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Many childbearing women in the United States struggle for their health and well-being. Every year, more than 55,000 experience severe maternal morbidity, or a “near-miss” of dying, often with long-term and even life-long consequences, and tragically about 700 lose their lives. Beyond these dire outcomes, large proportions experience problems such as disrespectful care; care that does not reflect the best evidence; complications from unneeded procedures; depression and anxiety; inadequate support for establishing and continuing breastfeeding. Many also lack other essential supports such as paid family and medical leave and paid sick days. Across these and many other indicators, Black and Native women fare far worse than white women, a result of racism, not race. Similarly, rural and low-income women regularly fare worse than their counterparts.

This situation is devastating for our most marginalized and oppressed communities. Moreover, our failing maternity care system reaches across the entire population: maternity care affects everyone at the beginning of life, and 85 percent of women who give birth to one or more children. Lessons from the “developmental origins of health and disease” clarify that early exposures can set the stage for a healthy or unhealthy life course.

Fortunately, an unprecedented number of federal and state policymakers, community-based and other advocacy organizations, funders and others are stepping up to respond to this unacceptable and avoidable situation as an opportunity to do better. Superior results in peer nations and in high-performing areas and through high-performing care models in this country inspire and point the way. Some maternal health bills have passed in Congress and statehouses, many others have been filed and others are being developed. Favorable policies and programs are being established, and quality improvement initiatives are being implemented. Many others are exploring options for action, and some are creating significant initiatives.

The National Partnership for Women & Families has released a new report for all who are stepping up or thinking of stepping up to help create a high-performing maternity care system that works for all women and families. Maternity Care in the United States: We Can- And Must-Do Better is a broad overview of the state of the nation’s childbearing women and newborns, the state of our maternity care system, and priority high-yield directions for rectifying substandard care, experiences and outcomes, at exorbitant costs. An equitable, high-performing system for all childbearing women and families is within reach.