The US is one of thirteen countries in the world where maternal mortality is currently worse than it was fifteen years ago and significant racial disparities underlie this dismal truth. In the US, Black women are three to four times more likely to die from pregnancy-related complications than white women, even when socioeconomic status and education are considered. Additionally, although national maternal mortality statistics are abysmal overall, the risk of death from childbirth and pregnancy varies significantly by state, suggesting that maternal death is not natural or inevitable, but linked to decisions made by individual states. Georgia represents one US state that fairs poorly. In 2017, it was ranked 48th in the nation for maternal mortality. This report examines state-level system failures, including policies, funding, and institutional factors, that likely contribute to racial disparities in maternal mortality within the state, while offering policy and advocacy recommendations for improvement. The analysis and recommendations focus on maternal healthcare quality and access, health insurance access and costs, funding for maternal health, accountability around data analysis, the use of data with regard to maternal mortality review committees, and the engagement of religious communities, in Georgia. Class and gender inequities are considered as interconnected determinants of maternal health, as well. The report focuses on state-level systems under the influence of policymakers to suggest that structural reforms will be central to ameliorating the burdens of maternal death, particularly on Black women and others that are disproportionately vulnerable.