Michigan midwives, doulas rally for midwifery care

SOUTHFIELD — Effective this month, Ascension Providence Hospital’s Southfield campus announced that they would be transitioning away from midwifery services in their Alternative Birthing Center.

Ascension’s address to expectant mothers stated, “Moms and babies will continue to have access to the highest level of infant and obstetrical care, including maternal-fetal medicine and neonatal specialty care, a level III neonatal intensive care unit, 24/7 obstetric emergency care, and more.”

When asked why this change was implemented, Ascension did not say, and declined to be interviewed.

However, for moms like Kate Smela, this shift to solely obstetric physician-led delivery was jarring.

First-time mom Smela always knew she wanted to take an alternative approach to giving birth. After connecting with her doula, Celeste Kraft, the owner of Gentle Spirit Doulas, she switched to the ABC in Southfield.

Being a first-time mom and new to the area, Smela said she felt confident in her decision to transfer at around 30 weeks along into her pregnancy.

“I remember when I transferred, they (her doulas) were stressing that I needed to do the orientation and make sure I got accepted, because a lot of providers won’t even accept you after 34 weeks. So this is why this news is so crazy. And the hospital or whoever in corporate made this decision wasn’t honoring people.”

Smela was officially due on March 6, but as she emphasized, “There’s no set date in pregnancy,” which is why she feels that her trust has been broken in the system. “I read the letter, and it said, you will receive the same kind of care at the ABC with an OB physician. That totally defeats the purpose. I wanted to birth at an alternative birth center with a midwife. So, it just breaks your trust. I think it is super important to trust where you’re going, who you’re birthing with, and who’s going to be in the room. I was like, ‘Nope. I’m going to find somewhere else to go.’”

Kraft said she immersed herself in doula work long before she knew the term “doula.” She is a certified labor and birth doula, postpartum and infant care doula, and a doula trainer. Kraft said the news came as a shock to the six midwives, who she said were left jobless.

“One of the midwives reached out to me an hour after she found out because we refer so many clients there, and because we have births coming up with clients soon that are going to be affected. They are devastated. I will say that all six of them are the main breadwinners for their families. This is devastating in just so many respects,” she said.

In response to this news, Kraft started a petition, “Save Accessible Midwifery Care for Detroit-Area Families,” and held a rally Feb. 12.

Kraft worries that with this being the third Ascension Providence Hospital to remove midwives that Michigan women might be facing a larger issue.

“When people look at maternal and infant mortality and morbidity rates, people assume because we’re in the U.S., we have the best health care. And that is true in many areas. But not when it comes to birth,” Kraft said.

Kraft said that the US is near the bottom of all the industrialized nations regarding birth mortality rates.

“In other industrialized nations that have much better outcomes than we do, it’s built on the midwifery model. Black women are three to four times more likely to die during pregnancy birth or the first year after giving birth. That’s criminal. And yet we want to remove midwives from an urban area at this center that’s had midwives there for over 40 years and has a proven track record of lowering intervention rates, lowering the risk of cesarean, lowering the infant mortality rate, and doing this at a lower cost to families and insurance companies.”

Stephanie Yaldoo, a nurse midwife at Trinity Health Hospital, said they are committed to continuing to make midwifery accessible to the community.

“Our focus has been patient-driven. Yes, obstetricians are great. But I think women who seek midwives seek something different,” she said. “They seek more choices; they seek a different experience for birth.”

One of Yaldoo’s patients, Annette Armstrong, is several months postpartum from the birth of her second child. Armstrong expressed that her first birth in a traditional hospital setting didn’t go as smoothly as she had hoped, and postpartum, she realized how traumatic it was.

“It felt like a factory line being moved along. I wasn’t given choices of how my birth was going to look. I wasn’t informed.”

Armstrong explained that after having a bad experience with a doctor during her second pregnancy, she decided to look elsewhere, which proved difficult as many places didn’t accept her insurance. At 32 weeks into her pregnancy, she found the midwives at Trinity.

“With my second birth, I felt so empowered. If I’m blessed to have more children, I want to be in the midwives’ care. As someone who had to transfer late into the pregnancy, that was a very scary time for me. It’s entirely disheartening to me, and I’m very devastated that there are women who are encountering this and feel like they’re going forward in their journey alone and that they don’t have the support that they once did,” Armstrong said.

Kraft’s petition can be accessed at change.org.