The experience of pregnancy and labor often marks one of the most critical social, cultural, and emotional events in a family. I recently lived this experience in my own life, as my wife gave birth to our first child. This event has made me vigilant about protecting the experiences of other women and families in the communities I serve in Brooklyn.
Unfortunately, the United States is the only high-income country that has rising maternal mortality and morbidity rates. We are also the only country that has not fully embraced midwifery care as the standard of care for all pregnant people. In every other industrialized nation of the world, midwives are the primary birthing providers — and those countries have the lowest rates of maternal mortality and morbidity.
Black women in the US are three to four times more likely to die from a pregnancy-related complication, but in New York City, it is even more acute — Black women are eight times more likely to die. It is time for New York City to invest in midwifery care.
The midwifery practice model focuses on the full spectrum of needs of the pregnant person, nurturing both the physiologic and psychological needs of the mother while respecting their family and culture. Midwives believe that birth is a sacred event that should be free from trauma, empowering, satisfying, and safe, even if a risk condition develops. Hallmarks of midwifery care include evidence-informed practice, minimal interventions, serving historically disenfranchised communities, creating care through trusting relationships, and provision of care that is culturally conscious and respectful.
We know that it is not just being Black or Indigenous that makes women and children more likely to suffer poor outcomes; the root of these disparities is the systemic and historic disenfranchisement they encounter in all parts of their life. Recently, a national study showed that when midwives are more fully integrated, there are far fewer complications, and greater satisfaction in care — this creates a safer and more fulfilling experience for both the mother and child. Greater integration of midwifery care could diminish the risks that many marginalized women face in their pregnancies and births.
We need federal, state, and city governments to work towards the transformation of maternity care for New Yorkers. Close to 250 babies are born every day in our city, and we have close to 40 facilities where you can have your baby — yet still, women and infants die.
One powerful shift would be to have midwifery care accessible to all New Yorkers. As of now, across the country, only 12 percent of births are attended by midwives. Midwives are not available at all of the facilities throughout the city. And more importantly, many New Yorkers do not even know that midwifery care exists.
My wife and I received high-quality midwifery care at Woodhull Medical Center, a NYC Health + Hospitals facility. We trusted the care at Woodhull because they employ midwives — a practice that is not used at any other H+H facility.
New York does not need more hospitals, but we do need every hospital in New York City to have midwifery care available. This requires bold leadership — unafraid to envision creative solutions to persistent problems and willing to disrupt business as usual. It is a vital public health strategy to create health equity and justice for women and mothers from historically disenfranchised communities, those most often cared for in the NYC H+H system.
My vision is for every hospital in this city to include midwifery care so that all people are seen, heard, and cared for — just like my wife and I were. Let us make a commitment to making midwifery care accessible for all New Yorkers.
Too often, we are caught reacting to a poor outcome or creating a policy in response to a disaster. It is time to celebrate, uplift, and grow what is working. Let’s strive to guarantee access to high quality, loving, and compassionate midwifery care for all families.
Antonio Reynoso is a member of the New York City Council representing District 34 and a candidate for Brooklyn borough president. This op-ed was written by Reynoso in collaboration with Helena Grand, a midwife at Woodhull Medical Center and Paulomi H. Niles, a PhD, MPH and LM.
