Racism in maternal healthcare is not reserved for the poor. An unsparing picture of inequities in prenatal care and childbirth in the United States, Expecting Inequity reveals that not only are Black people three to four times more likely to die from a pregnancy-related cause, but racial disparities in maternal mortality persist across income levels. That is, wealthier Black people are much more likely to die during pregnancy, childbirth, or the postpartum period than their white counterparts. Focusing on a San Francisco obstetrics clinic that caters to the affluent, Khiara Bridges looks at the choices around prenatal care and childbirth that class-privileged, pregnant Black people are making in order to survive what has been called the “Black maternal health crisis.”

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Bridges, whose previous work exposed how race and racism are embedded in maternal healthcare for the poor, draws on two years of participant-observation to show how wealthier Black people try to leverage their class privilege to avoid some of the negative effects of their Blackness—only to discover that in a country that has never reckoned with its horrific racial past, there is no escaping racism’s reach. Throughout the book, engaging, heartbreaking, infuriating stories of women’s experiences with pregnancy and prenatal care illustrate how race and racism matter regardless of wealth or status.