they relate to maternal complications and warning signs for such conditions as maternal hemorrhage, hypertension, and preeclampsia. State perinatal quality collaboratives are working to identify health care processes that need to be improved and use the best available methods to make those changes as quickly as possible, while the Alliance for Innovation on Maternal Health is working with States and health systems to align national, State, and hospital level quality improvement efforts through the creation and dissemination of maternal safety bundles to improve overall maternal health outcomes. (19) The CDC reports that more than half of all maternal deaths occur in the immediate postpartum period—between 42 days up to a full year—whereas more than one-third of pregnancy-related or pregnancy-associated deaths occur while a person is still pregnant. Yet, for pregnant women, Medicaid coverage lapses at the end of the month on which the 60th postpartum day lands. (20) A growing body of evidence-based research has shown the correlation between the stress associated with one’s race—the stress of racism—and one’s birthing outcomes. The stress of sex and race discrimination and institutional racism has been demonstrated to contribute to a higher risk of maternal mortality, irrespective of one’s gestational age, maternal age, socioeconomic status, or individual-level health risk factors, including poverty, limited access to prenatal care, and poor physical and mental health (although these are not nominal factors). African-American women remain the most at risk for pregnancy-associated or pregnancy-related causes of death. When it comes to preeclampsia, for example—which is related to obesity—African-American women of normal weight remain the most at risk of dying during the perinatal period compared to non-African-American obese women. (21) The rising U.S. maternal mortality rate is predominantly driven by the disproportionately high rates of African-American maternal mortality. (22) African-American women are three to