She’s probably sleeping.

Terrina Riley remembers a hospital nurse offering her that reassurance after she noticed the normally active baby in her belly had stopped moving. As Riley tells it, she was seven months pregnant and had already spent a few days in a Washington, D.C., hospital bed, worried about the amniotic fluid she was losing each hour.

When her sister went into labor five months into her pregnancy and lost the baby, Riley had “prayed and prayed and prayed” she would never know how that felt. And then, there she was, lying in the same labor and delivery unit, knowing something was wrong even before the nurse turned on a machine to check for her daughter’s heartbeat.

The room should have filled with the sound of a rhythmic swooshing: swoosh, swoosh, swoosh.

“Shhhhhhhhhhh,” is what Riley recalls hearing. In the moments that followed, she says, she pleaded with her daughter, “Please, please, wake up.”

As she tells me this, the 29-year-old starts crying and then sobbing. Two and a half years have passed since that day, but to listen to her talk is to know immediately that she is still hurting, still angry, still pleading.

Please, please, wake up.

She might as well be saying that to all of us.

We have known for a while now that among the world’s wealthiest countries, ours has some of the most shameful infant and maternal mortality rates. We have also known that communities of color carry a disproportionate burden of that loss. So, what have we done to improve those numbers?

Not enough, apparently.

This week, the March of Dimes, which is based in Arlington, Va., released a report card that reveals, “Moms and babies face higher risks than ever before.”

“Overall, the rates of maternal death and premature birth (the leading contributor to infant death) are increasing,” according to the report.

The report breaks down the numbers by states and cities, assigning them grades based on local preterm birth rates. It also does something else significant. This year, the report dives deeper into maternal health data and, by doing so, sends a clear message that we can’t help babies without also trying to help the people who carry them.

“We don’t have two crises,” Stacey D. Stewart, president and CEO of March of Dimes, says. “We have one.”

Right now, she says, the country doesn’t have an environment that supports expectant mothers in a way that ensures they have the healthiest pregnancies possible. Even in the District, where pregnant individuals can receive full medical coverage through Medicaid, many residents live in areas that she describes as “maternal care deserts.” There are no maternity wards east of the Anacostia River, forcing those in the city’s poorest neighborhoods to travel the farthest to deliver their babies.

The report card gave the District a C-minus, which falls slightly below the national grade and in line with Maryland. But when you look closer at who is seeing their babies born too soon, the District stands out as having one of the highest racial disparities in the country.

“In District of Columbia, the pre-term birth rate among black women is 65% higher than the rate among all other women,” the report says.

After I wrote a column last year under the headline, “Why Washington is one of the worst places to be black and pregnant,” Riley, who is African American, called me. At that time, she was still living in the Washington area, hoping to find a lawyer so she could sue the hospital. (Because litigation remains a possibility, I’ve decided not to name the hospital at this time. But if a case goes forward, I will tell you in detail about her claims and the hospital’s responses.)

What we already know though, because of the national data, is that Riley’s experience is not unique. In hospitals across the country, too many babies are being born too early, resulting in their deaths, lifelong health issues and a societal cost that averages $65,000 for each preterm birth.

When I spoke to Riley again this week, she told me she had moved to York, Pa., with the two children she had before she lost her daughter. She said she felt the D.C. region had taken too much from her, and she needed a new start.

After a sonogram machine confirmed what she feared that day in the hospital, that there was no heartbeat or movement, Riley still had to deliver her daughter. She named her Rianne-Page. After the delivery, Riley recalls the staff taking the baby, cleaning her and handing her back in an outfit that resembled an angel’s gown.

“Y’all got outfits for dead kids?” she recalls thinking. “That isn’t what you put a live baby in.”

At one point, she learned that a laminated heart was placed on her door to let people know she had lost a baby. Soon after, she says, she started noticing other hearts on other doors. She says she stayed in the hospital for several days after the delivery because she refused to let her daughter go. She bathed her, brushed her hair and talked to her.

Her other children, a son who is now 9 and a daughter who is now 8, came to visit their sister and pray with their mother. Riley lost a child, but they lost two people. They lost their sibling and the mom they once knew. Riley says she knows she’s not the same person she was when she stepped into that hospital, belly bulging.

“This society stole something I can never get back,” she says. “You stole something from so many people.”

In recent years, D.C. Mayor Muriel E. Bowser has focused attention and resources on maternal and infant health, with the city hosting two summits on the topic.

The March of Dimes is also launching an initiative in the District that aims to improve the health outcomes of moms and babies. Group prenatal care has been found effective at reducing preterm births, so the organization is working with the Elaine Ellis Center of Health in Northeast Washington to start a group for expectant mothers by mid-2020. The hope is to provide an atmosphere where, under the guidance of a professional, members can turn to one another for support.

Those are good starts. But more is needed. Four states last year received a failing grade in the report card. This year, six states and Puerto Rico failed.

In Pennsylvania, Riley says, she has been able to move her children into a neighborhood where they don’t have to constantly hear sirens. In Washington, she says, she struggled to find employment. There, she has twice been named employee of the month at the McDonald’s where she works.

Riley says she has also started receiving needed therapy.

“I touched a baby for the first time last week,” she tells me before she starts crying. “It felt so good. She was so pretty, skin so soft, hair so curly. She was just smiling, and she had no teeth. For a moment, my mind slipped, and it became me, holding my baby.”

She confesses that sometimes she closes her eyes and purposely pictures her daughter, who would have turned 3 in April, alive and walking. She does this knowing that she only has to open her eyes and step into her bedroom to find a reminder that her daughter never took a breath.

On the windowsill, a glass case covers a tiny urn.

On it are the words, “In Loving Memory.”

What we should see when we look at it, though, is the plea we are long overdue in responding to:

Please, please, wake up.

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