At first glance, tennis star Serena Williams and the late activist Erica Garner don’t have much in common. They lived different lives on different ends of the socioeconomic spectrum.

But as black women in America, they both shared horrifying stories due to complications from childbirth.

Our country spends more on health care than any other high-income country — but still holds the worst record for maternal mortality in the developed world.

This maternal health crisis is driven by the high rates of African-American women who die while pregnant or within one year of the end of a pregnancy. Black mothers die at three to four times the rate of white mothers due to pregnancy-related complications.

While existing health disparities can add to the risk, one recent study found that racism is a major driver of the gap.

An issue brief published by the Center for American Progress suggests that stress induced by racial discrimination plays a significant role in the high rates of black women’s maternal mortality.