, but my girls are really the ones who are going to dictate how the day's going to go.

It's been exciting.

It's been joyful.

And it's been exhausting.

I was given the tools I needed to help keep myself and my babies safe.

AMNA NAWAZ: Grateful, she says, for the support of her doctor that brought her to this moment.