Women have a greater lifetime risk of dying in pregnancy-related causes in the USA than in 40 other countries. For women of colour the risks are especially high. Despite the huge sums of money spent on the health care system, women continue to face a range of obstacles in obtaining the services they need. This report shows the human cost of these systemic failures and highlights the steps that are urgently needed to move towards a health care system that respects, protects and fulfils the human right to health without discrimination.