Birthing parents and babies do not have the best odds on their side in Detroit.
The 2018 Kids Count in Michigan Data Book puts the city's infant mortality rate at 13.5 per thousand, almost double the rate of Michigan (6.9 per thousand). The figure for less-than-adequate prenatal care is nearly 47 percent, also higher than the statewide statistics.
So why the poor outlook when there are a number of pregnancy, birthing, and postpartum supports available for parents in the city? It would appear many young families are not taking advantage of them.
That’s what the five founders of Detroit Pop-up Midwifery Clinic hope to change. Jahmanna Selassie, Heather Robinson, Athena Hall, Nicole Marie White, and Elon Geffrard are bringing education and resources right into Detroit neighborhoods so parents and parents-to-be can learn about options for maternity care, giving birth, and caring for newborns.
"We want to talk about choices and knowing your rights. So if you go into the hospital, you know that you can ask for help and ask for more time," says Nicole White. "And we want to talk about nutrition and breastfeeding and just let folks know about all the incredible things that are happening in this city, like Black Mothers' Breastfeeding Association and other initiatives like Detroit Mama Hub that can be resources."
The group chose locations for their first four pop-up clinics by identifying neighborhoods with the highest infant mortality rates, some with rates up to 24 per thousand.
In the case of Detroit Pop-up Midwifery, "clinic" does not mean that clinical and diagnostic care is provided to women, but, rather, the clinic will educate women on how their medical experiences can be better, how they can be more equipped to enter their pregnancies not completely dependent on the medical system, and why they should have a say in their care.
The founders want the community to drive the discussions and content presented in each neighborhood.
"Since this is our first iteration and this is a pilot process, we want to go into communities and ask folks what they want," says White. "We don't want to make assumptions that people want us [as midwives, doulas and community educators] to do clinical care, but we want to hear where the gaps are."
As they discover what is missing from peoples’ pregnancy, birth, and postpartum care, they are looking to uncover what they can do as midwives on the ground to help support parents’ visions.
"We all do home birth, and that's not for everybody, but we do think that midwives are the answer, and that's regardless of setting," says White. They would like to see more midwives attending to births in hospitals, at birthing centers, and in homes.
While the use of midwives is a driving force behind the clinic’s mission, it’s not just any midwife.
"We are ramping up visualization of midwives of color because oftentimes people want their care providers to have some kind of similar background, maybe even look like them, so there's more of a connection," says Heather Robinson.
The community-based midwifery approach aims to impact the disparities that exist in maternal health across the United States that impact black families and people of color. U.S. infant mortality rates for non-Hispanic blacks are higher than for other races, and neonatal mortality (deaths that occur less than 28 days after birth) for that group is twice the rate of whites.
Detroit Midwifery plans to use current networks for outreach and to spread the word about the pop-ups. Organizations like Metro Detroit Midwives of Color, SisterFriends Detroit, Black Mothers’ Breastfeeding Association, Michigan Midwives Association, and the community host sites will help build awareness. Over time, the founders believe word of mouth will also be key.
The clinic will be popping up in different neighborhoods each month, with once-a-week sessions taking place threeDPMC plans on hosting workshops like this in neighborhoods around Detroit. weeks in a row. In March, Mama Hub (northwest Detroit) will host a visit by Detroit Pop-up Midwifery Clinic. Future locations include Matrix Human Services (Osborn neighborhood in northeast Detroit) in April; FREC (Ford Resource and Engagement Center) on Bagley in southwest Detroit in May; and Crowell Recreation Center (Brightmoor neighborhood in northwest Detroit) in June.
The founders believe that each meeting's content and traction will depend on who’s in the room on any given day. "I think that's what's essential," says White. “It's going to be led by the community, and the midwives are there just to hold space and to help facilitate whatever the group wants."
What's most important, says Robinson, is that women and families know that different kinds of care exist so they can seek out what it is that they need for themselves. "Because, by default, many people just receive what they think is the only option for them, or the only doctor's office, or the only hospital. And there are many options," says Robinson.
That doesn’t mean the clinic midwives are pushing natural birthing methods; they understand some people want to have their baby in a hospital with an epidural. "And that's fine," says Robinson. "We just want folks being empowered with education and choices and opportunities to really make those decisions for themselves."
It’s also not about turning people into consumers of midwifery care, because a family member can be a midwife. "It’s a way in which you care for someone," says Robinson. The approach is about building relationships beyond brief doctor visits, caring for both mom and baby, and fostering a feeling of accountability for birthing parents in how they care for themselves.
This empowering philosophy has the potential to improve outcomes for babies and young families in
Detroit – and that’s what Detroit Pop-up Midwifery Clinic is all about.
Update 3/20/19: An earlier version of this story incorrectly listed infant mortality rates as percents, when it should have listed them per thousand. That oversight has been corrected.
This article is part of "Detroit Innovation," a series highlighting community-led projects that are improving the vitality of neighborhoods in Detroit, while recognizing the potential of residents to work with partners to solve the most pressing challenges facing their communities.
Photos by Nick Hagen.