Women of Color Flock to Birth Centers Amidst the Nation's Maternal Health Crisis

Vernette Kountz had given birth to four children in hospitals, including a set of surrogate twins, before deciding she was ready for a more personalized and unique birthing experience. Despite her previous healthy and smooth deliveries, she felt that her hospital and medical office visits were rushed and impersonal.

Kountz described the medical model as making her feel shuffled around and told what to do with a plethora of assessments and ultrasounds. She found it to be more transactional and less intimate. In 2021, she opted to have her fifth child at the Atlanta Birth Center to receive the holistic, personal, and intimate care she had longed for as a mother. She had a water birth to deliver her son, Hudson, at the facility.

Kountz expressed her deep appreciation for the experience, so much so that she is planning to give birth to her sixth baby at the same birth center in January. "It's not just about providing care for a pregnant mother," she explained during a mid-November appointment at the center. "It's about creating a space for all aspects of her, fostering a level of intimacy that you don't typically find in a traditional medical setting."

A birthing pool is available in all birthing rooms at the Atlanta Birth Center.

Alyssa Pointer reported for CNN that Kountz is part of a small but increasing group of women of color opting for birth centers for their prenatal, childbirth, and postpartum care instead of traditional medical facilities.

Although most births in the US still occur in hospitals, recent data from the National Partnership for Women & Families shows that in 2020, nearly 2% of people opted for "community birth settings" like birth centers or home births. The nonprofit also reported a 30% increase in Black women choosing these settings, as well as a 26% increase for Native American women between 2019 and 2020. Additionally, there was a 24% increase for Hispanic women and an 18% increase for both White and Asian women.

Some families are choosing to move away from traditional hospital birth settings, a decision that comes as the nation faces a maternal health crisis. Black women are nearly three times more likely to die from pregnancy complications than White women, according to the CDC.

Birth centers, which are often home-like facilities, offer clients longer appointments and greater freedom and autonomy in their birth experience. They are designed to care for those with low-risk pregnancies and are prohibited from performing c-sections by state regulations, according to the American Association of Birth Centers.

According to Tamara Taitt, Executive Director of the Atlanta Birth Center, clients with complications such as elevated blood pressure, a breeched baby, or fetal underweight are transferred to a local hospital. Additionally, the birth center does not provide epidurals or medications to induce labor. Taitt further stated that birth centers typically have risk assessment criteria to determine if it is safe for a person to give birth at the facility or if they require hospital transfer.

Literature about conceiving, birthing and raising a baby are available for patients to check out at the Atlanta Birth Center.

Alyssa Pointer for CNN

Stethoscopes hang on a wall inside a birthing room.

Alyssa Pointer for CNN

As maternity ward across the country are shutting down due to low birth rates and financial issues, there has been a shift towards birth centers. For example, the Centinela Hospital Medical Center in Inglewood, California, a city with a predominantly Black and Hispanic population, closed its maternity unit in October. The hospital stated that the demand for maternal health services had drastically decreased, with fewer than two deliveries a day.

Leseliey Welch, who is a co-founder and co-director of Birth Center Equity, emphasized the importance of birth centers in prioritizing respect, trust, and bonding with families. This is particularly crucial for women of color, especially those who have faced trauma or racism in the healthcare system. A report from the National Partnership for Women & Families in November highlighted that Black women are twice as likely as White women to report instances where medical professionals have ignored them, refused their requests for help, or failed to respond within a reasonable timeframe.

Fueled by a desire to address those inequalities, Welch said she plans to open Birth Detroit in 2024, the citys first free-standing birth center led by Black women.

Kountz, left, speaks with midwife Anjli Hinman, during a visit in November.

Alyssa Pointer for CNN

A more tailored experience

Numerous birth centers aim to offer families the comforts of their own home. In the case of the Atlanta Birth Center, the delivery rooms are designed to look like bedrooms, complete with queen size beds, lamps, wall paintings, and changing tables for babies.

On a recent Friday, Kountz eased herself into a light blue velvet chair in a dimly lit room across from her midwife, Anjli Hinman.

Kountz, 32 weeks pregnant, held her belly and told Hinman that it had been a good day as she didn't have much pelvic floor dysfunction and was able to walk up and down the stairs at home without help.

During their conversation, they discussed Kountz's mental health, her job as a chiropractor, her family life, water intake, and sleep routines. After their chat, Hinman checked Kountz's blood pressure and used a fetal Doppler to listen to the baby's heartbeat.

"I see them moving," Hinman said, as she moved her hand around Kountz stomach.

Hinman examines Kountz during her November appointment. Kountz is due to have her sixth baby in January.

Alyssa Pointer for CNN

According to Kountz, the interpersonal moments at the Atlanta Birth Center make appointments feel truly special. She added that the staff is fully committed to her physical, mental, and emotional well-being. Joia Crear-Perry, president and founder of the National Birth Equity Collaborative, believes that birth centers are becoming more popular because women want to interact with providers who understand their cultural needs.

Crear-Perry stated that many women of color opt to give birth at a birth center in order to address the racial bias they often encounter in traditional healthcare facilities.

The Breath of My Heart Birthplace has been providing services to the Indigenous community of rural northern New Mexico since 2010. Founder Beata Tsosie-Peña mentioned that the facility currently assists with approximately eight childbirths per month, half of which are for Native American families. According to the CDC, "American Indian and Alaska Native women are twice as likely to die of pregnancy-related causes as White women."

Tsosie-Peña explained that the center was established to provide a culturally traditional space for childbirth with bilingual staff, recognizing a need in the community. Families who choose the center for delivery are able to participate in ceremonial traditions such as music, fire, food, herbal medicines, and special clothing, which may not be feasible in a hospital setting.

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At the Atlanta Birth Center, birth nurse Retta Sola converses with student nurse midwife Shanti Moore and midwife Hannah Walters at their work station, as they await a patient to begin labor in November. (Photo by Alyssa Pointer for CNN)

A life-changing time

Kountz expressed her excitement to deliver her baby in the "Fire Room" at Atlanta Birth Centers upon returning to Atlanta. The facility offers three nature-themed birthing rooms, including the "Fire Room."

The Fire Room features a striking orange and black painting of a tree, a queen size bed with a cozy orange and blue comforter, a rocking chair, and a canvas with the quote, "Some women fear the fire and some women simply become it."

Hinman, Kountz's midwife, believes that birth centers play a vital role in addressing the maternal health crisis among Black women due to their holistic approach. She emphasized that staff members closely monitor their clients, especially during the postpartum period, when many are at risk for life-threatening complications and depression.

A study published in the journal JBI Evidence Synthesis revealed that almost 50% of maternal deaths happen on the first day of birth, 24% occur between days two and seven, and 25% occur between days eight and 42. Hinman emphasized that a simple check-in with a client can potentially save their life.

CNNs Rikki Klaus contributed to this report.

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Words of encouragement and affirmations are displayed throughout the Atlanta Birth Center.

Alyssa Pointer for CNN