Fact checked by Jim Lacy
Sierra Bartlett wanted a water birth. It was 2021, and she was living in Chicago’s West Town neighborhood, 20 weeks pregnant with her first child. She had recently learned that West Suburban Medical Center offered water births with the midwives who attended births there. Hesitant at first, Bartlett, who is Black, wanted to be careful about who she entrusted with her care; maternal death rates for Black women are up to four times higher than for white women nationally.
Bartlett had seen an obstetrician-gynecologist through the first half of her pregnancy, but the appointments felt rushed. The doctor did little to address Bartlett’s hyperemesis gravidarum — severe nausea and vomiting. Her doula, a professional who supports people through labor, encouraged her to meet with the midwives.
Midwives are healthcare professionals who care for women before, during, and after pregnancy. They can practice in hospitals, clinics, birth centers, and in homes. They often consider pregnancy and birth as natural processes instead of medical conditions, and working with them tends to result in more birthing choices and better health outcomes for women. If she met with the midwives at West Suburban, Bartlett could explore whether delivering her baby in water was a possibility, her doula said. Bartlett scheduled an appointment.
Her first meeting with West Suburban Midwives, which attended births at West Suburban Medical Center just across the city’s dividing line in Oak Park, lasted 45 minutes — more time than she’d had with her obstetrician over all her visits combined, Bartlett says.
“I was very aware of the racial disparities in birthing outcomes, so being listened to was huge,” Bartlett says. “I wanted someone who would help support me and offer some options to get me where I wanted to go.”
Bartlett soon switched to the practice. And a few months later, she gave birth to one of the 132,000 babies born in Illinois that year, roughly 9% of whom enter the world with the help of midwives.
Midwifery helps resolve healthcare access disparities
Access to midwifery care is expanding in some Chicago neighborhoods, thanks to a birthing center scheduled to open in 2026 and a growing midwifery practice on the South Side. Yet, despite improvements to midwifery access in some places, the region has a long way to go before women from any neighborhood can give birth where and how they’d like.
Access to midwifery care may be particularly important as obstetrical care units shutter across the country.
And birthing options that existed just a few years ago may not survive. West Suburban Medical Center, where Bartlett gave birth to her first child, severed ties with its last remaining midwifery group and family medicine physicians last year.
Access to midwifery care may be particularly important as obstetrical care units shutter across the country. More than 530 hospitals nationwide closed their obstetric units between 2010 and 2022, according to a study published in JAMA. In the Chicago area alone, 20 hospitals closed their doors in the last two and a half decades, including many with obstetric units.
Many cease operations in part because the units require a lot of staff, making them particularly expensive. Obstetricians also pay very high insurance rates because they are subject to more malpractice lawsuits than most other specialties. The closures in the Chicago area have severely impacted maternity care, primarily on the South and West Sides. Expanding midwifery access could improve maternal health and provide more birthing options for pregnant women, say some healthcare providers.
Better results
Midwife-assisted births often result in better health outcomes than those without midwives, logging fewer cesarean sections, decreased infant mortality rates, and higher satisfaction with the quality of care, according to the American Pregnancy Association. Midwives — which include certified nurse midwives, certified midwives, and certified professional midwives, each with a different degree — provide maternal care and deliver babies. They specialize in uncomplicated births and do not have the same medical training as family medicine physicians, who can receive training to perform c-sections, or obstetrician-gynecologists, who can attend more complex births.
“I think every single hospital should offer midwifery care because of those statistics of quality and safety,” says Kathleen Harmon, a certified nurse midwife who oversees the midwives in the University of Illinois Chicago’s Center for Women’s Health. “There are things that a woman needs to know for every single trimester, and I think because a midwife spends a little bit more time per visit, they have a little bit more time to get that message across.”
As hospitals shut down, midwives Jeanine Valrie Logan and Karie Stewart saw midwifery access disappear on the South Side. To provide more options, they founded a nonprofit and planned to operate the city’s first Black midwife-led birth center in The Bush, a small South side neighborhood. The women petitioned lawmakers to confront maternal health disparities, and last year, Governor JB Pritzker included $23 million in the state budget to address birth equity. The facility is scheduled to open in 2026.
Another South Side medical center, University of Chicago Medicine, is also growing its midwife practice. Though the group ended its relationship with its midwifery group 20 years ago, it reversed course in 2016. Officials announced in November that they planned to increase the number of midwives who work at the medical center.
Yet, access is often dependent on the proximity of the providers. When West Suburban Medical Center announced in late 2024 that it would no longer offer delivery privileges to midwives from PCC Community Wellness Center, 500 women under the center’s care were suddenly left to give birth without the help of a midwife who had been overseeing their care, says PCC director of midwifery Annette Payot. Most patients didn’t have the time or resources to have a midwife from another hospital farther away.
Since then, many of the midwives who worked at West Suburban Medical Center have obtained credentials at other hospitals so they can continue to treat their patients, and PCC’s own birth center, located at Berwyn, is still open and thriving, says Payot. “We’re still here. There’s definitely positivity.”
For women such as Bartlett, having supportive alternatives is key. “I think to have an empowered birth you need to have options,” she says. And families need to know those options exist, so they can seek out what works for them and their baby.
Originally published in the Spring/Summer 2025 print issue.
Susan Cosier is a Chicago-based writer focused on science and the environment. Her work has appeared in Scientific American and Science.
