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Approaches are needed that tackle the root causes, including the structural drivers of health, argue Raquel Catalao and colleagues Inequalities in maternal health outcomes for ethnic minority and Indigenous populations across the globe are driven by cultural, structural, and interpersonal racism. Strategies to mitigate this racial injustice require government commitment, structural policy changes, and community led solutions. Biomedically driven interventions alone will not fix this, and novel systemic approaches are required to tackle the social determinants. Maternity care provides a unique setting for understanding the links between social determinants and health inequity through its focus on the experiences at a critical transitional period of life. We focus here on high income countries, where our experiences mostly lie and where data tend to be more widely available. In this context, there is a clear and alarming pattern of people from racialised groups (that is, those who are

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