Midwives have been around since colonial times, when they would tend to the community as herbalists, nurses and more. While midwives provided essential services to birthing people, a heated debate arose in the early 1900’s about midwifery licensing as midwives bore the brunt of the blame for high maternal mortality rates. In 1911, the Bellevue Midwifery School was opened in New York City, allowing people to receive proper training, licensing and supervision of their practice. However, the 1970’s financial crisis led to significant cuts, including birth facilities.
Today, NYC only has two birth centers in Brooklyn.
Racial disparities in maternal mortality rates have been a rising public health crisis, especially in the city, with New York having one of the highest disparities in maternal mortality. Black people are up to 12 times more likely to die in childbirth than their white counterparts. With these findings, alongside research in the Department of Health’s Maternal Mortality Review Report published in 2014 that reported Black women comprised about 51.5% of pregnancy-related deaths, there was a need to respond.
In 2018, Andrew Cuomo announced the creation of the taskforce on maternal mortality and disparate racial outcomes to combat and reduce the racial disparities in maternal mortality and morbidity rates in New York City. This taskforce would work to determine recommendations for policies and programs that would change health outcomes for women of color.
Things were looking up for birth workers as the demand for their services was identified, that is, until the coronavirus hit. With the onset of the pandemic, budget cuts started to occur at the city's public hospitals which caused staffing issues as nurses and midwives were getting sick with COVID-19. The New York Maternity Task Force pressured the DOH to release a process for licensure so more birth centers could open up again, but city health officials determined that birth centers must go through the same lengthy process of licensure as an intensive care unit hospital. This made it difficult for birth centers to open, blocking women from getting the care they need during their pregnancy.
The New York COVID Maternity Taskforce then recommended passing the birth center bill A.259a/S.1414a, sponsored by Assembly Members Richard Gottfried and State Senator Gustavo Rivera. It ultimately passed unanimously in both the state Senate and Assembly. The only thing now holding it from becoming law is Gov. Kathy Hochul’s signature.
There are about 384 birth centers across the country, though New York City is home to only two of them and is struggling to open more. Organizations and communities such as the New York State Association of Licensed Midwives and the New York State Chapter of the American Association of Birth Centers are calling on Hochul to sign the birth center bill to eliminate barriers for midwife-led birth centers. As maternal mortality is still an issue that is alive and well, communities are hoping Hochul will address this issue so racial disparities in birthing can eventually be eliminated.