The Problem In New York
It wasn’t always this way, in 2001, NYC had four free-standing birth centers and multiple within-hospital birth centers or midwifery-led care floors. Now, New York State has just three out of the 345 birth centers in the United States, with just two in New York City, both located in Brooklyn. New York City has one of the most staggering disparities in maternal mortality in the country, with Black people 12 times more likely than their white counterparts to die giving birth. New York State’s C-section rate is at 34.4%, ranking 40th out of the 50 states in the U.S. (that is, 11th highest) — not to mention that the United States as a whole is the only developed nation who’s maternal mortality rate has steadily increased in recent years.
In Downtown NYC alone, the loss of midwifery and birth services has been staggering: SoHo Midwives closed in 2002; Elizabeth Seton Childbearing Center closed in 2003; St. Vincent’s closed in 2010; Mt. Sinai closed their in-hospital birth center in 2018; Beth Israel closed its midwifery unit in 2017; Bellevue closed it’s birth center in 2007 and slashed it’s 24-hour midwifery program in 2017; and NYP Downtown’s birth center was a short-lived and failed experiment.
Now, in the midst of this pandemic, we are left with The Brooklyn Birth Center and Birthing Center of New York, both in Brooklyn, as well as just 20 independent home-birth midwifery practices to handle the immense number of requests for out-of-hospital births that have poured in from pregnant people afraid to enter hospitals for fear of contracting the virus.
The Governor and the Department of Health have started to take some modest steps, but not nearly enough. The Governor and State have retraced their steps and declared that all people have the right to a companion in their birth, and private hospital systems such as Mt. Sinai and New York Presbyterian will now oblige (at their own risk) in allowing birth companions (public hospitals have continuously allowed support persons). However, there is no such guarantee for a support person during a hospital postpartum stay during the pandemic, and the risk of unnecessary trauma — as some new parents may be separated from their newborns as a matter of protocol — and the likelihood of nonexistent follow-up postpartum care are all too real.
On March 27th, emergency legislation was passed to allow midwives who are not nurses and hold the Certified Professional Midwife License to practice in New York State. Previously, while this certification was recognized in 34 other states and New York, New York subsequently criminalised CPMs practicing in New York State.
While legislation to allow midwives to open their own birth centers passed in 2016, the process of creating regulations through the Department of Health was a begrudgingly slow one that took until November 2019, and, today, all that remains is the establishment of a pathway for licensure, upon which we are still waiting.
New York’s pregnant people urgently need safe auxiliary maternity units, expanded prenatal and postpartum care, and licensure for midwife-led birth centers to carry us through the weeks and months ahead.
