(upbeat music) - [Bill] On Detroit's East Side, Sade Dortch, she's expecting.

- Here is baby's room, baby to be.

- [Bill] Due in just a few weeks, age 29.

She works for Amazon Flex.

So you got the name for your baby.

- Baby Nevaeh.

It is heaven spelt backwards.

- [Bill] Her first child, 12-year-old son Rico doing fine, but less than a perfect start.

Dortch, then 16, giving birth at the hospital.

- The nurses felt by me being young, I couldn't tell the difference between the time to push and just me being dumb from the epidural that was given to me during the process.

And when she told me to do a practice push, she noticed I was crowning and she told me to stop.

- [Bill] Dortch said she stopped pushing, told to wait for the doctor who had stepped out to see another patient.

- That was kind of like a doozy right there, just running in between each client trying to help each person.

So at that time my son had got stuck, and I had to have a double episiotomy if I said that word correctly, just to get him out.

- [Bill] Dortch said they didn't listen that the epidural wasn't a problem, believing her son wouldn't have gotten stuck had she just kept pushing instead of waiting.

And she thinks she could have avoided that episiotomy.

- Clap your hands, everybody.

- [Bill] Looking to head off problematic pregnancies like Dortch's, that's the focus of this March of Dimes event, raising money and awareness in Pontiac this summer.

- What needs to be done is more attention to the plight really of motherhood in America.

It is one of the most dangerous places to give birth.

- [Bill] Nationally, the March of Dimes has been tracking statistics and rating the states.

Michigan's infant mortality rate is 6.4 per 1,000 live births where the national average is 5.6, ranking 34th, far from the worst, but room for improvement.

Earlier this year, Hayley Harding wrote an in-depth story for The Detroit News looking at maternal deaths and reporting on possible solutions to the problem.

- At every two minutes, a mother dies during pregnancy or childbirth.

That's around the world.

- [Bill] Harding's talking with Dr. Sonia Hassan, obstetrics and gynecology professor at Wayne State University, where she's also associate Vice President of the Office of Women's Health.

- Why is it that we have such a higher rate of Black women dying specifically?

And I know this is true across the country, but it's also very, very evident in Michigan.

Why is that?

- It is true across the country, and as you say, yes, it's about almost a three times higher risk to women that can die who are Black in pregnancy or related to pregnancy.

There are things like preeclampsia that are higher rates in Black women.

Preterm birth is higher rates in Black women, and some of those fundamental medical issues have to be taken care of.

- [Bill] Reporting for The Detroit News, Harding found the Michigan deaths connected to pregnancy on the rise by 33% from 2019 to 2020, the latest year statistics were available from the state.

And in Michigan, there are between 80 and 90 maternal deaths a year.

- In Michigan, we know two thirds of those are preventable, and so causes range from high blood pressure, from bleeding, from infection, from other issues with excessive care for example.

All of those things can play into it.

It's a really large problem, but it's something we've gotta really change.

- [Bill] Another big problem, access to care.

Getting mothers-to-be in for checkups seems more like a logistical challenge, - Whereas we have a number of hospital systems, they're difficult for people to get to.

And so you have inaccessibility to healthcare, you have transportation issues, you have women who simply don't receive prenatal care for a variety of reasons.

- [Bill] The risks for Black mothers, that's on Asia Lovelady's mind.

"One Detroit" first met her at her baby shower in July.

- I wanted a African American provider and there's not a lot of them.

- [Bill] Lovelady and her fiance, Al Criswell, live in Ypsilanti where they did find a provider that they were comfortable with.

- So that's what I wanted in my pregnancy, somebody that can listen to me, understand me.

If I'm having questions and if I'm freaking out, they just know what to say and how to say it.

You try not to put race into it too much, but it's kind of hard not to a lot of times.

- [Bill] Lovelady works in healthcare administration, but for her, red flags went up over a medical issue unrelated to pregnancy that made her wary of the system.

- If you one of those quiet, shy people like I used to be, you can't do that no longer.

Not when it's dealing with your health.

- [Bill] Healthcare disparities.

Is there a solution?

Part of it may be in California, which found itself facing a rising maternal death rate 18 years ago.

- In fact, the numbers in 2006 I believe were about double what they had been in the late '90s.

So it was quite a rise.

- [Bill] Dr. Deirdre Lyell, a professor at Stanford Medicine, co-chairs the California Maternal Quality Care Collaborative, CMQCC, created to fight that rising death rate.

According to the March of Dimes, these days, the Golden State's death rate is lower than most.

- People quickly understood that the two biggest opportunities were around hemorrhage and hypertension.

So hemorrhage when someone really bleeds a lot in labor and delivery.

What CMQCC did was identifying these two areas, created toolkits, and those are essentially standardization of care.

And once you've standardized how a unit, a labor and delivery unit say responds, and also who else needs to be at that table, then you can really start to make progress.

Well in California in fact found that by 2016, the rate of maternal death had a fallen by 65%, which is a pretty remarkable number.

- [Bill] The CMQCC has recruited medical providers, most every hospital across the state all working off the same page.

- What would you recommend that other states looking to address maternal mortality do to try to get their numbers down?

- One core element is data.

And in California, we have the Maternal Data Center that's run through CMQCC, and that provides hospitals, 211 of our hospitals, nearly 99 of births in California are members and get data through the Maternal Data Center.

Once you have data, that's really powerful, because then you can start with your quality improvement initiative, which CMQCC helps to lead with hospitals to to track how you're doing, are you making a difference?

Are you using every tool at your disposal?

- [Bill] Maya Bragg and family at home in Detroit's new center area, recently back home from California.

- I've had a cesarean, I've had a all natural birth, birthing center, and I've also had a hospital medicated birth with her.

So all three have been different.

- [Bill] Her latest born in Detroit, her oldest born in Detroit too.

But her middle child, she arrived as an all-natural birth.

For Bragg in Los Angeles, it just made sense.

- Majority of my friends in LA are very knowledgeable about alternatives regarding birth, and so I thought that like a holistic birth would be a good experience.

- [Bill] A birth not at a hospital, but at a birthing center in LA run by midwives, trained professionals focused on the birthing process.

- I was like, I know that people in Detroit don't know about this or don't have access to it.

- [Bill] When Bragg and her family moved back, she sought out Birth Detroit, which runs a maternal health clinic in the city's Fitzgerald neighborhood.

Birth Detroit's co-founders advocate for better maternal care, that includes more midwives and doulas who also assist mothers to be.

- We're not doing enough prenatal care, we don't spend enough time with our patients and our clients.

We don't do what is done all around the world for postpartum care, which is treating the mother and baby together and seeing them four or five times.

In the United States, you leave the hospital and you don't even get seen until six weeks.

- [Bill] In the Birth Detroit waiting room, Mhlelusizo Ncube, native of Zimbabwe, who's expecting soon.

So how many times have you been here so far?

- At the Birth Detroit?

Ah, I can't count, but maybe seven, eight times, I think so.

- [Bill] Since when?

How many months back?

- I came here in September.

- [Bill] Okay, so you've been doing regular checkups then.

- Baby's active, baby's been moving lately.

- We ask our clients how they're doing.

We make sure that all their needs are met socially with baby.

We measure the belly, we make sure we listen to baby's heart rate, make sure everything is okay with the baby, ask questions, concerns, and then figure out how we can support them on the rest of their pregnancy journey.

- [Bill] Studies cited by the World Health Organization and others show maternal mortality can be reduced when more midwives are involved.

- With high risk pregnancies, we can always refer out to different outside hospitals.

We can always refer our patients to wherever they wanna go if we need a second opinion or we wanna just have somebody lay eyes on the patients as well.

- Next, come on up.

- [Bill] Birth Detroit's other location just off Grand River Avenue a bit south of Joy Road on the west side.

It's October 2024.

A celebration for Detroit's first soon to be open freestanding birthing center, a place to give birth that's not a hospital.

New from the ground up with staff, visitors, and dignitaries taking part.

- You build institutions like this one that recognize that the act of birthing is at its core, the most natural, the most human thing that we do.

And if we can't do it for everyone with the kind of grace and dignity and justice that folks deserve, then we gotta start thinking differently about that.

And that's institutional, and that's what we're here to celebrate today.

(crowd cheering) - In fact, we need to do some things fundamentally different in our system, and that is what we are daring to do at Birth Detroit.

- I think we're changing culture with what we're doing and showing people you can have this, you can be a midwife, you can have a baby at a birth center, you can work at a birth center, and folks look like you doing this too.

- [Bill] Along with raising the millions needed to build the center, the Birth Detroit co-founders have been pushing for new laws intended to improve maternal health statewide.

- This package of bills came out of those conversations and is really community-led and community-driven, community-centered.

- [Bill] The bills together called the Michigan Momnibus Package, which does things like track data to better reveal inequities in obstetric care and pay licensed midwives for work done with state programs.

- Senator Hoitenga?

Senator Damoose?

- This bill package should help close that gap.

When Black and brown birthing people, when they know they have that support system, when they know they have that network of people who are going to be supportive of their journey and that they'll be listened to and won't be dismissed.

There's way too many stories of birthing people not being listened to.

- [Bill] October 2024, the legislation moves forward.

- Very happy to see the Momnibus rolling out of committee.

And thank you again to Senator Geiss and all the advocates here who've been so helpful over the months on developing this legislation.

- [Bill] What's next?

That's a big political wait and see, but also October '24, this announcement in Detroit.

- Today, we are announcing in Michigan that the leading health systems and universities are joining together for the first time to stop moms and babies from dying.

- [Bill] The SOS Maternity Network, led by Wayne State University's Dr. Sonia Hassan, includes 14 institutions to be meeting regularly with the financial support from the state of Michigan along with Priority Health and Wayne State.

- I'd like to see continued collaboration among providers in Southeast Michigan.

I'd love to see that expanded statewide so that moms and families everywhere have access to the care that they need when they're pregnant and after they give birth.

- [Bill] Hospitals working together to decrease preterm birth, the leading cause of infant mortality in Michigan, according to Dr. Hassan.

Another mission, bring down the rate of preeclampsia, pregnancy-related high blood pressure that can also lead to very bad outcomes.

- The one thing that startles people or a couple of things is everything that happens in utero to a person determines a lot of their medical history in their life later in their life.

So in that pregnancy, in that one pregnancy where you have two patients, first, if the baby is born preterm, that baby is known to have a higher risk of heart disease, diabetes, and obesity later in its life.

That is a known thing.

In addition for the pregnant woman, if she has a preeclamptic pregnancy or she's preterm birth, she is also at high risk to have heart disease, cardiovascular complications in her life, even 10 to 20 years later.

- [Bill] On Detroit's East Side, Sade Dortch gets a head start, packing a go bag for the big day when daughter Nevaeh arrives.

- I'm just hoping that I can get through my delivery safely and soundly and we both walk out of the hospital together, and whatever life may bring from there, only time will tell.