• Buy Expecting Inequity: How the Maternal Health Crisis Affects Even the Wealthiest Black Americans.

Transcript

0:00:08 Michele Goodwin:

Fans and friends, welcome to the Book Club, part of our On the Issues with Michele Goodwin at Ms. magazine platform. You know we report, rebel, and we tell it just like it is. Spring marks the launch of this special book club series at Ms. magazine and Ms. Studios, featuring four incredible authors, Professor Dorothy Roberts, Patricia Williams, Khiara Bridges and Keisha Blain. 

Their pioneering works span history, memoir, art, health, family, politics, law, and reproductive justice. We bring this special series together, highlighting the significant contributions of these four award-winning authors, among whom are two MacArthur fellows, otherwise known as MacArthur Genius Awardees. 

Their path-breaking research and storytelling showcase the hidden, forgotten, and overlooked, giving a breathtaking look at the unexamined and the underexplored. This book club series is one of our ways, at Ms. Studios to reflect on the 250th anniversary of the Declaration of Independence through a lens that centers women and explores the experiences of Black women. We present to you the Ms. Book Club Spring Edition. 

Welcome to this episode of the Spring 2026 Ms. Book Club, featuring my conversation with renowned Professor Khiara Bridges, author of Expecting Inequity: How the Maternal Health Crisis Affects Even the Wealthiest Black Americans. Let’s just take a pause on that. Pretty gripping, not only the title, but the research and scholarship, the writing, the narrative that’s found in this book. Let’s take it straight from the jacket.

Racism in maternal healthcare is not reserved for the poor. An unsparing picture of inequities in prenatal care and childbirth in the United States is revealed by Khiara Bridges. Her book reveals that not only are Black people three to four times more likely to die from a pregnancy-related cause, but racial disparities in maternal mortality persists across income levels.

That is, wealthier Black people are much more likely to die during pregnancy, childbirth or the postpartum period than their white counterparts. Focusing on a San Francisco obstetrics clinic that caters to the affluent, Khiara Bridges looks at the choices around prenatal care and childbirth that class-privileged pregnant Black people are making in order to survive what has been called the Black maternal health crisis. It’s thick, it’s rich, and there are times in which it’s laugh-out-loud funny, only because of the sadness that’s captured in this.

When you’re listening, pay close attention to the tracksuits and other things that we talk about. I am your host, Michele Goodwin, and in this episode, I speak with Professor Khiara Bridges about the chilling findings from her research. As it turns out, not even wealth, privilege, education, the best concierge care that money can buy, none of that delivers for Black people in the same way it does for their white counterparts when it comes to their reproductive healthcare.

So, sit back and take a very close listen. Khiara, I am so grateful to be with you and so very excited about your most recent book, Expecting Inequity: How the Maternal Health Crisis Affects Even the Wealthiest Black Americans, and that’s a whole lot just within the title. Break it down for us just a little bit, and then, we’ll go deeper.

0:04:45 Khiara Bridges:

So, I came to the project because I had come across a statistic that is very familiar, hopefully, and that statistic is that Black people in the U.S. die from pregnancy-related causes at three to four times the rate as their white counterparts, which, you know, clearly indicates that there is a problem going on in the U.S., but that statistic obscures the fact that there are racial disparities across income levels. A lot of people might look at that statistic and think that Black people have higher rates of maternal deaths because Black people disproportionately bear the burdens of poverty in this country.

And so, that disproportionate poverty is being reflected in the higher rates of maternal deaths. However, the reality is that even at the higher socioeconomic levels, Black people still die more frequently than their white counterparts. So, what I wanted to do, I wanted to use my training in anthropology to ethnographically document how racism shows up in the lives of wealthier Black people, what they are doing to survive, you know, what has been styled the Black maternal health crisis, and so, I thought that taking on this project would allow me to say, hopefully, insightful things about race and class and maternal care in the U.S. today.

0:06:09 Michele Goodwin:

In this work, you focus on a San Francisco obstetrics clinic. Isn’t that right? That caters to affluent people.

0:06:20 Khiara Bridges:

Absolutely. I call it Golden Health in the project. It’s a pseudonym. I think that if anyone has any familiarity with San Francisco or the Bay Area, they’ll be able to identify the hospital in a very short amount of time, but I wanted to give it some anonymity, but when you say the hospital caters to affluent folks, I mean, I don’t…that is not an exaggeration at all. This is a place where you can find very, very, very wealthy people, and the health system is, I mean, it’s hard to say designed to cater to those folks, but it has those folks in mind when it is laying out its array, its panoply of offerings to its patients.

0:07:08 Michele Goodwin:

And so, in looking to this golden place and examining the decision-making treatment around prenatal care and childbirth that the class-privileged, so to speak, should come to be able to expect. I can’t think of a better space than to conduct essentially this experiment. So, tell us a bit about how it went.

0:07:39 Khiara Bridges:

You know, I feel incredibly lucky, and it’s one of the unfortunate aspects of research that I can’t thank the people who allowed me access to this space by name in order to protect the confidentiality of the space, but it was. It absolutely was an ideal space to examine the questions that I was interested in examining, which is like how affluent class-privileged Black people are surviving this Black maternal health crisis.

And what I found is that, absolutely, affluent Black folks are leaning into their wealth and they’re leaning into their status in order to have the pregnancy outcomes that they desire, and by leaning into their status, I mean, and sometimes the efforts were small. One of the most common tactics that the folks who I worked with displayed was the refusal to take off their wedding bands during pregnancy.

And even though, you know, they were experiencing physiological changes, even though their fingers were swelling up, they refused to remove their wedding bands because they didn’t want to be Black and pregnant and have any signal that they were unmarried, because they knew that that would invite a host of responses, even in medical spaces. Even in medical spaces. Another tactic that I saw deployed was bringing in their partners. They never came to their appointments by themselves.

They always had a partner with them, and one of the most interesting variations of this tactic was when they brought their partners in, and their partners were non-Black. They were very conscious that a white husband, a white partner, would signal something about their elevated status that might allow them to achieve better healthcare.

Other tactics included ensuring that they were being cared for by Black obstetricians or Black midwives. In fact, I have an entire chapter in the book about racially concordant care. There is a host of research that demonstrates that, in some cases, being cared for by a Black provider will improve the outcomes of Black patients.

And so, I saw Black patients utilizing this possibility in their own care, but perhaps the most…I would say one of the punchlines of the book is my critique of the fact that Black people even had to do this, my critique of the fact that in a country as wealthy as the U.S., in a country as technologically sophisticated as the U.S., that we’re leaving it to individual people to essentially purchase themselves an exit from a structural crisis, from a structural phenomenon.

And that’s sort of consistent with neoliberalism just as a general matter. Neoliberalism says the freedom is in the market, and you need to buy yourself the things that you need in order to be free, and I think that that’s a failure, and it’s incredibly unfair to individual Black folks, who are doing what they can to essentially achieve something that some people might say is like basic human rights, which is adequate healthcare.

0:11:18 Michele Goodwin:

What I notice are multiple parts of what it is that you’re unpacking and unfolding in this. You really are powerfully, provocatively, and given the empirical work, actually, turning the kaleidoscope such that people can see from different angles, so that one part of this that is clear in your book is that these patients know what the other alternative is.

If you don’t purchase in, there is being the statistic of Black death and morbidity. This knowing part about performance, the performance of the wedding band, the performance of the spouse showing up, the performance of the white spouse showing up, and for those of us who have one, we know what it’s like.

0:12:18 Khiara Bridges:

Me, too.

0:12:20 Michele Goodwin:

When they show up, I mean, we could tell side stories about that, and so, that part of knowing, right, and taking, then, this assertive affirmative action in the care for their lives, but it also shows, in what you unpack here, is that even with doing all these things, they also understand it may not be enough.

0:12:51 Khiara Bridges:

Right. Exactly. I mean, one of the things that I say in the book is that they know that they’re trading in statistics. They know that this is essentially trying to increase the odds or trying to better the odds of surviving pregnancy. They know that there are no guarantees. They know that they still might be treated poorly if they have their wedding band on. One of the titles of the chapter is “Going to the Doctor in Yale Sweatpants.”

Because they know that even if you go to the doctor, showing that you are an alum of some of the most elite colleges and universities in the U.S., even if you have a Black physician, even if you do all the “right things” that you still might be treated poorly, you still might not get the healthcare that you deserve, that everybody deserves, you still might have a negative pregnancy outcome, an adverse pregnancy outcome. So, you know, as I say in the book, you know, these folks who I work with are not fools.

They’re just doing the best that they can to make the health system, healthcare system work for them. A lot of them, you know, essentially, were trying to just get the same care that they believed that their white counterparts were getting, and so, these were just, you know, small tactics, small strategies to essentially achieve equality when it comes to healthcare.

0:14:20 Michele Goodwin:

Oh, you are well-learned, with a law degree, a PhD. You come at this with those multiple lenses to this. So, I want to ask a question about how the law fits in here, because, for so many, they may think of this as, well, this is a problem that law fixes, that in this book, you’re talking about expecting an equity, but doesn’t law fix all of that? And the whole point of this that you’re doing is that law does not, and it has not, and you express that across previous works as well, previous books and numerous articles.

0:15:10 Khiara Bridges:

Yes. So, one of the…so, this project, I think it’s fair to say it builds off some of my previous research, and my first book was called Reproducing Race, and in that book, I worked with low income, Medicaid-insured pregnant folks as they navigated healthcare bureaucracies in an effort to achieve the pregnancy outcomes that they desired, and what I saw in Reproducing Race was that the law was omnipresent. The law was everywhere.

The law was regulating the minutiae of their care, was telling their physicians or their healthcare providers that they needed to get certain tests, that they needed to be screened by certain professionals, like social workers and financial advisors and things of that nature. So, the law was really very present in the lives of low-income pregnant folks, and what I saw, as I transitioned to looking at commercially insured pregnant folks, and you know, affluent pregnant folks is that the law recedes.

In the book, I describe it as when one has that insurance card that signals that you have commercial insurance, you have purchased an exit from this hyper-regulatory environment that characterizes health insurance for low-income people in the U.S. In this space, you essentially purchase an entrance into market logics, and so, the market is dictating the quality of the care. The market is dictating what kinds of care is available to commercially insured folks.

And of course, the market is failing in that regard. So, essentially, yes, the law might be able to fix it, but in the U.S., with our employer-based healthcare system, the assumption underlying healthcare in the U.S. is that the market is going to produce better outcomes at cheaper prices, and we know, at least those of us who have been following along know, that we have failed on both accounts.

So, the law might fix it, but I think that in the U.S., we’re so committed to the idea that the market is a superior provider of healthcare that we prevent the law from fixing it. The other thing that I wanted to…that I say in the book, and that I want to share with the audience today, is that the law is actually getting in the way of equitable outcomes, and specifically, you know, I wrote this book as Students for Fair Admissions v. Harvard was being released and becoming the law of the land, and as some of you…

0:18:00 Michele Goodwin:

And that’s the affirmative action case.

0:18:02 Khiara Bridges:

Absolutely. That’s the case in which the court said that it violated the Constitution, as well as federal anti-discrimination laws, for Harvard and UNC to implement race-based affirmative action in order to achieve some modicum of racial heterogeneity within their entering classes, and so, Students for Fair Admissions might be a narrow decision, but it has been taken up by conservative actors to say more than what it says.

And by that, I mean, it has been taken by conservative actors as an argument that institutions have to be colorblind across society, that institutions cannot take into account race in kind of any part of their administration, and that makes it difficult for institutions, like Golden Health, that might want to be race-conscious when they are thinking about delivering healthcare to their patient population. It makes it difficult for institutions that might want to engage in race-conscious efforts to address racial disparities in maternal mortality and morbidity.

Again, I mentioned, already, racially concordant care. There are a host of studies that demonstrate that Black people have improved outcomes, in some contexts, when they are cared for by Black providers, and so, Students for Fair Admissions, when read broadly, when interpreted broadly, might prevent institutions from ensuring that Black patients can have access to Black providers. So, here, the law is getting in the way.

0:19:35 Michele Goodwin:

You’ve just dropped some very important nuggets on the audience, right, like golden mana from heaven, because you’re really helping people to understand the way in which the law gets in the way, in the way in which the Supreme Court has gotten in the way, and that this is not a question about inequality. These are questions about inequity, and I wonder if you can unpack that, too, as a distinction. Do they overlap, in thinking about inequality and inequity? What are the distinctions, because it’s very purposeful in your title?

0:20:11 Khiara Bridges:

Yes. So, I think that there’s an idea, and I think that the Supreme Court and the defenders of the Supreme Court believe that a decision like Students for Fair Admissions is aligned with equal treatment, right? So, we are going to treat Black people and non-Black people, all racial identities and descriptions, equally.

And you treat them equally by ignoring the context in which those racial groups actually make sense, and so, in a context of dramatic and empirically documented inequality, inequity, to treat racial groups and to treat individuals equally is to reaffirm the marginalization, the subordination, the various hierarchies that describe society today, and so, what I’m interested in is how do we actually produce, I mean, would I call it equity?

Would I call it equality? I’m thinking justice. Like, how do we produce just outcomes in a society that is as racially fraught as the U.S., in a society that has never come to terms with its horrific racial past, in a society that continues to deny, first, the fact of the horrific nature of our past and the fact that the past continues to the present? So, I think that justice is a frame that the Supreme Court…that is not motivating the Supreme Court’s analysis, that the Supreme Court, the sort of outcomes that the Supreme Court’s decision will compel, it’s at odds with racial justice.

0:22:19 Michele Goodwin:

One of the things that comes to mind with that, because in thinking about the Supreme Court, it’s a Supreme Court that has claimed that it has to look to originalism. Its originalism is let’s look at the framers and what the framers thought, and that is so deeply problematic, too, because it’s as if the court divorces the 14th Amendment and Reconstruction from its actual origins in the Constitution, right?

So, we see the 14th Amendment bandied about, but it’s part of the Reconstruction. It is part of not just an ending of slavery. It is about the promotion of citizenship and what does it take to be a full citizen, which is really, in part, at the core of what I see in so much of your writing, which is justice, its dignity, what does it take to be treated with dignity and integrity in our society? And ironically, it is actually baked into the Constitution, but not read into the Constitution by this court.

And so, that brings me to this next question, because I think about the breadth of your work, you know, including your prior book, The Poverty of Privacy Rights, in the United States. I see how that flows to this, in your prior book, your book prior to that, and I think about the landmines. So, slavery, itself, to get to freedom in this underground railroad, people are navigating the landmines.

Now, they’re not the landmines that we come to understand from war, but there are traps. There are booby traps, and there are the hunters and the dogs and all of these terrible kinds of things. When I think about what you’ve documented, from people, from women, from Black women who are in poverty, to those who are at the highest economic strata, they’re still navigating the landmines, right? I don’t know. I mean, can you connect with that? Because that’s what I’m seeing in what it is that you’re documenting, from wear this wedding band to don’t show up with sweatpants.

0:24:28 Khiara Bridges:

Right. Yeah. You know, in recent weeks, months, I keep…this idea of like traps keep popping in my head, and I’m like, you know? So, for example, when the second Trump Administration started, and one of the first acts was to fire a whole bunch of federal employees, right, to reduce the size of the administrative state.

And so many Black people had acquired middle-class status through employment with the federal government, and then, here comes Trump, and he fires those folks and threatens the viability of the Black middle class, and I remember thinking, at that moment, man, the U.S. is a trap. Like, you know, you think you escape. You think you escape because you do all the right things, like, you know, the folks who I worked with in this book. They do all the right things.

They go to colleges and universities. They go to elite colleges and universities. They land these good jobs with these good benefits. You know, they get married before they get pregnant, and then, they lose their job at the Trump administration, right? And so, it’s like this country sets up these traps, and so, I think that you’re absolutely right in noting that the folks who I was working with in this book, they’re dodging these landmines of…

So, for example, one of the most intentional things that they do in order to survive pregnancy is choose Golden Health as their healthcare provider, as opposed to going to hospitals that might be closer to them, that might be geographically more convenient to them, because they recognize that there might be a trap in there. There might be a landmine in there.

That might be an institution that does not take racial disparities, maternal mortality, and morbidity as seriously as Golden Health, and so, they might find themselves, you know, receiving inequitable care that might make them part of that horrific statistic saying that three to four times as many Black people die from pregnancy-related causes as their white counterparts, and so, you know, all of these techniques, choosing a Black physician or a Black midwife, wearing the Yale sweatpants and not just Nike sweatpants, choosing a midwife as opposed to an obstetrician, because they’re afraid of the hyper-medicalization of obstetric care.

And they think that that might contribute that, might be something that’s contributing to the Black maternal health crisis. All of these choices are efforts to dodge these landmines that are, again, structural, structurally produced, and it’s so unfair to leave it to individuals to hop over individual landmines as opposed to remedying the landscape, as opposed to getting rid of the landmines, in the first place, that we are producing through the various decisions that we make as a society.

0:27:48 Michele Goodwin:

So, another aspect of this that comes to mind is that it’s now been put on these women, or these women who are at Golden Health, they also become investigators of this, which is also very interesting, as well, right? It’s as if they have to put their sleuth hats on, right, to go about and to fight and predict the traps, you know, the booby traps. 

You know, I’m thinking of when people go to a beach, and they’re holding that little wand to try to see where the metal is, right? That that’s, in part, what the patients that you follow in this, they’re doing that work, and that seems at odds, it is at odds, with how people understand the journey of wanted pregnancies.

0:28:39 Khiara Bridges:

Right. Absolutely. I love the imagery of having to suss out racism, right? That’s what the wand is. The wand is attempting to suss out interpersonal racism, but also structural racism. You know, one of the things that I talked about with my interlocutors for the book is the role of doula care, right?

So, we know that doulas help to produce better pregnancy outcomes. Doula care, for those who are unfamiliar, they’re not medical professionals, but they really just provide advocacy and support throughout pregnancy, but certainly in the labor and delivery room, and a lot of the women who I interviewed for the project insisted upon having a doula with them. Of course, this is all out of pocket expenses, insurance. That’s care.

So, you know, here’s where class privilege helps to buy the pregnancy outcomes that you desire, but there are…so many of my interlocutors, and I had this conversation where they told me that they didn’t know whether they should have a Black doula or a non-Black doula, and I was like, well, you know, why is that even a concern?

And some of them said, you know, I think I would be more comfortable with a Black doula, but I’m afraid about there being too many Black people in the labor and delivery room. They felt like I might need to balance out, you know, the Blackness in the room, because I’m going to be there. My mother’s going to be there. If I have a Black doula in there, might there be too many Black people in…?

0:30:26 Michele Goodwin:

Right. So, you know, what’s so fascinating about that, right, is this understanding, as well, the ways in which too much Blackness, even if you’re wealthy, you have the wedding band, you’re wearing whatever the insignia that show you, that shows others your class status, but that the pendulum can swing the other way. There’s too much Blackness, which is ironic, right? Because that’s not the perception with too much white wealth, right? 

0:30:57 Khiara Bridges:

There’s no such thing. 

0:31:00 Michele Goodwin:

Yes, there’s no such thing. It only gets higher, right? It’s a pile of greatness, but it turns out, with Blackness and elite status or wealth, it decreases by volume, right?

0:31:12 Khiara Bridges:

Yeah. So, I mean, there’s the landmine, right, like this dance that Black people have to do in order to, I call it in the book, manage their Blackness. Like, how do they perform their Blackness in a way that essentially allows them to receive the healthcare that their white counterparts get?

And so, you don’t want to be too hoity-toity, too, right? You know, you don’t want to be too uppity, but you want to have just the right amount of Blackness that will not be threatening, it will be familiar, it will do the thing that you want it to do in the labor and delivery room and throughout your prenatal care, and this is an obvious point, but it’s worth mentioning is that this is just a concern that white people just don’t have, which is not to say that they don’t have concern. 

Of course, you know, white people, absolutely, everybody should be worried about giving birth in the U.S. You know, the U.S., as a general matter, has really poor pregnancy outcomes compared to the countries that we call our peers, but those concerns are, I wouldn’t say they’re different. They just do not include the concern about how one’s race will be perceived and the effect of that perception of race when it comes to healthcare.

0:32:38 Michele Goodwin: So, as we near towards the end of our interview, and I have so much, I love being in company with you. So, I didn’t say, you know, so much more to engage on, because I could talk to you for hours and hours about this. So, pregnancy, for those who desire, want pregnancy, want a child, there’s the perception that there’s so much happiness and glee throughout, and that it’s almost a euphoria that is painted, not to say that that is reality, but that is what is painted.

But as you unpack the traps, the various strategies that these people have to undergo, these Black folks have to undergo, in order to try to ensure that they survive this pregnancy, it seems to me that part, also, of what you’ve done in your research in this book is to show that it’s really a tale of two different cities. It’s two different universes. It’s not to say that there isn’t happiness that these wealthy, elite, Black women, people, you know, have during pregnancy, but theirs is not necessarily just what we get out of commercials, or what we get from politicians and their expectations.

0:34:18 Khiara Bridges:

Absolutely. You know, there are, you know, my work is in conversation in and indebted to a lot of the work that nonprofit organizations have been doing, for some time, around Black maternal health, and some of these nonprofits have said, you know, what if Black people didn’t, like, what if we don’t count it as a win, when Black people just merely survive pregnancy and childbirth? Like, what if Black people actually were thriving during pregnancy and childbirth? For pregnancy, childbirth…

0:34:54 Michele Goodwin:

Extraordinary, right, to think that, you know? 

0:34:56 Khiara Bridges:

Yeah.

0:34:58 Michele Goodwin:

If you’re not just afraid, and you know, on pins and needles during your pregnancy, what if you could just be happy and relax?

0:35:06 Khiara Bridges:

Right. Right. Exactly. Like, to bring a life into this world could be one of the most empowering, affirming, superhuman, you know, creating experiences of one’s life. However, many, many, many people in the U.S., and many, many, many, many more Black people in the U.S. experience that the process of creating life as a life and death struggle for them to survive.

And so, the question that your question left me with is what if Black people did not have to attempt to achieve happiness despite their pregnancy experiences and experiences that they had in the hospital during childbirth? What if their happiness was, what if that was a runway to the happiness that they would have when it comes to raising their children? 

So, because I found in my interviews that the lovey-dovey, the endorphins, the bonding, the commercial-type experiences of pregnancy and motherhood only began after the pregnancy ended, when they were able to take their babies home and essentially had freed themselves from this healthcare bureaucracy.

And the question that I think we all should be interested in is what if our healthcare system could actually contribute to this empowerment, this affirmation, the endorphins, the love, the joy that we think should be part and parcel of pregnancy and childbirth and mothering and parenting? It’s important to say that, right now, that we’re not doing that, and there are racial disparities with regard to who gets to experience their healthcare system as something that is a runway to the happiness that parenting should produce.

0:37:21 Michele Goodwin:

And that’s so tragically sad, too, because it leads to mind, again, the system that over time is a system of the traps that you speak of and a system that has yet to embrace this notion, this idea, this ideal that Black people deserve happiness, that Black women deserve happiness. In the introduction, the title of it, I think, is really quite powerful, “I Think I’m Dying: Class Privilege and the Persistence of Racial Disadvantage.”

As an author who’s been face-to-face with these issues, as a researcher who’s researched from Golden Healthcare to the most vulnerable spaces, I wonder what that’s like for you to be in touch with people who still struggle towards justice in the United States when it comes to their pregnancies and reproductive healthcare?

0:38:39 Khiara Bridges:

Yeah. Thank you for asking that question. It has been difficult. You know, I remember when I was working on Reproducing Race, and I was working at a public hospital in New York City, and I remember interviewing this pregnant Black woman, beautiful woman, and she told me her story, and it was like one tragedy after the other.

So many people had failed her. It was like her family first, and then just society generally, just like threw her away, and I remember going home, crying hysterically because I also felt powerless, and I would Google her name regularly because I just knew she was going to be a headline one day. I just knew that she was going to die, and yeah, it’s heavy. It’s heavy.

And the pregnant folks who I worked with for Expecting Inequity, their stories are not tragic in that same way, or at least if there is tragedy in their stories, they have managed to overcome, to some degree, inasmuch as they are class privileged at this point in their lives, but as you noted, the title of the first chapter is, you know, “I Think I’m Dying.” Like, this was a woman with a JD from a T14 law school, who was married to a white man, who constantly called her doctor throughout her pregnancy, telling her doctor, I think I’m dying, because she was having symptoms of a condition that her doctors completely failed to diagnose.

It was a heart condition that could have killed her. They only diagnosed her during her labor and delivery, nine months after she had been reporting these symptoms of rapid heart rate, palpitations, losing consciousness, “I think I’m dying.” So, it’s sobering. It’s sobering because, to a certain extent, the patients who I interviewed for this book are closer to me in terms of class privilege, in terms of socioeconomic status, in terms of, you know, we have the credentials from the elite institutions. 

And it’s sobering because that doesn’t guarantee us the things that we would hope they would guarantee after all the hard work that we put into gathering these credentials. Though, talking to the folks who I interviewed for this book reminds me of my own vulnerability, and it also just reaffirms, it’s also a reality testing sort of thing. It just reaffirms for me the reality of racial disadvantage. It reaffirms for me the reality of racism. This country has never come to terms with its racial past, and so, it seems silly and quixotic to imagine that you can escape that racial past simply because you got your JD from Columbia Law.

0:42:09 Michele Goodwin:

You know, that’s really so beautifully spoken, and it’s painful. It’s painful to hear and to know, and I’m sure with so many of our listening audience and people who will read the transcripts from this, that they will feel it. Those who shared that experience may look, you know, at something that Serena Williams, you know, she’s probably got the most visibility around this, with saying that, look, even she, as this 23-time Grand Slam winner, whose face is known around the world, Wimbledon, Australia Open, the U.S. Open, all of that. 

And it could not save her from what’s been seemingly baked into the system of healthcare when it comes to Black women, and again, when I think about these metaphors that we’ve talked about, you know, when you sort of think about a great-great-great-great-grandmother’s wildest dreams, in so many ways, it describes the people that were part of this research, the women who were part of this research, the wildest dreams, and it turns out they’ve not yet cracked the system.

0:43:23 Khiara Bridges:

No. No. Yeah. You know, I actually thought about my grandmother, a lot, when I was researching this book, and you know, when I was thinking about talking to these very wealthy, very status-rich Black people, and how they’re struggling to get the healthcare that they deserve, that everybody deserves, I was just thinking about my grandmother and just how incredible she, both of them, you know, how incredible my grandmothers were, because they had to get healthcare within Jim Crow, right?

They had to get healthcare within dramatic denials of humanity and dignity, and like ostentatious demonstrations of anti-Blackness, and so, there, you know, to a certain extent, yeah, we ought to celebrate, yay, you know, that we have made politically inadvisable those dramatic demonstrations of anti-Blackness, but the work isn’t done, and we are our ancestors’ wildest dreams.

But I’m thinking about my dreams for two generations, three generations in the future, and the work isn’t done. I want, you know, the people who, for whom I am their ancestor, I want them to be thriving during pregnancy. I want them to emerge, you know, feeling capable of doing things that they thought were impossible prior to giving birth. That is what I want for the future generations.

0:44:59 Michele Goodwin:

Well, on that note, I want to tip towards my final two questions, and they relate. In your conclusion, it’s if we really cared how to solve the Black maternal health crisis, how do we get there?

0:45:16 Khiara Bridges:

You know, so, that chapter is funny because I waited. I didn’t want to write the conclusion to this book, because I didn’t know how to end it, and I was writing the conclusion shortly after the 2024 election, and my editor at the press was like, okay, so, you know, how do we…it should be hopeful, it should be optimistic, this conclusion.

I was like, I can’t do that for you. I’m not feeling hope or optimism right now, but she says, you know, this book will be forever. So, it is, it’s hopefully will be read beyond the next four years, beyond the next 8 years. So, what do you want to see from this country in 15 years, in 25 years? How do we solve the maternal health crisis for Black people?

And it’s many, many, many, many interventions that I describe in the book, but you know, I think that the healthcare system in the U.S. is broken. It is odd. It is weird that healthcare is a billion-dollar profit generating wealth acquisition enabling system. It’s just weird, because the fact that healthcare is big business, and that people are making massive amounts of money on the delivery of healthcare, perverts the decisions that individuals make within it.

And it perverts decisions that institutions make within it, and in a country, like I’ve said, time and time again, during this interview, in a country that’s never reckoned with its racial past, those perverse and those perverted decisions that the profit motive leads institutions and individuals to make, those decisions will disproportionately harm people of color in this country. 

So, you know, in order to fix the maternal health crisis, generally, and the Black maternal health crisis, specifically, we’re going to have to do something about employer-based healthcare insurance and the two-tiered healthcare system that we have in the US. We have to take racism seriously. In order to solve the Black maternal health crisis, we have to come to terms with anti-Blackness. We have to come to terms with racism. 

As I describe in the book, it can’t be, we can’t…as I describe in the book, we can’t expect equity across racial lines when it comes to health, generally, when Black people enter hostile environments whenever they step foot outside of their home. It can’t be that Black people are compelled to experience the chronic stress of inequality, when they drive in their cars, when they walk down the street, when they go shopping, when they go to work, when they come home from work, when they get on the internet and make the mistake of opening up the comment section. 

Like, we cannot expect health equity if there is a hostile environment everywhere in the U.S. So, we have, in order to solve the Black maternal health crisis, we have to do something about anti-Blackness in this country. I’ll stop there. Those are the two big ones, and I think that if we address those two big ones, all the other little ones will fall into place.

0:49:05 Michele Goodwin:

It has been my absolute pleasure and honor to spend time with you and to talk about this brilliant work, this very brilliant book, Expecting Inequity: How the Maternal Health Crisis Affects Even the Wealthiest Black Americans, and before I let you go, I want to just read a line from the concluding chapter of the book. It’s in that first paragraph, and I think it says so much.

And this is a call out, I think, to lawmakers, state level, federal, etc., and you say, when the government in a country as wealthy and powerful as the United States sees its citizens and residents dying, wholly preventable deaths, and does little more than wish them good luck in finding and purchasing the goods and services in the market that may help them survive, it abdicates its responsibilities and loses legitimacy. Wow. Mic drop. Khiara Bridges, professor of law, brilliant person all around, it’s been my pleasure and great honor to spend time with you.

0:50:25 Khiara Bridges:

Thank you, so much, for having me here, Dr. Goodwin.

0:50:29 Michele Goodwin:

Fans and friends, thank you for joining us for this special Ms. Book Club Spring Edition. Be sure to check out the other books and authors that are being featured. The Ms. Book Club is a special feature of our Ms. Studios platform. Our executive producer is Michele Goodwin. Our producers are Allison Whelan, Roxy Szal, Oliver Haug and Mariah Lindsay. Our sound engineer is Natalie Hadland. Art and design are by Brandi Phipps. Our assistant producer is Emersen Panigrahi.