Isabella Hollowell said Green Smith stayed by her side for roughly 10 hours as she labored before giving birth to her daughter in 2022. After Green Smith cut the umbilical cord, she held up Hollowell’s infant and said, “Look what you made, Mama. Look what you did.”

“She didn’t rush me. She made me feel safe. She listened to me,” Hollowell said.

On social media, Green Smith said that when she started working as a nurse in labor and delivery units, she saw shortcomings in the way pregnant women were treated.

“I wanted to be the change,” she said in her recent TikTok.

The United States is an outlier among high-income nations in its rate of maternal deaths, and numbers for Black women are particularly abysmal. While the overall U.S. maternal mortality rate has decreased in recent years, the rate for Black women remains stubbornly high. In 2023, Black women died at a rate of 50.3 deaths per 100,000 live births, compared to 14.5 deaths per 100,000 live births for white women, according to the Centers for Disease Control and Prevention.

The higher mortality rates for Black mothers persist regardless of their level of education or income. Experts say systemic racism and implicit bias from health care providers are among the factors that exacerbate this disparity, contributing to delays in care or symptoms being dismissed.

Green Smith’s goal as a midwife, she said in a 2023 Instagram video, was to hear how women envision their birth experiences and to “figure out how to individualize that care to empower them and help them have the birth of their dreams.”

The American College of Nurse-Midwives praised Green Smith’s advocacy for equitable health care.

“That a Black midwife and maternal health expert died after giving birth in the United States is both heartbreaking and unacceptable,” the group said in a statement.

Many at Wednesday night’s vigil agreed.

“This isn’t a new problem,” said Bailey, the nurse. “But because it happened to her, it’s going to shed some light.”

Wardlaw said Green Smith’s baby, Eden, is getting stronger every day, and the family hopes she won’t be in the NICU for too long.

“She is a feisty little fighter,” Wardlaw said. “She has her mother’s personality.”

Green said she will tell Eden about how her mother, down-to-earth and determined, was fighting to change the world.

“I just want her to know who her mom was, the legacy she left,” Green said. “She was so excited for her.”

Bracey Harris reported from Charleston and Elizabeth Chuck from New York.