“And that,” she added, “is democracy.”

This is the second story in a two-part series examining how the United States could curb deaths from pregnancy and childbirth.The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Across the U.S., programs at all levels of government — federal, state and local — are striving to reduce maternal mortality and erase the racial gap.Many are making headway in their communities and paving the way for other places.The Associated Press examined efforts that are focused on individual patient needs and efforts seeking to improve medical care generally. Here are key takeaways.

Healthy Start is a federal program that has worked with vulnerable populations for decades. This year, the federal government gave out $105 million in grants to fund local projects. Officials say it’s essential part of the Biden administration’sIt “manages women through their pregnancy,” said Corrina Jackson, who heads up a local Healthy Start project in Tulsa, Oklahoma. “You try to get them in their first trimester and then work with them to delivery day, and then we also work with the babies to make sure that they reach their milestones.”

Healthy Start programs coordinate prenatal and postpartum care, as well as educate moms on health and parenting; provide referrals to services for things like depression or domestic violence; and help with transportation.

In Jackson’s more than 25-year tenure in Tulsa, she said there have been no maternal deaths among clients. The maternal death rate for Oklahoma as a whole, meanwhile, is currently higher than the national average.-- along with an implanted device to keep her heart beating – has died, her surgeon announced Tuesday.

Lisa Pisano was near death from kidney and heart failure when surgeons at NYU Langone Health performed the dramatic pair of surgeries in April. The New Jersey woman initially seemed to be recovering well but about 47 days later,and put Pisano back on dialysis after the organ was damaged by her heart medications.

Despite the dialysis and implanted heart pump, Pisano eventually entered hospice care and died Sunday, NYU Langone transplant surgeon Dr. Robert Montgomery said in a statement.Montgomery praised Pisano’s bravery for attempting the latest pig organ-to-human experiment, what’s called xenotransplantation. The research aims to one day shore up the dire shortage of transplantable organs.