The atmosphere in the operating room had turned tense. Just moments earlier, the soothing sounds of Frank Ocean’s “Moon River” from my birth playlist filled the air, and the medical staff chatted casually. Now, an uneasy silence settled over the room. My husband had stepped away, but from across the room, I heard my newborn baby’s soft gurgles and grunts as he adjusted to life outside the womb—a sound that brought me instant relief. But that moment was fleeting.

“Are you absolutely sure you’ve never had any uterine procedures before?” My ob-gyn at Cedars-Sinai, who had guided me through every stage of my pregnancy, sounded unusually tense. Between deep breaths and the nausea from medication, I assured her I hadn’t. Before this C-section, I had never been pregnant, never had a miscarriage, and never undergone any kind of surgery.

Eventually, my son was placed beside me, and we met for the first time. But he was quickly taken away again as the doctors told me they needed more time to work on me. What I didn’t know then was that they had discovered I had placenta accreta—a condition where the placenta, instead of detaching after birth, embeds itself into the uterus and surrounding organs. The placenta that had nourished my baby had grown into my uterine wall, forcing the doctors to turn my uterus inside out to remove it.

In the U.S., about 1 in 14 pregnant people with placenta accreta die, often from severe blood loss—something I narrowly avoided. The condition has become far more common over the decades, rising from 1 in 30,000 pregnancies in the 1960s to 1 in 533 by the 2000s. (Previous C-sections increase the risk, so as surgical births have grown more frequent, so has accreta.) Typically, it can be detected during pregnancy via ultrasound, but mine went unnoticed, making the emergency discovery during surgery even more dangerous.

Compounding the risk was the stark reality that Black and Indigenous pregnant people over 30 face maternal death rates four to five times higher than their white counterparts. At 36 and of Indigenous heritage, I was acutely aware of how easily I could have become another tragic statistic. Looking back, I wonder if living in California might have saved my life.

California accounts for about one in nine U.S. births, and in the absence of national maternal care standards, the state has made remarkable progress in reducing maternal deaths. (By contrast, Texas has the highest maternal mortality rate in the developed world.)

The driving force behind California’s success is the California Maternal Quality Care Collaborative (CMQCC), a groundbreaking initiative to make childbirth safer. Founded nearly 20 years ago by Stanford doctors and nurses, it was the first statewide effort solely focused on maternal health. Since then, California’s maternal death rate has dropped by 65% between 2006 and 2016, even as the national rate climbed. Inspired by this, all 50 states have since launched their own perinatal collaboratives—though participation varies, and only 36 receive federal funding.

At the heart of CMQCC’s work are free, downloadable toolkits that help hospitals prepare for childbirth emergencies. In my case, the Cedars-Sinai team followed hemorrhage protocols—including guidelines for placenta accreta developed by Stanford’s Dr. Elliott Main for the CMQCC.

The weeks after my delivery were grueling, a painful and emotional ordeal I survived thanks to my husband’s unwavering care. I’m not sure if I’ll ever fully recover, but I know how fortunate I am to be here.I still haven’t fully processed everything that happened to me. At the time, even talking about it with friends and family felt strange—like it had happened to someone else. Between my son’s immediate needs and the overwhelming reality of motherhood, I barely had time to think about it anyway.

Thanks to my doctor, Jamie Temko, and the team at Cedars-Sinai, I survived to experience the joys and challenges of being a mother. But with preventable maternal deaths increasing nationwide and deep inequalities persisting, I can’t stop thinking about those who didn’t make it. If they’re not here to tell their stories, who will speak for them?