This presentation aims to examine the history of obstetric racism, the challenges it poses to maternal healthcare, and its impact on pregnancy-related deaths through the lens of a comparative case study focused on Rural Alabama (1870-1910) as the region underwent the modernization and professionalization of childbirth to the healthcare crisis in modern America. The late nineteenth century's demonization of the midwife, which correlated with the professionalization of medicine, was not an accurate representation of the skills acquired by practitioners. Instead, it was a shining example of racial bigotry, which became an instrument of social control against a targeted group of minorities. Obstetric racism exacerbated persistent challenges already faced by African American women, such as Jim Crow politics, socioeconomic marginalization, and gendered societal norms. The evidence of this assertion can be viewed in the United States Census Bureau statistics, which reveal that in 1880, the maternal mortality rate of African American women was two times higher than their white counterparts. However, in 2021, in modern America, Black women died at a rate of 2.6 times higher than White women from pregnancy-related deaths. More than 140 years later, America, a developed nation with advanced medical knowledge and equipment, has one of the highest maternal mortality rates of any developed nation. These persistent disparities highlight the lasting legacy of obstetric racism, revealing how historic injustices continue to shape maternal health outcomes today.