Jeanine Valrie-Logan had 12 clients scheduled during a recent evening shift at The Birth Center at PCC in Berwyn, a Chicago suburb.
The first client is a woman nearing her due date, and her baby girl has been kicking a lot. Later it’s a young couple who say they’re feeling tired and stressed caring for their newborn daughter. And then a pregnant woman with questions about treating her gestational diabetes.
Valrie-Logan says she always spends as much time with her clients as they need, even when her schedule is packed. She discusses strategies for getting better sleep, nutrition and other aspects of maternal care for up to a year after birth with them. She says it's part of a holistic approach to pregnancy that's typical of birth centers, but not so much in hospitals.
"You're left to your own devices to find a pediatrician or to do your follow-up at six weeks, where community birth looks like, 'I'm gonna see you in 24 hours, and then I’m going to see you in three days, two weeks, six weeks,” she says. "It's more love and hand-holding to make sure everyone is safe and cared for."
Valrie-Logan is a certified nurse midwife, but not a doctor, so she has to refer people to an affiliated hospital nearby if there are complications. But for low-risk pregnancies, birth centers like PCC are designed to give people an option in between going to a hospital and giving birth at home. They're usually more affordable than a hospital, too.
Pregnant people in America are more likely to die during or soon after pregnancy than anywhere else in the developed world, and the maternal death rate is nearly three times higher for Black women than white women. Some maternal health care experts say birth centers could help close the racial health equity gap.
In one of PCC’s birthing rooms, the lights are low, there's a queen size bed, a birthing tub and a private bathroom. Valrie-Logan gave birth to her first two children – Satya and Ahimsa – at home, but she chose to have her third, Nyabingi, at the birth center. She says the atmosphere was relaxed, with her daughter sleeping by her side while Valrie-Logan went into labor.
"My other daughter was here, my husband was here and my sister-in-law was over there taking pictures, and it was just like we were hanging out on a Friday evening,” she says. “And then we went home the next morning.”
Valrie-Logan wants patients to have that kind of experience at the center she's trying to build in Chicago.
“Oh my god,” she says, smiling. “I get so dreamy thinking about the South Side Birth Center."
Endia Williams is dreamy, too. She's making the hour-long drive to PCC to have her first child at the suburban birth center later this year. But she would rather stay on the South Side.
“That's really the reason that a birth center on the South Side is so important because a lot of people don't have a middle-ground option," Williams says. "People are going to go to [the South Side Birth Center] because they see themselves in who works there. People want to have someone that understands them.”
A freestanding birth center opened last year on Chicago’s North Side. Williams says it’s a welcome addition to the city, but even farther from some parts of the South Side than suburban Berwyn.
"They do make it a point to be welcoming to as many people as they can because they do want to effect that change,” she says. “But it's on the North Side and it's kinda hard to do that when it's on the North Side.”
The number of hospitals providing obstetrics in the area has declined in recent years, while the national maternal mortality rate has gone up. Valrie-Logan’s would be the first freestanding birth center on the city’s largely Black South Side.
Meanwhile more people are choosing to give birth outside of a hospital, according to The National Partnership for Women & Families, with the sharpest increases in Black, Indigenous and Hispanic communities.
Rachel Hardeman knows at least one reason why. She teaches reproductive health equity at the University of Minnesota and works with the Roots Community Birth Center in Minneapolis. She says workers there saw firsthand how racial trauma impacts maternal health after a police officer shot and killed Philando Castile during a traffic stop in the Twin Cities area in 2016.
"We were seeing pregnant people come in stressed out and not wanting to find out the sex of the baby that they were carrying, because they were terrified to know that they were having a boy, given what was happening in our community,” Hardeman says.
Workers at the birth center took those concerns seriously, she says, and offered support.
Hardeman, who is on the board of the regional wing of Planned Parenthood, says the Supreme Court's overturning of Roe v. Wade will exacerbate the maternal challenges faced by Black people across the country. Illinois enshrined abortion rights in state law in 2019, and Minnesota is moving to protect abortion rights, too. But Hardeman says abortion bans in nearby states will disproportionately impact people of color.
"We are going to have more people who are forced into pregnancy and therefore more people who are in the risk pool for experiencing an adverse outcome,” she says. “So we are going to see undoubtedly that our mortality rate is going to continue to rise.”
Maternal and infant mortality rates are highest up to a year after birth, and 20 states including Illinois recently extended postpartum coverage under Medicaid from two months to one year. Most of PCC’s clients are on Medicaid, and Valrie-Logan expects many of hers at the South Side Birth Center will be, too. Medicaid reimbursements often aren’t enough to support birth centers and other health clinics in low-income areas, so Valrie-Logan plans to operate her center as a nonprofit and pursue grant money.
In June the Biden Administration put out what it called a "blueprint for addressing the maternal health crisis.” It called on Congress to make more available to people who want to give birth outside of a hospital. Democrats in the House and Senate have sponsored bills to increase funding for maternal health care. If passed, they could give a boost to birth centers like Valrie-Logan's.
Valrie-Logan is fundraising with the help of another local nonprofit, Chicago Beyond, and hopes to open her birth center late in 2023.
"There's certain things that aren't billable,” Valrie-Logan says. “Like the time and the energy and the love that goes into caring for people in community."
This segment aired on July 14, 2022.