So why, exactly, is the maternal death rate going up in the United States? In the last ten years, pregnant women and new mothers are dying in the United States more than they used to. That’s a direct reversal of the general trends of the last two centuries; normally, rich places have fewer dead mothers every year, not more. But a hot combination of racism, sexism, ableism, reduced public support for female health, and the crippling of science-based sex education has finally made it more dangerous for American women to be pregnant than it used to be.[*43]