Dr. Janell Green Smith understood the risks of childbirth in America. She taught families how to recognize warning signs. She worked inside the healthcare system. She built her career around protecting mothers, especially Black mothers, from preventable harm.
She still died giving birth to her first child.
On Friday, January 2, Dr. Smith, a South Carolina–based midwife, scholar, and Black maternal health advocate, died from complications during delivery. She was 31. Her baby survived. She did not.1
Her death has sent shockwaves through the midwifery and maternal health communities. It has also forced a painful question back into public view: How is it possible that in the United States, a medically trained midwife could die from childbirth complications in 2026?
The answer is as uncomfortable as it is familiar. Dr. Smith’s death is not an isolated tragedy. It is part of a long, well-documented pattern in which Black women face higher risks during pregnancy and childbirth, regardless of education, income, or access to care.
A Life Dedicated to Safer Birth
Known to many as the “Loc’d Midwife,” Dr. Smith was widely respected for her commitment to patient-centered, evidence-based, and culturally competent care. She worked not only as a clinician, but as an educator and advocate, partnering with organizations like Hive Impact Fund to support families during pregnancy and early childhood.
In a statement following her death, the American College of Nurse-Midwives (ACNM) described her as:
“A respected midwife, scholar, and advocate whose life and work reflected a deep commitment to respectful, evidence-based, and equitable care”.
The organization called her death “heartbreaking and unacceptable,” adding:
“A Black midwife and maternal health expert died after giving birth in the United States underscores the persistent and well-documented reality that Black women — regardless of education, income, or professional expertise — face disproportionate risks during pregnancy and childbirth due to systemic racism and failures in care”.
ACNM went further, naming her passing what many public health experts have been saying for years: “a profound failure of the systems meant to protect birthing people”.
The Broader Crisis Behind Her Death
The United States has the highest maternal mortality rate of any high-income country in the world.2 While the total number of maternal deaths varies year to year, the underlying pattern remains consistent: pregnancy and childbirth in the U.S. are far more dangerous than they should be, and far more dangerous for Black women in particular.2
In 2023, the maternal mortality rate for Black women was roughly 50 deaths per 100,000 live births, compared to about 14 per 100,000 for white women.2 That means Black women are still three to four times more likely to die from pregnancy-related causes than their white counterparts.2
Public health researchers and maternal mortality review committees have repeatedly found that the majority of these deaths are preventable. The most common contributing factors include:
- Missed or delayed diagnoses.2
- Inadequate follow-up after delivery.2
- Poor coordination between providers.2
- Failure to respond appropriately to patient-reported symptoms.2
These are not rare or unpredictable complications. They are system breakdowns. Dr. Smith’s death is particularly painful because it challenges another common myth: that knowledge, training, or proximity to healthcare protects Black women from these outcomes.
It does not.
Like Serena Williams and CDC epidemiologist Dr. Shalon Irving before her, Dr. Smith’s story underscores a grim reality: for Black women in America, status does not equal safety.
What Real Accountability Would Look Like
Honoring Dr. Janell Green Smith’s life and work requires more than public mourning. It requires confronting the specific, well-documented failures in the U.S. maternal health system and committing to reforms that evidence shows can save lives.3
One of the most critical gaps is inconsistent and insufficient monitoring during pregnancy and after delivery.3 Although much attention is placed on the day of birth, a significant portion of maternal deaths occur in the weeks and months after someone leaves the hospital.3 Yet postpartum care in the U.S. often consists of a single visit around six weeks after delivery, a timeline many experts now consider dangerously inadequate.3 Expanding postpartum coverage, increasing follow-up, and improving early detection of complications such as infection, hemorrhage, blood clots, and hypertensive disorders are widely supported, evidence-based interventions.3
Accountability also means examining how hospitals and clinicians respond when patients report symptoms.3 Research and patient accounts repeatedly show that Black women are more likely to have their concerns minimized or dismissed, even when those concerns precede serious complications.3 Addressing this requires more than symbolic bias trainings. It requires tying hospital quality metrics, accreditation, and reimbursement to measurable outcomes in maternal safety and equity, and ensuring that failures to follow evidence-based protocols have real consequences.3
Finally, real accountability means building systems that treat patient-reported symptoms as clinical data.3 Many maternal deaths are preceded by repeated attempts to seek help. Closing this gap requires better triage protocols, clearer escalation pathways, and a healthcare culture that takes concerns seriously the first time.
Maternal health outcomes are not only a women’s issue or a racial equity issue. They are a measure of whether a healthcare system is functioning as it should. A system that cannot keep a healthy, medically trained 31-year-old midwife alive during childbirth is a system in crisis.
Supporting Her Family
Dr. Smith is survived by her husband, Daiquan, and their newborn child. A GoFundMe has been created to help support the family as they navigate both immediate and long-term needs. According to the fundraiser, donations will go toward funeral and memorial expenses, living costs, newborn supplies, and ongoing support for her husband and child.
The family has shared that contributions of any amount will help provide stability and relief during this period of profound loss.
You can support the Smith family here: https://www.gofundme.com/f/dr-janell-green-smiths-family
The Legacy She Leaves
Dr. Janell Green Smith’s death is not only a personal tragedy. It is a reflection of a maternal health system that continues to fail Black women, including those who dedicate their lives to improving it.
She leaves behind a body of work rooted in patient advocacy, community education, and a commitment to respectful, evidence-based care. She also leaves behind a hard truth: education, preparation, and professional expertise are not enough to protect Black women from structural failures in U.S. healthcare.
At NOWINCLUDED, we believe that stories are not just reflections of what is happening in healthcare. They are part of how change happens.
If you are grieving, processing, or carrying your own experience with pregnancy complications, birth trauma, or loss, our community exists as a place to share those stories, connect with others, and find support grounded in truth and lived experience.
Join the NOWINCLUDED community and share your story.
Dr. Smith’s legacy should not only be remembered. It should also be used as a call to action to demand better for yourself and for generations to come.
References
- Grant, K. (2026 , January 5). Midwife and Black Maternal Health Advocate, 31, Dies Due to Childbirth Complications with Her First Baby. Retrieved from People Magazine: https://people.com/midwife-and-maternal-health-advocate-dies-from-childbirth-complications-11879419
- Hill, L., Rao, A., Artiga, S., & Ranji, U. (2025, December 3). Racial Disparities in Maternal and Infant Health: Current Status and Key Issues. Retrieved from KFF: https://www.kff.org/racial-equity-and-health-policy/racial-disparities-in-maternal-and-infant-health-current-status-and-key-issues/
- Safarzadeh, A. (2025). Dismantling inequities to end the black maternal mortality crisis in the United States. International Journal for Equity in Health. doi:10.1186/s12939-025-02488-1
