Resources
We are so happy you’re interested in getting involved with our work here at the MI State of Birth Justice. There are so many ways for you to help, and we truly appreciate each and every effort.
Why Birth Centers?
A birth center is a freestanding home-like place where midwives provide prenatal, birth, and postpartum care. Birth centers provide personalized, family-centered care before, during, and after normal pregnancy, labor, and birth.
In 2016, 98% of births took place in a hospital setting with a physician attending. Birth centers are proven to decrease the risk of cesarean (C-section) births, lower hospital expenses, and provide better neonatal health outcomes.
Click here to view Birth Center Licensure and Regulation FAQs
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Magnolia Birth House in North Miami Beach, Florida.
State of Birth Justice Tool Kit 2022
This tool kit was curated by Birth Detroit, Elephant Circle, and Mothering Justice with support from SisterSong as a resource for education on Birth Justice, policy, and legislation.
Click here to view the Tool Kit.
Safeness of Birth Centers
Home and birth center births have lower rates of interventions than hospital births-such as cesarean birth or induction of labor. Which means pregnant people giving birth at home or in birth centers have lower rates of intervention related injuries and complications.
In 2018, CMS Strong Start study found that women who received prenatal care in birth centers had lower rates of preterm birth, lower rates of low birthweight, lower rates of c-section, and higher rates of VBAC.
Studies suggest that home and birth center births may be as safe as hospital births for low-risk pregnant individuals and infants when they are part of an integrated and regulated system; multiple provider options are covered by insurance; providers are well qualified and have the knowledge and training to manage complications; transfer to a different birth setting is seamless; and risk assessment occurs throughout pregnancy.
Cost-Effectiveness of Birth Centers
Birth centers are more cost-effective by;
Retaining autonomy (control) over birth center operations and program regardless of ownership (some hospitals own freestanding birth centers)
By providing “high touch” rather than “high tech” care, birth centers depend on the services of acute care hospital thereby minimizing the routine use of medical intervention and technology.
By providing a program of primary care that emphasizes education, wellness, prevention, self-help and self-reliance in family health maintenance.
By using staff efficiently; staff are only in-house when a mother is in-house. Since birth centers do not compete with emergency services or hospital acute care, levels of staff are used efficiently and appropriately.
By promoting responsibility with the childbearing family for health and prevention of illness.
By using existing community services when available (instead of creating costly duplications) for transport services, social services, medical consultation, laboratories, etc.
By using established policies and procedures for screening and transfer of women with problems to acute care services.
By using cost-effective construction that meets safety codes.
In 2018, CMS Strong Start study found that women who received prenatal care in birth centers had more than $2,000 lower costs compared to women who received care in hospitals.
Reimbursement / Licensing
Michigan is one of the 10 states in the U.S. that do not license and reimburse birth centers.
In 2011, the average Medicare/Medicaid facility services reimbursement for an uncomplicated vaginal birth in a hospital was $3,998, compared with $1,907 in birth centers.
Ensuring that birth centers are included in each network tier and that out-of-pocket costs are low would give people the ability to choose the best birth location and likely lead to higher utilization of birth centers, reducing costs to health plans.
Midwifery-Led Care
Community-based midwifery care offers women and families a safe, quality, culturally congruent alternative to routine care in institutionalized settings. Certified Nurse Midwives (CNMs) and Certified Professional Midwives (CPMs) focus on physiologic birth. Midwifery led care is strongly associated with lower interventions, cost-effectiveness and improved outcomes. States where midwives are most accessible have the best outcomes for mothers and babies; states where access is most limited have the worst indicators of maternal and neonatal well-being. Increasing the number of midwives can solve shortages of maternity care providers that disproportionately affect rural and urban low-income mothers.
One of the most notable community-based model of healthcare is The JJ Way®. Developed by midwife Jennie Joseph (“JJ”), The JJ Way® has proven to be successful for over 20 years. The primary purpose of the model is to ensure that every woman has a full-term health and positive pregnancy, supported birth experience and healthy baby. The primary components of the model include: (1) an Easy Access Clinic™, in which no woman is turned away (2) provision of education and support services and intentional and culturally relevant health messaging at each visit, and (3) the birth center model, providing full-service midwifery care and women’s health services.
The JJ Way® has resulted in consistently low rates of prematurity, low birth-weight babies, and maternal morbidity, and high rates of breastfeeding among women at highest risk of poor outcomes. Both quantitative and qualitative studies show that the JJ Way® is an evidence-based system of maternal health care that improves health, reduces costs, produces better outcomes, supports health equity, and saves lives.
Additional Resources
Birth Justice Agenda
Birth justice is the human right to a safe and respectful birth experience. This includes our rights to bodily autonomy, the power to make choices, and access to midwifery care. Birth Detroit believes that all people deserve access to all safe birth options. Our mission is to midwife safe, quality, loving care through pregnancy birth and beyond. We envision a world where birth is safe, sacred, loving and celebrated for everyone. Our values are Safety, Love, Trust and Justice.
"Colorado Passes Landmark Birth Equity Bill Package" Article
An article written in The Bill of Health's description of Colorado passing a birth equity bill package.
How a Bill Becomes a Law
This is a general and very brief description of the major steps of the legislative process a bill must go through before it is enacted into law.
Lack of Information is a Weapon of Oppression Essay
If you are in a position to influence or block policy solutions and do not have the information you need, cede your power to someone who does. Unfortunately, this essay written by Elephant Circle arises from our experience with professionals who have insisted that they cannot support a particular policy solution, or even need to block policy change, due to a lack of information.
Legislative Barriers
Birth justice advocates across the state, especially those serving families in urban and rural areas, are working to address structural inequities and improve maternal health in Michigan. Licensing birth centers and reimbursing midwifery care across birth settings are two important strategies. This document outlines the barriers limiting the reach of this crucial work and identifies legislative solutions.
This document was made possible through a collaboration between Birth Detroit, Mothering Justice and Elephant Circle.
MI Momnibus Bill
Momnibus is a piece of legislation (an act) that includes several bills to improve maternal and infant health by addressing systemic racism and other social determinants of health. The Black Maternal Health Momnibus Act of 2021 was introduced at the federal level in 2020 by Congresswoman Alma Adams, Congresswoman Lauren Underwood, Senator Kamala Harris, and Black Maternal Health Caucus members. It contains nine bills to “comprehensively address every dimension of the maternal health crisis in America.”
The Michigan Momnibus, introduced by Michigan State Senator Erika Geiss will address barriers to access to care and racial and gender justice in the perinatal period through a package of eleven bills. The work is still being done to get this act passed.
The State of Birth Justice Survey
Mothering Justice and Birth Detroit, with support from Elephant Circle and SisterSong, have convened a series of community town hall conversations on the state of birth justice in Michigan and developed a short survey to invite input from communities across Michigan. This survey will help us learn about maternal health challenges, solutions, ideas and questions across Michigan’s diverse geographies, communities and life experiences to inform strategies for change.
If you are over 18 and live in Michigan, this survey is for you. Survey questions focus on maternal health issues, care, access and policy. There are no wrong answers. You can skip any questions you do not want to answer.
The survey takes less than 10 minutes. All answers are anonymous. Thank you!
The State of Birth Justice Tool Kit
Comprehensive State of Birth Justice tool kit with additional reading resources.
What is Birth Justice?
Birth Justice is a movement that is designed to respect the rights of all individuals who aspire to become birthing individuals and have a child in a supportive environment: one in which the birthing individual has autonomy over their body and the ability to choose the ways in which their birthing process flows, from the prenatal to the postpartum process.
What is "Community-Based"? Essay
The term “community-based” is used dozens of times in the Momnibus legislation and is an important concept in improving maternal health. It is a term that is used in many disciplines, from social work to public health, healthcare, the arts, design, technology, research and more. Frameworks like “reproductive-justice” and “intersectionality” are also informative and relevant to the use of “community-based” in this context.
"We Are Not Asking Permission to Save Our Own Lives": Black-Led Birth Centers to Address Health Inequities
Birth justice leaders from various organizations come together to explain the benefits of midwifery care, particularly Black-led care.