Pregnancy in America is increasingly perilous, not because of medical inevitabilities, but due to systemic failures rooted in history, inequality, and institutional neglect. Despite being a high-income nation, the U.S. continues to see alarmingly high maternal mortality rates, with preventable deaths revealing deep cracks in the healthcare system. This conversation explores how past injustices and present-day disparities shape the experiences of women today, particularly those from marginalized communities.