Deaths during or right after childbirth have been increasing, going from 20.1 deaths for every 100,000 live births in 2019, to 23.8 deaths in 2020, to a stunning 32.9 deaths in 2021, during the height of the coronavirus pandemic, according to a report from the Centers for Disease Control and Prevention.

And it’s even worse for Black women, across class lines and regardless of education. It’s something that hit all of us last month with the death of gold medal Olympian Tori Bowie, who was found dead in her Florida home, her baby’s head crowning.

We’re heading back toward medieval times when it comes to having a baby on American soil.

If you can’t get to Europe or Canada — where you can show the maternal death ratio on two hands — it turns out that Uruguay, Kazakhstan and Iran are all safer for childbirth than the more affluent United States.

But the danger here is not shared equally. Compared with the World Health Organization’s numbers, it’s like White American women are giving birth in France and Black women in a developing country. Black women’s death rate during and after childbirth is triple that of the national average — a calamity. Not just because of the numbers but for the reasons.

“Black women frequently experience disrespect, procedures without consent, rough handling, and dismissiveness toward pain from doctors,” Jocelyn Johnston, a professor at American University’s School of Public Affairs, wrote in a report she led about D.C.’s appalling maternal death rate — twice that of the United States overall. “Various studies have indicated implicit racial bias among medical professionals.”

Policymakers used to focus scrutiny of these disparities on health behaviors and barriers to care, but research supports a more expansive link between structural racism and poor outcomes.

“Maternal mortality for Black women has nothing to do with health or economic status,” D’Andra Willis of the Afiya Center in Dallas, a Black-centered reproductive justice group, told NBC News. “You could be the richest or the poorest, Black women are still three to five times more likely to die in childbirth than any poor white woman.”

A five-year study in New York found that Black, college-educated women were more likely to die during pregnancy and childbirth than White women who never finished high school.

We saw the injustice last month with Bowie, and in how her experience resonated with other Black women.

“These are my teammates. We are Olympic champions,” wrote Allyson Felix, who was on the relay team with Bowie that won the gold in 2016. “Three of us tried to give birth. Two of us experienced near-death complications. One of us died. We have to, and we will do more. Tori’s death cannot and will not be in vain.”

We saw it in 2017 when Shalon Irving, an established epidemiologist at the CDC and a lieutenant commander in the U.S. Public Health Service, died of cardiac arrest three weeks after giving birth in Atlanta. She had just been to her doctor, who didn’t follow up when Irving said she felt ill.

We saw it in 2016, then Kira Dixon Johnson, a marathoner, entrepreneur and recreational pilot who spoke four languages, died at Cedars-Sinai Medical Center in Los Angeles after doctors took hours to address her fluid-filled abdomen and blood-filled catheter.

“The inequities that Black mothers face are not isolated incidents but, rather, the byproduct of systemic racism in our society that has festered for far too long,” President Biden said last year, in a proclamation on Black Maternal Health Week.

The medical profession too often dismisses the pain of Black women, no matter how fit, educated or wealthy they are. The answer to that must include boosting representation in medicine.

“I was rushed and dismissed,” Melissa Davis, a Black mother of eight children and a doula who works primarily with Black mothers in D.C., told my colleague Justin Wm. Moyer. “I know what a mom is going through … I’m the one that’s standing in the gap.”

Black doctors made a difference in my own story, something I’ve reflected on as I’ve considered all that separates me from these women who never got to see their children grow up.

The numbers weren’t in my favor.

During my first pregnancy, I was a police beat reporter, dragging myself to crime scenes during the muggy summer months. My blood pressure was high, my gestational diabetes raging; I wasn’t telling doctors about my discomfort, I just tried to tough it out.

This was in D.C., which remains one of the statistically most dangerous places for a woman to give birth.

“Bed rest,” said my doctor, a Black man, as soon as he saw my vitals, after admitting me to the hospital when I went in for a simple checkup and ending my work day, my work year.

My doctors knew what I was ignoring — that my chart was a connect-the-dots to death. They knew the danger signs to look out for. They were looking for them and listening — even to what I wasn’t saying.

This level of experience and understanding is the happy ending in a story where everything could’ve gone wrong — an unhealthy, busy, preoccupied patient who survived because of privilege, quality health care and caring, experienced professionals.

It’s the way it should be. That’s what the conversation in D.C. — and across America — needs to focus on.