I don’t allow myself to remember much about my patient who died. I don’t remember her name. I don’t remember the date. I don’t even remember how old I was at the time. But as a result of this memory, I am forever changed.

In almost a decade of maternity nursing, I’d never had an adult patient die, and I haven’t had a patient die since. Over the past 13 years, I have delivered numerous babies who died in utero or were born alive, but were expected to die shortly after birth because of their low gestational age or conditions that were incompatible with life. I am familiar and comfortable with providing support to a family who were preparing to lose, or had just lost, a much-wanted baby. This day was different. I received a report from the nurse going off duty on a living, breathing, labouring young woman, only to leave the hospital with nothing to give to the next nurse coming on shift.

She didn’t die because of any fault of the medical or nursing staff. There was no neglect or system failure. She died of an amniotic fluid embolism. The dreaded AFE: three little letters that send obstetricians and maternity nurses into a frenzy. AFEs are like miscarriages – they typically can’t be predicted or prevented. They just happen. With very little warning, my patient went from a tired woman who had been in labour for several hours to a woman fighting for her life on an operating table.

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At the time I was a PhD student studying unplanned pregnancy and STD prevention. I was well aware of the racial disparities in maternal mortality and morbidity; well aware that the pregnancy-related deaths among black women were triple those of our white counterparts; well aware that unplanned pregnancy and STD rates were higher among young adult black women than women of other races and ages. But until this day, I only knew these facts in theory. When my patient died, the reality of maternal mortality hit me like a ton of bricks. The reality that women who look like me are at a higher risk of death made me sad. Then, it made me angry.

Since that day, I have been on a mission to right some of the horrible wrongs of the US healthcare system — wrongs such as inequitable care provided to minority women, inequitable services available to those under the poverty line, and inaccessible healthcare facilities for families living in rural communities. I have since graduated with my PhD in nursing and completed a postdoctoral fellowship in health services research. I use my research on maternal health disparities to educate vulnerable populations and suggest solutions to address the inequities at hand. I see my research as a tool for social justice. I may not march in the streets often, but I am more serious than ever about encouraging women – particularly young black women – to prevent unintentional pregnancies and be as healthy as possible before planning to become pregnant.

I applaud women like Serena Williams and Beyoncé for sharing their personal stories of maternal complications. It’s important that women know how real maternal mortality and morbidity are. While life-threatening, pregnancy-related conditions can occur with any woman, they occur most often among black women. To this end, it is also important that healthcare providers do a better job of assessing, education, and most importantly, listening to black women.

Women like my patient don’t have to die in vain. Her death inspired me to do more to prevent future pregnancy-related deaths among black women. I have taken up that cause through teaching, research and community outreach. Others can help decrease maternal morbidity and mortality by working in direct patient care or patient education. We can all do our part, and we should.

• Tiffany M Montgomery is an assistant professor of nursing at Widener University and a labour and delivery nurse at Einstein Medical Center in Philadelphia in the US

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