Empathy in Action: Amplifying Voices to Uplift Black Maternal Health


In 2024 we observed Black Maternal Health Week by hosting a special Instagram Live. The session brought together Tiny Health medical advisor Dr. Nicole Calloway Rankins, and Erica M. Freeman, the founder of Sisters in Loss. From higher rates of maternal mortality to the stigma surrounding pregnancy loss and infertility, the two addressed significant issues surrounding Black maternal health.


Motherhood is a journey filled with joy, challenges, and endless love. But for many Black mothers, that journey often comes with unique hurdles and systemic barriers. Today, we're diving into a crucial conversation about Black maternal health—a topic that demands our attention, empathy, and action.

As we celebrate the strength and resilience of Black mothers, we also acknowledge the sobering reality that Black women in the United States are nearly three times more likely to die as a result of childbirth than white women [1]. Behind these numbers are real stories of loss, pain, and injustice. 

Amidst these challenges, there is power in community, advocacy, and education. 

In this post, we’ll recap an important and uplifting conversation between Tiny Health Medical Advisor and OB/GYN Dr. Nicole Calloway Rankins, and Erica M. Freeman, the founder of Sisters in Loss. As they shed light on the issues surrounding Black maternal health, they also bring support, resources, and empowerment for Black mamas on their journey to building their families.

Note: This story includes content about pregnancy and infant loss that may be sensitive for some readers.

Advocates for Black maternal health

Photo of Dr Nicole Rankins, OBGYN
Dr. Nicole Calloway Rankins, OB/GYN is a Tiny Health Medical Advisor and host of The All About Pregnancy & Birth Podcast

In addition to her role as our Medical Advisor, Dr. Nicole Calloway Rankins is an esteemed OB/GYN with over 20 years of experience demystifying childbirth and empowering expecting women. She’s also the host of The All About Pregnancy & Birth podcast. During Black Maternal Health Week, she hosted an Instagram Live with Erica Freeman, founder of Sisters in Loss, an organization dedicated to replacing silence with storytelling around pregnancy and infant loss and infertility of Black women. 

Photo of Erica Freeman, founder of Sisters in Loss
Erica Freeman is founder of Sisters in Loss, a community of Black women replacing silence with storytelling around pregnancy and infant loss and infertility.

Erica’s journey is marked by  resilience and compassion: ”I have come into this work as a patient advocate, but really, my birth story inspired the work I do as an activist. And making sure that we’re changing policies, not only statewide but at the federal level.” 

Building a family through unimaginable heartbreak

Erica delivered her stillborn son at 39 weeks due to complications with preeclampsia. Still grieving, she became pregnant again just a couple months later, and went into preterm labor with her daughter and delivered her at 18 weeks. “My baby girl was maybe ten or eleven ounces. She lived for one or two minutes, but we were able to see her breathe.” Erica made the brave decision to give her daughter’s body to science so the teaching hospital where she was born could better research preterm birth.

“That’s a really interesting choice, especially in the Black community, where we are sometimes rightfully distrustful of science and experimenting,” Dr. Rankins observed. “So I’m curious: what led you to that decision?” 

Erica responded, “I buried my son and just decided not to go through that process again. Mainly, I felt like there are a lot of babies that are born early, and I thought maybe they could find something that could keep them alive.”

After two heartbreaking losses, Erica became pregnant again. This time, she landed in the ER with complications at 32 weeks due to a complete placental abruption. Luckily, the OB/GYN on call recognized her and knew Erica’s history. “As soon as I was rolled into the triage area, she immediately took me to get a crash emergency C-section. She trusted me. If she hadn’t listened to how I was feeling about my body, I wouldn’t be here today.”  

Right after he was born, Erica's son needed to be revived by doctors. To complicate matters, Erica was airlifted to another hospital for platelet transfusions due to hemorrhaging. Her extended family arrived at the hospital to a nerve-wracking touch-and-go situation. Nine blood transfusions later, she was in the clear. 

"If it was any other doctor on call that day and they hadn't listened to me, I wouldn't be here. And my son wouldn't be here. It's why Black Maternal Health Week is so important to me," Erica said.

Erica Freeman with her son
In addition to her work with Sisters in Loss, Erica Freeman is a special needs and disability advocate and self-proclaimed cerebral palsy mom.

Advocacy is everything (for yourself included)

Dr. Rankins asked Erica if she ever felt mistreated or ignored by the medical community in her pregnancy journey, an all-too-common experience that drives many women of color to pursue this line of work. 

Erica responded, “I did with my second loss because I felt like they dismissed me in the emergency room. I told them I was having pelvic pain. It felt like labor, and I was starting to hemorrhage a little…But they didn’t even examine me or do an ultrasound.” Erica believes if they had examined to see if her cervix was starting to open, then maybe they could have prolonged her pregnancy and saved her daughter’s life. 

One of the lesser-discussed hurdles Black women face during childbirth is the fight to ensure their voices are heard. Advocating for your needs and pushing back against a medical system that historically hasn't prioritized your concerns is a big ask.

Part of Erica's advocacy is empowering Black women to create supportive birth teams around them. If a provider isn't listening, she recommends pregnant moms use their agency and switch providers. Erica said this is especially important because “Black women experience more challenges around infertility and misdiagnoses of conditions like polycystic ovarian syndrome.” 

Dr. Rankins added her OB/GYN perspective, "So much boils down to that individual relationship and treating each patient as a person, meeting them where they are, and what their needs are." 

The power of storytelling

Erica’s life-altering journey led her to create Sisters in Loss—a sanctuary where Black women find solace and support in shared experiences. ​​She encourages women who have experienced a miscarriage, infant loss, or infertility to share their stories to inspire others. 

It wasn’t until Erica lost two babies that family members started to share their miscarriage and stillbirth stories with her. “It’s just so common and we don’t talk about it. There are some things, especially in infertility, which can be taboo in Black communities. I think we’re getting better about it, but infertility and pregnancy loss, there’s so much wrapped up in women being fertile as part of our value and our worth,” Erica said.

Those early conversations with loved ones inspired Erica's Sisters in Loss podcast. Since 2017, this special needs mom, grief specialist, and doula has been talking about what real healing looks like through her platform. 

Erica's advice to expecting moms is on point: "I always encourage people to go and know their numbers and stats. Know what's happening inside and outside your uterus. And ask more detailed questions about your maternal health because that's only going to prepare you for when you're ready to conceive."

Sobering statistics highlight Black maternal health inequities

Black women in the U.S. face higher risks during childbirth, with postpartum depression affecting many and breastfeeding rates trailing behind. Economics, influenced by systemic racism, adds another layer of challenge.

  • Non-Hispanic Black women in the U.S. are nearly three times more likely to die as a result of childbirth than white women [1]. 
  • Up to 44% of Black women experience postpartum depressive symptoms, but many go undiagnosed and untreated [2]. 
  • About 77% of Black infants are breastfed, compared to about 85% of white and 82% of Latina babies [3]. 

“The financial barrier is always going to be a factor,” said Erica. “We know how structural, institutional racism has worked throughout all of our systems. It does not negate the fact that our white counterparts have more disposable income based on how racism has played a role in the U.S. It’s not as easy for a Black woman to drop that $30K+ on an IVF or IUI treatment.“ 

But the news isn’t all bad. Erica mentioned the availability of grants and other creative methods Black women can access to help them grow their families.

Advancing Black maternal health, rights, and justice with solidarity

Black women facing maternal health challenges are not alone. Erica Freeman and her team at Sisters in Loss are rewriting the narrative around Black maternal health by offering hope through coping tools, coaching, special events, and courses. Her community is thriving. And organizations like Black Mamas Matter Alliance and 4Kira4Moms also support, educate, and advocate for Black mothers. 

At the heart of Black maternal health awareness is recognizing the inherent worth and dignity of every person and acknowledging the fundamental right to safe and respectful maternity care, free from discrimination and bias. And it's about confronting the uncomfortable truths of our past and present, forging a path forward that prioritizes equity, inclusivity, and the well-being of all.

Supporting healthy pregnancies begins with education and awareness. As we elevate conversations around Black maternal health, we strive for a world where all mothers and babies thrive. That shift starts with empowering each other to create positive change. Please share these resources—or this post—with anyone who may need support.

The more voices we uplift, the stronger we can advocate for a future where every Black mother and woman receives the care she deserves. 


[1] Hoyert DL, “Maternal Mortality Rates in the United States, 2021,” NCHS Health E-Stats, 2023, doi: https://dx.doi.org/10.15620/cdc:124678.

[2] K. Floyd James, B. E. Smith, M. N. Robinson, C. S. Thomas Tobin, K. F. Bulles, and J. L. Barkin, “Factors Associated with Postpartum Maternal Functioning in Black Women: A Secondary Analysis,” Journal of Clinical Medicine, vol. 12, no. 2, p. 647, Jan. 2023, doi: https://doi.org/10.3390/jcm12020647.

[3] CDC, “Facts About Nationwide Breastfeeding Goals,” Centers for Disease Control and Prevention. Accessed: Apr. 08, 2024. [Online]. Available: https://www.cdc.gov/breastfeeding/data/facts.html