Maternal deaths in the United States have been on the rise since the 1990s, according to Harvard’s public health school, with 700 to 900 new and expecting mothers dying each year. The Centers for Disease Control and Prevention says half of these deaths are preventable.

Moreover, women of color are facing the most challenges: the risk of death for black mothers is three to four times higher than for white mothers. White women die in about 12 of every 100,000 births, but for black women, this number rises to 40.

It’s not a hidden issue. Famous black women like tennis great Serena Williams and pop star Beyoncé have each shared stories of suffering pregnancy-related complications. In Williams’ case, she had to actively advocate for care when a nurse suggested her shortness of breath was probably nothing.

Williams also said she had to undergo an emergency C-section after her daughter’s lowering heart rate reached dangerously low levels during her contractions. While her daughter arrived fine, Williams said she suffered a nearly week-long trauma with a pulmonary embolism causing her to have multiple surgeries.

“The common thread is that when black women expressed concern about their symptoms, clinicians were more delayed and seemed to believe them less,” Neel Shah, an obstetrician-gynecologist at Beth Israel Deaconess Medical Center in Boston and director of the Delivery Decisions Initiative at Ariadne Labs, told Harvard public health school’s magazine.

This lack of attentive care puts mothers—and their children—in danger. Tressie McMillan Cottom lost her newborn after the hospital failed to diagnose days of pain as the preterm labor it was.

“When the medical profession systematically denies the existence of black women’s pain, underdiagnoses our pain, refuses to alleviate or treat our pain, healthcare marks us as incompetent bureaucratic subjects. Then it serves us accordingly,” she wrote in an essay published by TIME.

Aside from racial discrimination, black women face physical hurdles as well. Research has shown that those who experience repeated fight-or-flight situations and extreme hardship age faster biologically. This phenomenon is called weathering, and puts black mothers in their 20s or early 30s—normally prime ages for childbirth—at higher risk for health complications and chronic conditions.

The basis of this issue is a societal one, something that must be addressed on a wider scale. “If someone is experiencing weathering because of the discrimination they face in their lives,” University of Michigan professor Arline Geronimus told Harvard, “the solution is not just to tell them to get more exercise.”