April 11th through the 17th is National Black Maternal Health Week.

The observance was created by the Black Mamas Matter Alliance.

It's a time to raise awareness and address the systemic inequities and health disparities that disproportionately impact black mothers.

This year's theme is Rooted in Justice and Joy.

Joining me now to talk about black maternal health is Leseliey Welch from Birth Center Equity, along with Cassy Jones-McBryde from the Michigan Chamber for Reproductive Justice.

Welcome, both of you, to American Black Journal.

- Thank you.

- Thank you.

- Let's start just by talking a little about the issue of black maternal health in the city of Detroit.

This is a, a, a crisis area in, in many ways, and I'm not sure that everyone always sort of takes note of that, but we have a higher incidence of people losing pregnancies here.

We have a higher incidence of people being sick when they are pregnant here.

And because this is a majority African American city, that becomes a black problem.

I'd love to hear from both of you where you feel like we are with that level of crisis.

- Yeah.

I would first emphasize that there... There's nothing inherently wrong with black bodies-- - Right (laughs) - That has produced this problem.

- Right, right.

- So-- - This is about poverty and isolation-- - Yes.

- And underinvestment.

- So we have an inequity in those outcomes, and we also have an inequity in care options.

And we live in a country that has historically disinvested and not repaired the investment in midwifery care, which we absolutely 100% know makes a difference-- - It makes a huge difference.

- In our care outcomes.

And so part of my work is advocating for increased access to midwifery care in our communities because we know it would reduce our instances of preterm birth, of low birth weight, of maternal mortality and morbidity.

It would increase our rates of breastfeeding.

It would increase our experiences of autonomy and respect, and all of those things will empower our families.

- Yeah, yeah.

- That's very true.

I think that there is a need to lift that.

Not only is it because we may, you know, lose our children or, or suffer or step backs when we have to take time off work, but we die a lot in giving birth, black people.

So 80% of the deaths that happen and related to pregnancy are preventable deaths.

That means that we have solutions that we're just not addressing or accessible to those that are the most vulnerable.

So the work that I do is connect the policy aspect and equity and birth equity into every system because we've to justice as everything, and we have to make sure that we have the things that we need to thrive, and access to those things are very important for us.

And that the level of, of, of divestment that we feel in in this work is staggering.

- Yeah.

- People die.

There'll be seven women that will die by sunset today.

And so that's every day someone loses their life and they don't need to.

- Yeah, yeah.

When we think about this, this, this period of time when you try to focus on these things, what are some of the things that you need people to kind of draw out of that focus to, to move in a different direction?

- Hmm.

One of the things that we've just launched at Birth Center Equity is a national 25 year initiative called Beloved Birth 50 by 50.

And the goal of Beloved Birth 50 by 50 is to have 50% of births in the US be attended by midwives by 2050 for all of those reasons we just described, and to influence a culture shift in birth in our country.

So right now we live in a culture of birth that is physician-centric, that is physician-led, that is hospital-anchored and that's rooted in hierarchy, whether it is hierarchy around identity or around credential.

And what we are advocating for and proposing is a culture of birth that is family-centered, that is midwife-led with physician collaboration, that is once again rooted in communities like birth centers, and that honors the inherent value of all people and of all credentials.

- Yeah, yeah.

- And so.

- Yeah.

And there are people working diligently in this work that are making sure that we have the guardrails to care and that's in policy.

So we have the Michigan Momnibus that is still fighting to be fully introduced... Not introduced, but realized.

We have passed the Senate twice and we're looking for House support, and we're confident that it will happen.

We also have organizations like the Well Coalition that work toward water affordability.

That's part of reproductive justice.

- Yes.

- And also we always forget about how people experience their birth while in custody.

There's a prison or postpartum directive that is currently not really fully realized because care is relative to the directive in prisons, and also there's no consistent care and custody while you're fully in custody in your jails.

So our awareness this week is for us to raise the how harm is happening in all systems and making sure that we don't forget the ones that are often left behind that are incarceration.

- Hmm, hmm.

I wanna have you talk just a little more about these, the idea of birthing centers and why that's different from the setting and environment in which we manage maternal health now, and, and what's different about that?

You said something earlier about midwife-led as opposed to physician-led.

Why is that difference important?

- Yes.

So birth centers are homelike places where midwives provide prenatal care, postpartum care, birth care, but also care, we say period to period.

Right?

So reproductive healthcare, GYN care, well woman exams.

And midwifery care is important because midwives approach birth as a normal physiological experience in our life cycles, and it is not overly medicalized.

So in countries that have better birth outcomes than the United States, you see a midwife first unless a physician's care is medically indicated.

Right?

And we know that in our country, upwards of 60%, some say 80, 87% of us could safely give birth with midwives.

Right?

In a community setting.

And so the birth center provides an opportunity, is the only healthcare facility that is uniquely built to center the midwifery model of care, but you can have midwives in hospital and home and in the birth center, but we love the birth center because we feel like it provides the best of all worlds and is also can be a center for community wellness.

- Yeah, yeah.

And, and you've opened a birthing center-- - Yes.

- Recently here in Detroit.

Talk a little about that and where it is.

- So I'm proud to be one of four co-founders of Birth Detroit, along with Char'ly Snow, Elon Geffrard and Nicole White.

We started providing prenatal care in the city actually in pandemic in 2020 in collaboration with Brilliant Detroit in the small clinic, but we then worked to raise money to buy land and to build our brand new birth center, which opened, we cut the ribbon in fall 2024, and our midwives have been catching babies there ever since.

(participants laugh) - When you talk about the sort of systemic, I guess, context for this, I can't help but think of the recent shift in city government here in Detroit and the focus now on all kinds of health-oriented policy that's coming out of this administration, it seems like it would be a boost to the work that you're doing.

- Absolutely.

I'm also the Co-chair of the Detroit Right to Counsel Coalition, and one of the driving agenda items for our beautiful mayor is the housing.

- Yes.

- Is actually important for our families, and it is reproductive justice as well.

If you're not able to have a home to parent, then you're not fully thriving and supporting the way that you are, are, should, I guess, a God given right to have.

And so I think that with housing instability, there has to be data for that, and I'm proud of a study that was co-authored by Dr.

Sealy-Jefferson and other brilliant minds that connect how the illegal eviction crisis in Detroit.

We surveyed over 1,500 black women and we found that over half of them were evicted illegally.

That's a staggering amount, and they were all, you know, with families and care for community.

So that's, it is really a systemic problem that happens in Michigan and primarily in Detroit where there's so many predatory ways that landlords seek to-- - Sure.

- To take domain over your residence and over your lives.

So I'm very proud of the work we're doing in Detroit Right To Counsel, but like all of the movement work, we need funding to, to be sustained.

- Yeah.

Yeah.

I mean, there's something kind of fundamental, I think, about being able to think about maternal health in all of the different contexts that have an effect on it.

You've talked about housing, incarceration, right to counsel.

I mean, all of these things that we do and sometimes do poorly in the city have an effect on maternal health and therefore on a neonatal health and those other things too.

- People don't really think about the connection between all these systems that fail us and how we need to have the fact that they're not built for us originally, and it is hard to work within systems that are not designed for us.

That's why the work of midwifery care and birth workers to make sure that we center the lives and lived experience of the people that we serve in Detroit, the things that we talk about when it comes to disparities that we uplift within this week is also coupled with the joy that we find in the work that we do.

- Yeah.

- I mean, we are survivors because that is the outcome if you survive your birth, and that is the joy that you have, and that should not be the outcome that we looking for, just to survive our experiences.

We should enjoy the entire process, like you said, from period to period and be able to be free of, of obstructive racism and violence, to be free of, of all the systems that we don't fully enjoy.

- Yeah.

- Yeah.

- Yeah.

I do agree.

I tell people all the time, we deserve much more than just to not die.

- Right.

- And to not be sick.

- Right.

- It is one of the-- - This is supposed to be-- - Most sacred-- - One of the most-- - Life experiences.

- Yeah, yeah, yeah.

- And we need to reintroduce and celebrate the communal and sacred nature of birth.

And I think the theme for this week, the Rooted in Justice and Joy, invites us to create futures truly rooted in justice and joy and to do it for ourselves because we cannot wait (laughs) for other folks to take better care of us when we can create the systems of care that we deserve.

- Yeah, yeah.

Okay.

Congratulations on the work for this week, and of course, thanks for being here with us on "American Black Journal".

- Thank you.

- Thank you for having us.