I was walking through the San Francisco airport, heading home from a weekend that felt like a rare exhale—good food, deep laughter, uninterrupted rest. The kind of ease Black women rarely get to hold for long.
Still carrying that softness, I made my way toward my gate and everything waiting on the other side.
And then I stopped.
Something had caught my eye. It was an image I couldn’t move past. A Black woman rendered in circuitry and light, her body patterned like code, like pathways—systems layered into her very being. The garment she wore, as artist and scholar Nettrice Gaskins, PhD, later described to me, was inspired by the intersection of circuitry and kente cloth. A fusion of ancestral design and technological logic.
She was both history and future at once. Grounded. Composed. Fully intact. Not consumed by the system around her, but central to it.
Beneath it, a single word: mOTHERboard (2024).
A motherboard is the central system, the backbone of a machine. Without it, nothing runs. The meaning shifts, yet remains the same: mothers, and mother figures, as the backbone of our communities. The ones who make households, systems, and entire ways of life possible.
As a public health scholar, a Black woman, and a mother, I have spent years studying what happens when the backbone is under strain—when the system that holds everything together is asked to carry more than it was ever meant to.
Black women, and Black mothers specifically, are often treated as that backbone.
We hold families.We hold communities.We sustain systems that do not always hold us.
And we are expected to keep functioning, no matter the cost.
For over 400 years, Black women have been positioned as caregivers, stabilizers, and infrastructure. The Black maternal health crisis is not separate from that reality. It is one of its clearest expressions.
For many Black women in the United States, a positive pregnancy test does not arrive as uncomplicated joy. It arrives alongside something else: a quiet, persistent knowing that this experience is also shaped by risk.
Not abstract risk.Not distant possibility.But a well-documented reality.
Black women are more likely to experience complications, more likely to give birth too soon, more likely to lose a child, and more than three times as likely to die from pregnancy-related causes. These are not new statistics. They have been studied and repeated for decades—and in that repetition, they have been normalized.
We cite them. We build systems around managing them. Explanations are offered—that Black women enter pregnancy older, sicker, with more underlying conditions. These outcomes are framed as inevitable, simply the way things are. And over time, those explanations begin to feel like truth.
But what happens when we accept them without interrogating what produces them?
Because normalization does not just shape systems—it shapes expectations. It shapes what we tolerate. And over time, it moves inward.
It settles into the body.It lives in the background of joy.It turns what should be a moment of possibility into one that requires vigilance.
We enter pregnancy carrying knowledge—historical, communal, embodied—of what could go wrong. And so survival becomes the frame. But survival has never been the goal.
We deserve to live.
We know what harms Black mothers’ bodies, communities, and futures. What we have yet to fully commit to is building the conditions that allow Black mothers to live—not only survive.
So I ask a different question:What would it mean to build systems that allow Black mothers to live fully inside their lives?
For generations, Black women have organized to protect life in the face of structural harm. That work has been essential—life-saving, even. But protection cannot be the end goal.
We must also restore what has too often been taken from us: the ability to move through the world without constant vigilance, the space to breathe, to dream, to live fully inside our lives. If we are serious about that shift, then the question is not only what we measure or what we fund. It is whether we are willing to build something different. Because survival has shaped not only our systems—but our bodies, our expectations, and our imagination of what is possible.
If we are going to move beyond survival, we have to understand why it runs so deep. We have to understand what it has done to the body. Because imagination is essential—but imagination alone is not enough.
Resmaa Menakem’s work helps us understand why survival runs so deep—and why we must be careful where we locate the problem. As he reminds us, “If you don’t start with what has happened to Black women—and continues to happen—then you end up putting the defect inside of them.”
For generations, Black women have been treated as if they were available. In body, in care, in labor, in love, expected to give, to hold, to absorb, often without full sovereignty. That reality does not just live in history. It shapes how the body organizes itself in the present.
This is not only about the nervous system. It is about every system.
Survival, when it becomes the norm, does not stay contained. It embeds. And yet, what is often offered in response feels strikingly inadequate—calls for more rest and individual adjustment, without reckoning with the conditions that make those things difficult to access in the first place.
What Menakem offers instead is a different orientation: not fixing, not quick solutions, but tending. The slow, relational work of helping the body experience something different through connection, presence, and repetition.
Because moving out of survival is not a single moment of transformation. It is a practice.
A vigilance that sits beneath joy.A tension that does not fully release.A knowing—often unspoken—that something could go wrong.
If survival lives in the body, then the question becomes: what allows the body to experience something beyond it? Because safety is not only the absence of harm. It is the presence of possibility. And that possibility depends on something we do not talk about enough in public health: imagination.
If survival shapes the body, then imagination shapes what becomes possible. But imagination is not only about what we see—it is about what we question, and what we are willing to reimagine. Gaskins reminds us, “Sometimes we don’t need better answers—we need to ask different questions.”
And as we talked, she offered one that reframed the entire conversation:“What is the algorithm that runs the motherboard?”
Because if Black women have long been made to function as the backbone—the motherboard—then the question is not only how we support them. It is whether we are willing to change the system they have been asked to hold together.
If the underlying logic—the inputs, the assumptions, the conditions—remains the same, the outcomes will too. No amount of adjustment will produce something fundamentally different. Gaskins invites us to rethink the system itself. Through an Afrofuturist lens, she shows how art, technology, and cultural storytelling expand what we are able to see—and therefore what we believe is possible.
Afrofuturism is not simply about the future. It is about reclaiming the right to imagine it. Because if we cannot see ourselves living fully—if we cannot envision safety, joy, and ease—then the systems we build will remain organized around survival.
What does it mean to imagine a future when so much of the past has required us simply to endure?
If Menakem helps us understand how survival lives in the body, Gaskins helps us see what becomes possible when we allow ourselves to imagine something different. Together, they point us toward a deeper truth: moving from survival to living requires both—a body that can feel safe, and a future that feels possible.
As we mark the 10-year anniversary of Black Maternal Health Week, we are not starting from silence. We are building on the labor, vision, and courage of Black women who have long refused to accept harm as inevitable.
We have named the crisis.We understand the harm.We have identified racism as a root cause.
And still, we remain centered in survival.
We see it in the way risk is expected rather than disrupted, in the way vigilance is normalized, in the quiet calculations Black women carry into pregnancy—not just about what could go right, but what could go wrong.
This is why this year’s theme, “Rooted in Justice and Joy,” matters.
Because justice alone is not enough. Justice names harm. It demands accountability. It works to repair what has been broken.
But joy signals something else: safety, rest, and possibility.
Together, they open the door to something more expansive: liberation. Not simply the reduction of harm, but the presence of conditions that allow us to live. What remains is whether we are willing to build something different.
Because a body cannot be tended to while it is bracing for harm. And a future cannot be realized if we have never been allowed to imagine it. So the question before us is not simply what we know. It is what we are willing to create. Because when the foundation is cared for, everything built upon it has the chance to thrive.
Black mothers deserve more than survival.We deserve to live.
