The deadly disparity Black woman face has been public knowledge for so long that an entire week has been dedicated to Black maternal health, and now a new report shows that racism may play a bigger role in Black women dying during and after pregnancy than researchers thought.

According to an 11-year analysis presented at the American Society of Anesthesiologists annual meeting last week, other factors like health care access, insurance coverage and economic status can’t be the sole causes of the higher mortality rate among Black women.

Black mothers have a 53 percent higher chance of dying during childbirth than white women, the report shows, regardless of their circumstances.

“This study is the most up-to-date and extensive study—factoring in various states, insurance types, hospital types and income levels—to determine that the much higher maternal mortality rate among Black women often cannot be attributed to differences in health, income, or access to care alone,” said Dr. Robert White, lead author of the study and assistant professor of anesthesiology at Weill Cornell Medicine in New York.

While recent Centers for Disease Control and Prevention data show that 84 percent of all pregnancy-related deaths can be avoided. News reports show that Black women have often been ignored or received inadequate and poor-quality care in the nation’s hospitals and medical facilities. The CDC says they are three times more likely to die from pregnancy-related deaths than white women.

Earlier this month, TikTok user Jillian shared videos documenting her encounter with a nurse at a Philadelphia birthing center. The woman, who is seven months pregnant, went to the Philly Birthing Center seeking a doctor’s note exempting her from work for the last two months of pregnancy. Instead, the nurse accused the Black expectant mother of fraud, hit her with an object and threatened to call the police on the woman.

Jillian said the nurse was rough during the examination, leaving her in more pain. The nurse refused to approve the document but said she could give her a note limiting how many pounds she could lift.

The woman said she demanded to speak to the doctor. The nurse went into the front waiting room and blurted out her personal information, which got the doctor’s attention, Jillian said. As she walked to another room with the doctor, the nurse continued to make a scene.

“Please don’t take her back to my office,” Jillian recalled the nurse saying. “I said nobody wants to go to your office. You’re a weirdo for that.”

Jillian said that’s when the nurse first told her that she would call the police. A second video showing the interaction captures the nurse questioning and berating the pregnant woman.

“What were you thinking about when you got pregnant, that you were not gonna work,” the nurse asks the woman on video. “I am just curious because, like, I’ve had three kids I worked up until the second they were born.”

“But am I you? Are you me? Do you know how I feel?” Jillian replies.

The nurse said the woman’s chart and cervical exam did not match the note, which was considered fraud.

“I gave you the best medical advice, and you didn’t like that,” the nurse said.

But the woman argued that the internal exam did not account for how she felt in other parts of her body. As the nurse grew more agitated, the woman raised the cellphone closer to her face to show the employee’s identity. The nurse then swats the woman with an object in her hand and threatens to call the police again.

The incident received backlash on social media and from women’s health activists and state officials. Pennsylvania House members of the Legislative Black Caucus and the Women’s Health Caucus sent a letter to the state’s Human Right Commission on Oct. 12 calling for a probe into the incident.

“We must ensure that providers across our state are held accountable for their interactions with patients and ensure that they are held to a respectful and equitable standard of care,” the letter says.

Texas mother Mary Plummer said she almost lost her life eight years ago while in labor with her son, Caiden. Plummer and the newborn had to be resuscitated twice when she gave birth at Cleveland Clinic Tradition Hospital in Port St Lucie, Florida, in August 2014.

The labor nurse did not believe Plummer when she cried out in pain. Instead, she accused the pregnant woman of being on drugs and subjected her to a drug test. The nurse told the patient to “shut up” quieting her cries because she was typing.

The nurse pointed out that Plummer was not having contractions and accused her of faking her pain to snag more medicine to support her drug habit, even after the drug test came back negative.

However, Plummer said the pain was in her shoulder and her abdomen. Doctors later discovered Plummer had high blood pressure that led to a seizure.

The woman’s placenta was detached from her uterus, which had been ruptured, leaving her baby in a pool of blood, she said. It took 17 minutes each for the hospital to revive both mother and baby, Plummer said, and her nightmare did not stop there.

Once Plummer tried to reunite with Kayden at another hospital, she was met by a social worker to answer the allegations of drug use. The Tradition Hospital also falsely labeled her an HIV patient, barring her from breastfeeding her premature baby.

Plummer shared her story on TikTok, hoping it would help other Black mothers.

“There was so much shame associated with the story. I was always so afraid that telling the story, people were going to not really hear the fact that I wasn’t HIV positive,” she told Atlanta Black Star. “And that I was a drug addict, although I’m not.”

Caiden now has lifelong developmental issues from his complicated birth. Plummer and her husband successfully sued the hospital. In the final malpractice proceedings, the doctor agreed to cover Caiden’s medical expenses for life and create a $250,000 college fund for the boy.

However, Plummer said the compensation would have been greater if she did not sign a birth injury waiver.

Florida’s Birth-Related Neurological Injury Compensation Act limits compensation for families when a newborn sustains a brain injury during labor and delivery.

Plummers warns other mothers not to sign those documents and to keep loved ones in the labor and delivery room “who can fight for you.”

“They can just get away with murder,” Plummer said.