Sen. Elizabeth Warren (D-Mass.) explained exactly how she plans to fix the ongoing catastrophe of black maternal mortality rates in the U.S.

“We are facing a maternal mortality crisis in America,” the presidential hopeful wrote in an essay published in Essence on Tuesday morning. “And for Black moms, particularly those living in rural areas, it’s an epidemic.”

Even though the U.S. is one of the wealthiest countries in the world, it has one of the highest maternal mortality rates. The U.S. is one of only 13 countries where the rates of pregnancy-related illnesses and deaths are actually worse than they were 25 years ago. And black American women, in particular, are paying the price: Black women are 243% more likely than white women to die from pregnancy or pregnancy-related complications.

“This trend persists even after adjusting for income and education,” Warren wrote. “One major reason? Racism.”

Many black women, including big stars like Serena Williams and Beyoncé, have publicly shared the complications and difficulties they experienced during childbirth.

Warren laid out a specific plan to lower black maternal mortality rates: incentivize health systems to keep mothers healthy, push for more inclusive best practices that have been shown to help mothers of color, diversify hospital staff so they better understand the communities they’re serving, and hold hospitals accountable for preventable failures.

At the end of the day, black women “should be calling the shots” when it comes to their health care, the senator added.

“Black women shouldn’t have to develop elaborate birth plans or personally shell out thousands of dollars for extra eyes and ears at the hospital to ensure they survive the experience of childbirth,” Warren wrote. “We’ve done enough observing and debating the effects of bias and racism in our health care system. It’s time to demand better outcomes.”