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The recent death of Dr. Janell Green Smith, a 31-year-old certified nurse-midwife and doctor of nursing practice in South Carolina, has sent ripples of grief and fear through the Black maternal health community. Smith died less than a week after giving birth to her daughter, Eden, following complications from severe preeclampsia, a pregnancy-related blood pressure disorder. For many Black women, the news wasn’t just a tragedy; it was a stark reminder of the disproportionate risks they face during and after childbirth, even when championed by experts dedicated to improving those outcomes.
The loss of Dr. Smith is particularly resonant given her tireless advocacy for safer maternal care for Black women. She dedicated her career to addressing the alarming racial disparities in maternal mortality, a crisis where Black women are significantly more likely to die from pregnancy-related complications than their white counterparts. According to the Centers for Disease Control and Prevention (CDC), the maternal mortality rate for Black women was 47.4 deaths per 100,000 live births in the most recent data, compared to 18.3 deaths per 100,000 for all other races .
The emotional toll of this loss is profound. “When a Black woman hears about the death of yet another Black woman shortly after giving birth, she is likely to experience strong feelings of fear, outrage, shock, sadness, hopelessness,” explains Olusinmi Bamgbose, MD, a reproductive psychiatrist. “These emotions are likely intensified by the fact that this woman was a birth worker and Black maternal health advocate herself.” The death of someone so deeply invested in protecting Black mothers feels like a betrayal of trust, exacerbating existing anxieties.
A Shattered Sense of Safety
For birthworkers, the impact is especially acute. Star August Ali, a certified professional midwife (CPM) and licensed midwife in Illinois, and founder of the Black Midwifery Collective, describes a feeling of deep fracture within the community. “When someone who represents safety dies from the exceptionally harm they tried to protect others from, it breaks something deep,” she said. “What we are hearing from the community is not panic without reason—it is clarity.”
Community members are expressing “fear, disbelief, and despair,” August Ali notes, questioning what hope remains if someone as knowledgeable and dedicated as Dr. Smith could succumb to these risks. Her passing underscores the systemic failures that continue to endanger Black mothers, even those with expertise and access to care. This isn’t simply about individual cases; it’s about a system that consistently fails to protect Black women.
The tragedy further erodes trust in a medical system already viewed with skepticism by many Black women, a demographic with a historically fraught relationship with healthcare providers. “For communities already carrying trauma, this kind of death reopens old wounds,” August Ali explains. “For many, [Green Smith’s] death confirms long-standing fears that advocacy and expertise are not enough—particularly for Black patients. Instead of building trust, it deepens skepticism, grief, and hesitation to rely on medical care. It reinforces the belief that the system is unsafe.”
Navigating Fear and Finding Agency
Dr. Bamgbose, who also founded Ìtùnú Psychiatry, a private psychiatry practice, says she routinely hears these anxieties from Black patients who are pregnant, considering pregnancy, or already mothers. “They worry about being dismissed by their care team, losing their life, or losing their baby,” she said. Acknowledging these risks is crucial, but so is empowering women to capture agency over their birthing experiences.
While the statistics are daunting, Dr. Bamgbose emphasizes that hope and resistance are possible. “We have to resist the pull to feel like helpless victims. We are not helpless or hopeless.” A key step is focusing on what *can* be controlled. This includes carefully assembling a birthing team – choosing an OB, midwife, or doula who is supportive and aligned with the patient’s values – and enlisting the support of trusted friends and family to advocate during labor.
Accessing mental health support is also vital. Organizations like Postpartum Support International offer resources and connections to therapists and support groups specializing in perinatal mental health.
A Catalyst for Change
The death of Dr. Janell Green Smith, while devastating, can serve as a catalyst for renewed efforts to address the Black maternal mortality crisis. “We have the power to reimagine and reshape our reality and the future of our children,” August Ali asserts. “By using tragedies as a catalyst, we can shift our strategies, strengthen protections, and center care around trust, advocacy, and relationship. Fear and safety can coexist when you have knowledge, advocacy, and a team that truly sees and believes you.”
The conversation surrounding Black maternal health must continue, demanding accountability from healthcare systems and advocating for policies that prioritize the well-being of Black mothers. The legacy of Dr. Smith’s work lies in the continued fight for equitable and respectful care for all.
If you are experiencing feelings of anxiety, depression, or grief related to pregnancy or postpartum, please reach out for support. You can find resources at Postpartum Support International: https://www.postpartum.net/
Share your thoughts and experiences in the comments below. Let’s continue this important conversation.
