The mortality rate for African American mothers is nearly three times higher than white women and African American infants’ mortality rate is double the rate of white infants (Devido, Appelt, & Szalla, 2019, p. 1). Research has shown racism remains a prominent problem for the contemporary healthcare industry, with high mortality rates due to inequities in healthcare caused by racism, including stress, restricted access to healthcare, and mistrust in medical professionals amongst the African American community (Devido et al., 2019). In this analysis, the legacy of historical racism was explored in relation to its continued impact on the present-day treatment of pregnant African American women within the healthcare industry. A key finding was that African American women do not trust the healthcare system or the healthcare professionals due to: 1. awareness of historical inequities in healthcare provision; 2. awareness of the inequities experienced daily within the African American community; 3. awareness of the high mortality rates of pregnant African American women and babies; 4. personal experiences of the disparities in healthcare either directly or by community members. Specific strategies were identified to combat systemic and overt racism and to build trust within African American communities to directly increase the rate of survival for expectant African American women and their newborns. First, the active hiring of African American medical professionals by healthcare facilities, especially in those that serve African American communities. Second, the implementation of education, awareness, and inclusivity training to all healthcare professionals and providers to address and combat the issues and behaviors underlying the major disparities and systemic issues. However, given the embedded and systemic problems and the challenges of substantive change, healthcare provision for pregnant African Americans and their newborns should include high quality community-led and community-based healthcare and support.