Community Birth Centers are urgently needed for health equity in Springfield (Viewpoint)

Springfield is at a critical crossroads for maternal and infant health.

The recent suspension of services at Mercy Medical Center’s Family Life Center — and the possibility of a permanent shutdown — has exposed what families and care providers have warned for years: Our region’s maternal-health infrastructure is rapidly shrinking, and those already at highest risk will face the greatest harm.

The closing of Mercy’s center is a critical opportunity to evaluate birth equity in our city. As health professionals and community advocates, we are calling for urgent investment in midwifery-led, community-based birth centers to address these stark disparities.

After Holyoke Medical Center closed its maternity unit in 2020, families in the region were left with limited options. Now, Mercy Medical Center has announced that as of last week, it has suspended maternity and newborn services due to persistent staffing shortages. Mercy delivered more than 800 babies in 2022 and, with nearly 77% of Mercy’s patient revenue in 2023 coming from Medicaid and Medicare, the loss of services will disproportionately affect those who rely on public insurance, as reported by Trinity Health of New England and subsequent analysis by CommonWealth Beacon.

For many Springfield residents — especially those with limited transportation, unpredictable work schedules, or public-only insurance — these closures mean longer travel, fewer choices and greater health risks.

How CBCs provide real solution

Community birth centers (CBCs) offer a path forward for a region losing its maternal-care safety net. These centers — midwifery-led, community-anchored and evidence-based — are most effective when they are freestanding, operating independently from hospital systems to foster a distinct, community-focused model of care.

As hospital-based maternity units close, freestanding CBCs offer local, accessible prenatal, birth, and postpartum care. This is critical in Springfield, where many families rely on public transit or lack reliable transportation. Independent birth centers reduce travel burdens and help ensure that care remains available within the community without being subject to the operational vulnerabilities of large hospital systems.

In Massachusetts, maternal-health disparities mirror national trends and are worsening, driven by inequities in care access, social factors and structural racism.

The state’s severe maternal morbidity (SMM) rate nearly doubled between 2011 and 2020 — from 52.3 to 100.4 per 10,000 deliveries — reflecting trends documented in state surveillance and national evaluations of maternity-care outcomes, including the Strong Start for Mothers and Newborns initiative.

Recent analyses also show a growing racial gap over the past two decades. Black birthing people experienced the largest increase, rising from 69.4 per 10,000 deliveries in 1998–2000 to 173.7 per 10,000 in 2016–2018, more than double the rate of their white counterparts. By 2020, SMM rates were 2.5 times higher for Black women compared to white women.

Springfield consistently exhibits poorer outcomes compared to state averages. The infant mortality rate in Springfield in 2021 was 4.4 per 1,000 live births, compared with the statewide rate of 3.4, based on Massachusetts birth and death records.

Black babies in Hampden County were three times as likely as their white counterparts to die in infancy in 2020. Springfield also has higher rates of preterm birth and low birth weight, with Black and Latina women disproportionately affected, consistent with statewide patterns documented in the March of Dimes Massachusetts Report Card.

Unique nature of care

CBCs emphasize personalized, midwife-led care that fosters trust, continuity and cultural alignment — especially important in a city where many families are BIPOC, immigrant, or historically underserved. Freestanding centers can better maintain this philosophy without hospital-based constraints.

National research from the American Association of Birth Centers, the federal Strong Start for Mothers and Newborns initiative, and peer-reviewed studies show that midwife-led birth-center care is associated with significantly lower cesarean rates, fewer preterm and low-birthweight births, as well as improved equity in outcomes for low-risk pregnancies.

Because CBCs primarily serve low-risk pregnancies, they also avoid many unnecessary and costly medical interventions, a finding supported by evaluations from the Centers for Medicare & Medicaid Services and the Urban Institute. State-level reviews have identified independent birth centers as a value-based model that delivers high-quality care at lower cost while improving patient experience.

Springfield needs birth centers now

Springfield is not starting from scratch.

Members of the Springfield Maternal Child Health Commission — including community-based nonprofits, midwifery and perinatal health leaders, and BIPOC-led organizations — are well positioned and have a demonstrated history of collaboration in advancing maternal and infant health in the region.

Across Massachusetts and the country, similar coalitions have successfully developed freestanding community birth centers when supported by startup capital, Medicaid-aligned reimbursement and clear regulatory pathways.

If state or regional policymakers issued a targeted request for proposals, these locally rooted and experienced partners could step forward to establish a community birth center that reflects Springfield’s needs and values.

As services disappear, so do families’ options, safety nets and dignity in birth care — particularly for low-income residents, immigrants, and communities of color.

We urge policymakers, health funders and regional leaders to prioritize freestanding community birth centers as a key strategy for maternal-health equity.

Specifically, we call for:

— Investment and startup funding for freestanding, midwifery-led, BIPOC-centered community birth centers.

— Comprehensive Medicaid reimbursement and regulatory reforms that ensure birth-center care is both fully accessible to families and financially sustainable for the centers that provide it.

— Formal integration of community birth centers into regional maternal-health planning as essential health-care infrastructure.

— Community leadership in planning and oversight, centering those most directly affected by gaps in care.

Springfield families deserve safe, respectful, equitable care.

Birth equity is not a luxury — it is a human right. Now is the time to build the community-based birth-center care our region needs.

Jenise Katalina is co-chair of the Springfield Maternal Child Health Commission, which helped with the drafting of this commentary. The commission operates under the Springfield Department of Health and Human Services and is made up of health professionals and community advocates working to advance maternal and infant health equity in Springfield.