Birth Detroit

Our current work at Birth Detroit Care, a midwifery-led prenatal and postpartum clinic, has already transformed the spirit of care pregnant families in Detroit have received. The Elevate Prize would make it possible to scale this transformational impact and to achieve Birth Detroit’s mission to midwife safe, quality, loving care. We envision a world where birth is safe, sacred, loving and celebrated for everyone. The path to creating this world lies in leading in our own care to transform systems leadership and the spirit of care.

Birth Detroit would use funding to expand our current midwifery care clinics. Projected annual operating costs of the clinic are $150,000 for 2-days-a-week services. Advancing our work at Birth Detroit Care means more Detroit families will receive high-quality, relationship-based prenatal and postpartum care which will transform birthing outcomes, promote  cultural competency, and empower communities. We additionally will devote awarded funds to deepen our organizational capacity, leading to local policy changes to facilitate family access to Black midwifery-led care. We will also formalize health system relationships, increase the number of Black midwives we can support in Detroit, and scale Birth Detroit Care as a model for establishing integrated health systems where Black families thrive. 

I was a doula before I was a mom. There’s nothing like being present when a baby is born. Sadly, I’ve also experienced the funeral of a baby. I was with my brother and sister-in-law the day my nephew was born – too small, too soon and died the same day. Now, I see every mom as my sister and every baby as my baby. When you see communities this way, you work differently. Birth Detroit is a team of birth workers, advocates and community leaders working to open the first birth center in Detroit and the first Black-led birth center in Michigan. 

Birth centers are home-like facilities providing birth-related midwifery care. They are shown to improve birth outcomes, enhance birth experiences, lower costs, and reduce culturally-relevant disparities. Birth Detroit will transform birth culture by demonstrating how Black-led midwifery clinics and birth centers are valuable assets to our communities, birthing hospitals and public health systems. In October 2020, we opened Birth Detroit Care (BDC), our first midwifery clinic for over 100 pregnant families. Goals include: culturally congruent care and healthy birth outcomes for over 10,000 pregnant families in Detroit, training hundreds of Black midwives, and scaling our successes.

Despite increasing evidence that community-based midwifery improves maternal and infant health outcomes, enhances patient satisfaction and lowers cost, there is very limited access to these services in Detroit. Maternal and infant health outcomes in Michigan rank below the United States as a whole. The Michigan League for Public Policy (MLPP) reported in 2019, Michigan ranked 36th in the U.S. in infant mortality and 30th in maternal mortality. Additionally, Detroit’s Black babies continue to die at a rate two to three times higher than white babies. The Giving Voice to Mothers study suggests midwifery care models demonstrate reduction of racial disparities when compared to hospital-based care.

Birth Detroit is a community-based nonprofit operating Birth Detroit Care, a midwifery clinic open two days a week, which offers comprehensive prenatal and postpartum care provided by Black midwives. We also offer virtual childbirth education classes. We plan to expand our midwifery clinics with another Detroit nonprofit, Brilliant Detroit. We are also planning a capital campaign to raise money to purchase and renovate a building for Detroit’s first community birth center. We address racial inequities in maternal health by scaling Black-led neighborhood midwifery clinics and freestanding birth centers as part of integrated health systems.

Birth Detroit imagines a future in which Detroit is a leader in maternal and infant care. Traditional prenatal and birth care is failing Black birthing people, and we are no longer asking permission to save our own lives. The same structural factors at the root of racial inequities in birth outcomes are rooted in our systems of care, and we aim to use a strengths-based lens to find innovative and equitable solutions. Despite research supporting birth centers as essential elements of integrated maternity care systems, and showing that birth centers improve outcomes, there are no freestanding birth centers in Detroit -- and no Black-led birth centers in Michigan. Demonstrating that Black-led birth centers are valuable providers in integrated health systems is an innovation that’s time has come. We strive to center Black voices in birth center planning and promote Black-led midwifery, to empower our community, and increase birth equity. Our work is a step towards a future of racial healing and reclamation of Black-led midwifery. Furthermore, while most birth centers are for-profit businesses, we are growing a nonprofit model centering community voices, strengths, needs, and vision in birth center development.

Birth Detroit will continue providing services at our midwifery clinic. The impact for families has been tremendous. It is now possible to receive high-touch, relationship-based care during pregnancy, during the pandemic, and right in the neighborhood. Next, we will open the Birth Detroit Birth Center. Our capital campaign seeks to raise funds to purchase and renovate a building for the birth center, where up to 500 families yearly will receive prenatal and postpartum care. We estimate 200 families will choose to have their babies at the birth center. 

Birth Detroit will lead in modeling birth center development and integration into current health care systems. We will track outcomes and value, gaining and maintaining accreditation, and engaging in rigorous quality improvement, including measuring and managing client and family experience. Birth Detroit will transform birth culture by demonstrating how Black-led midwifery clinics and birth centers can be a valuable asset to our communities, birthing hospitals and public health systems. Anticipated impact over the next ten years include: culturally congruent care and healthy birth outcomes for more than 10,000 pregnant families in Detroit, training and capacity building for hundreds of Black midwives, and scaling successes for replication across the state and country.

Since opening in October 2020, Birth Detroit Care has served more than 75 families in almost 200 visits. Birth Detroit originally anticipated serving 100 families in one year and will likely serve closer to 150 families. Birth Detroit Care offers nontraditional clinic hours and serves families two days a week. This individualized, high-touch, person-centered model of care, coupled with hours that are responsive to working families, removes traditional barriers to care experienced by disenfranchised women and provides an accessible maternal medical home. Birth Detroit has provided virtual childbirth education classes to 70 couples this year and anticipates providing childbirth education classes to 120 couples/year. In partnership with Brilliant Detroit, Birth Detroit is organizing to expand the number of clinics by two in the next year and by five clinics in the next nine years. In 2022, Birth Detroit estimates serving more than 550 families with perinatal care and childbirth education.

Birth Detroit is currently engaged with a team of evaluation experts from local universities who are developing a qualitative and quantitative evaluation plan for Birth Detroit Care using Client Care, an electronic medical record, and client satisfaction surveys. The quantitative element of evaluation is led by an epidemiologist, who is extracting, cleaning, and recoding raw data from Client Care to create data measures Birth Detroit can then share with clients and funders. Metrics of success measured will address key causes of infant mortality and mirror UN Sustainable Development Good Health and Well-being indicators, including maternal mortality rate, neonatal mortality rate and under-five mortality rate. The study will also measure national key metrics for successful birth outcomes, including: number of pregnancies reaching a gestation of 37 weeks or greater; number of newborns with a birth weight of five pounds, eight ounces or greater; and number of clients who successfully initiate breastfeeding. Birth Detroit Care’s clinical team is very proud of family satisfaction and that 100% of the clients who have given birth are breastfeeding.

Birth Detroit’s biggest barrier is accessing start-up capital. Studies suggest that funding to Black communities accounts for only 1% of all community foundation funding (National Committee for Responsive Philanthropy, 2020). It is going to take Birth Detroit longer to get started than it would a white-led, for-profit birth center. Birth Detroit has received over $500,000 in funding from foundations since 2019 and plans to continue these partnerships. Birth Detroit is also completing a catalyst program, akin to a business accelerator, to develop diverse sources of funding. Winning the Elevate Prize would grant Birth Detroit access to the start-up capital needed to open more clinics. 

Legally, Birth Detroit experiences a lack of supportive legislation in Michigan for midwifery and birth center care, making it difficult to secure reimbursement for services. To combat this systemic issue, Birth Detroit has hired a Policy Director and is working in partnership with SisterSong and the Michigan Coalition of Birth Centers to collectively eliminate these barriers to sustainability. Birth Detroit has plans for a legislative educational campaign to highlight the immense value of birth centers and midwifery care in addressing inequitable birth outcomes, and would love support from the Elevate Prize in developing this campaign.

Birth Detroit is a young and growing nonprofit, and marketing and social media are currently volunteer-led areas of our organization. Birth Detroit would use the larger platform to create strong brand recognition around Birth Detroit Care and differentiate it from hospital-based prenatal and postpartum care. Birth Detroit would also utilize the platform to educate and promote birth center care and education about midwives, doulas, breastfeeding, and postpartum services in Detroit to address birth disparities.

A larger audience would lead to a larger donor network, which would help us reach our goals of expanding midwifery care to all who want it in Detroit. Birth Detroit has 300+ active donors who have given over $200,000 to Birth Detroit since 2019. With a broader audience, followers and donors would have more education about what’s unique and special about birth center care and Birth Detroit’s model specifically, and would in turn become stronger advocates for this work, not just in Detroit, but also in their home cities. The international recognition that the Elevate prize offers will help Birth Detroit open five clinics and two birth centers in the next 10 years and share our model of care with communities around the world.

Birth Detroit is guided by the wisdom of Black women, who have been our leaders since Birth Detroit’s inception. Birth Detroit uses an equity and evaluation tool that guides our internal and external decisions in alignment with our values of safety, love, trust and justice. Birth Detroit’s first step was to survey our predominantly Black community to see what they wanted in prenatal care. Only after Birth Detroit found out that 98% of our community thought a birth center was a good idea did Birth Detroit move forward. The opening of Birth Detroit Care is a response to that survey -- our community wanted services now, even before Birth Detroit opens the birth center. Our leadership in Birth Center Equity, a network of birth centers led by Black, Indigenous, and people of color, is essential to building a diverse, inclusive network of safe, thriving community birth spaces. Birth Detroit’s long-term vision is to support aspiring Black midwives with apprenticeship opportunities and subsidized housing at the birth center. Birth Detroit will transform birth culture by demonstrating how Black-led midwifery clinics and birth centers can be a valuable asset to communities, birthing hospitals and public health systems.

Birth Detroit was co-founded by four public health leaders with over 30 years experience collectively in perinatal care, and over 40 years experience managing grants, projects, and organizations. The co-founders are Leseliey Welch, CEO, a Black public health leader and co-director of Birth Center Equity (BCE); Char’ly Snow, CNM, Clinical Director, a Black certified nurse midwife and founder of Metro Detroit Midwives of Color (MDMOC); Elon Geffrard, Education Director, a Black doula and public health consultant; and Nicole White, CPM, Policy Director, a white certified professional midwife. All four co-founders have had personal experiences with maternal and infant mortality through their professional and/or personal lives. These experiences have shaped Birth Detroit’s mission, values, and commitment to action. Birth Detroit has been guided by our community since 2019, when Birth Detroit hosted a community survey of over 400 Detroiters. The results of the survey indicated that nearly all respondents felt that midwives (98%), doulas (97%), and a birth center (98%) are a good idea for Detroit. In addition, Birth Detroit Care administers regular surveys to clients on client satisfaction. Continued feedback is not only welcomed from clients and community members, it is essential to our continued mission and direction.

Early conversations about a birth center in Detroit were met with disinterest. Two local foundations said that a birth center did not fit within their strategic plans. I moved on to be Deputy Director at the Detroit Health Department. I started maternal-health programs there, and didn’t let go of the idea of a birth center because I knew it was one strategy we had not yet leveraged to improve maternal and infant health. I started stakeholder interviews to gain support and form my team. That’s how I connected with my three co-founders. We held a community survey of almost 400 Detroiters, who said a birth center is a good idea for our community. With that we went back to the same foundation partners. Kellogg would later give us our first planning grant for $250,000 and the Michigan Health Endowment Fund funded our first clinic. A strength for me as a leader of this movement is operationalizing a vision. I hold this quote from Just Transition close:  “if it’s the right thing to do, we have every right to do it.” I strongly believe access to midwifery care and birth centers is the right thing to do for our communities.

Podcasts: 

1. America  Dissected (podcast)- Cradle and All

https://podcasts.apple.com/us/...

1. Good Birth for All (podcast)- Interview with Leseliey Welch and Nashira Baril

https://podcasts.apple.com/us/...

Both videos below are searchable on YouTube if the links do not work in this application. Search the titles below. 

Birth Detroit Care Tour - Prenatal and Postpartum services for pregnant people.

Let’s Birth the Future Together- Birth Center Equity 

Funding from the Elevate Prize would allow Birth Detroit to open more midwifery clinics sooner, and lead to quicker fundraising for the birth center. The funding will enable us to open two more care clinics within the next year. Funding would cover the initial and operating costs of these clinics, which includes vital equipment, staff, doulas for high-risk clients, and transportation for all clients who need it, allowing Birth Detroit to reach 150-300 more birthing people per year (150 clients annually for each clinic opened). 

The Elevate Prize would help Birth Detroit hire a paid communications staff member. More attention to marketing and education campaigns will allow Birth Detroit to increase our client and donor base. The funding would enable us to run a community education campaign to help the public better understand the midwifery model of perinatal care and why it is essential to transforming birth outcomes in the Black community. The Birth Detroit experience gives birthing people access to safe, high-quality care in a warm, homelike, and safe setting that centers each woman in her care, creating a sense of empowerment and trust. Birth Detroit wants everyone to have access to this kind of loving, sacred birth.

Continued partnership with nonprofit Brilliant Detroit is essential to Birth Detroit’s vision of providing culturally-congruent care that is easily accessible. This partnership enabled Birth Detroit to open Birth Detroit Care and provide vital midwifery care right away, while continuing to plan for the birth center. 

Nationally, Birth Detroit’s work with Birth Center Equity (BCE) involves increasing access to capital for Black, Indigenous, and people of color-led (BIPOC) birth centers. Birth Detroit receives funding and leadership development training from BCE.

There is a shortage of Black, Indigenous, and people of color midwives nationwide. Birth Detroit’s partnership with Metro Detroit Midwives of Color (MDMOC) will address that shortage locally by offering employment opportunities and training to midwives of color. 

Significant policy changes take collaboration. Birth Detroit recently hosted two provider forums and one payor forum via its partnership with the Michigan Public Health Institute. Sixty participants attended. Birth Detroit’s Clinical Director will develop partnerships with birthing hospitals as well as insurance payors. Birth Detroit is committed to its partnership with the Michigan Coalition of Birth Centers, a chapter of the American Association of Birth Centers that supports urban-rural birth center collaboration.