My Remarks Presented at the Black Maternal Health Proclamation Signing Event

Executive Mansion, Raleigh, NC

April 15, 2026

Good morning. My name is Dr. Michele Benoit-Wilson, and I am an OB-GYN.

I am grateful to be in this room today, because the issue we are here to talk about demands exactly the kind of urgency and power that this room holds. With my 26 years of experience caring for women and their families, I want to put a human face on that urgency.

I am going to briefly introduce you to three women — Christine, Jamila, and Ayanna. Their stories are fictional, but every detail is drawn from real data, real conditions, and real failures of the system that was supposed to protect them.

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Let's start with Christine.

Christine is a 34-year-old teacher from Robeson County, three weeks home from the hospital with her second child. Her delivery went fine. The doctors said she was healthy. Nobody mentioned that the most dangerous weeks of her life were still ahead of her.

Over the past week, her husband Marcus has noticed Christine seems different. She gets winded walking to the kitchen. Her ankles and face are swollen. At night she can't lie flat — she props herself up on pillows because lying down makes it feel like she can't breathe. She's scared that if she says something is wrong, she will have to go into the hospital and be separated from her baby. So she waits.

What Christine doesn't know is that she is developing postpartum cardiomyopathy — a condition where the heart muscle begins to fail. Not with a dramatic moment, but quietly: shortness of breath, swelling, crushing fatigue. Symptoms so easy to dismiss as ‘new-mom exhaustion’ that women miss them entirely, until it's too late. Black women are diagnosed with this condition at two to three times the rate of white women. And nearly 50% of all maternal deaths in North Carolina happen not in the hospital — but at home, in this postpartum window.

Imagine if, three weeks after Christine came home, there was a knock on her door from a registered nurse. Not because anything had gone wrong, but because every family welcoming a new baby in her county is eligible for a three-week postpartum visit through Family Connects — an evidence-based program founded right here in Durham by Duke pediatricians— that now reaches families across 21 states. That nurse takes Christine's blood pressure, listens to her heart, and talks with Marcus as he describes the past week. She recognizes what this family cannot name. And she stays in the room while Christine makes the phone call to her doctor that she has been too scared to make — making sure Christine knows that calling for help means staying alive for her family.

Imagine if, because Christine has postpartum Medicaid coverage through her full first year, she is surrounded by a support system — her doula, her community, her family — all educated on something most people have never been told: that postpartum cardiomyopathy can recur, that a future pregnancy carries real risk, and that Christine needs a family doctor who knows her whole story, a cardiologist she can see regularly, and effective contraception that she’s not scared to use because of misinformation.

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Jamila is 27 years old and six months pregnant with her second child. They live in a rural county in eastern North Carolina. She became dependent on pain pills after a car accident three years ago and more recently started using Fentanyl. She desperately wants to stop using before her baby is born. At her first prenatal visit, she did something that took real courage: she told her family doctor that she was having trouble not taking the pills anymore, but was too ashamed to admit that she was also using Fentanyl. After her visit, there was no referral. Just some encouragement to stop using the pills — but no plan for how she could actually do it.

Substance use disorder is the number one cause of pregnancy-related death in North Carolina — more than heart disease, hemorrhage, and infection combined. Jamila’s county is a maternal health desert with no obstetrician or midwife to deliver her baby. Her family doctor does her best, but has no clear path to refer Jamila to an addiction medicine specialist — no one nearby who can prescribe the medication proven to help her safely manage her pregnancy. The nearest treatment program is more than an hour away and Jamila doesn't have a reliable car. She is desperate to make a change — yet she has no access to the resources she needs.

Imagine if the community doctor Jamila trusted had the next step ready — a direct referral pathway and a telehealth resource that breaks down the barriers of transportation and child care. Imagine if North Carolina's own Perinatal Substance Use Disorder Network had the funding it needs to reach Jamila's county. She would not need to choose between prenatal care and addiction treatment. She would get both — from providers who understand that what she has is a disease, not a character flaw.

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Finally, there is Ayanna. Ayanna is a 31-year-old college-educated accountant from Charlotte. Healthy, insured, doing everything right. At 38 weeks pregnant she tells her doctor three times that something feels wrong — abnormal swelling, a persistent headache, just not feeling like herself. Three times she is reassured and sent home. On the fourth visit, a different provider orders additional tests and finds her organs are on the verge of failure. She and her baby survive — barely.

Bias and discrimination were found to be contributing factors in 70% of maternal deaths in the most recent report of the North Carolina Maternal Mortality Review Committee. Ayanna's education and insurance offered no protection. Whether the impact comes from the chronic stress that systemic racism imposes on Black women's bodies over a lifetime, or from the interpersonal bias that can play out in a single clinical encounter — the evidence is clear: implicit bias in healthcare leads to worse outcomes, and for Black women, it can mean the difference between life and death.

But look into a new future with me.

Imagine if every office and hospital staff member who cared for Ayanna had completed mandatory implicit bias training as a condition of working there. No different than requiring healthcare workers to be vaccinated, reducing racial bias in health care is simply about safety.

And safety, like the lives it protects, is layered along with preventing heart disease, high blood pressure, and diabetes. Along with using telehealth to reach maternal health deserts.  Along with implementing Levels of Maternal Care, so communities and ambulances know exactly where to take a pregnant woman in crisis. Along with protecting Medicaid — the lifeline behind nearly 40% of pregnancies in this country. Along with postpartum visiting nurse programs, the way nearly every other industrialized nation in the world already provides.

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Christine. Jamila. Ayanna.

Three different women. Three different counties. Three different causes.

One number connects them: over 80% of pregnancy-related deaths in North Carolina are preventable. Not someday. Preventable right now — with the policies, the funding, and the moral imperative that we, as citizens of this state, owe to every family who calls it home.