Despite per-capita spending on health care that far exceeds every other nation, the United States has the highest rate of pregnancy-related deaths in the developed world. The racial disparities are stark — for every 100,000 live births in a given year, 42 black mothers died, compared to 13 white mothers. From pregnancy to delivery, thousands of American women live in “maternal toxic zones” characterized by lack of access to health care, high rates of cardiovascular disease, and discrimination, yet a shocking 60 percent of maternal deaths are preventable. Why are maternal mortality rates rising in the United States, while declining sharply worldwide? Do we need a Birth Bill of Rights that guarantees safe childbirth?