SEATTLE — A brown and tan building in a tree-lined Federal Way neighborhood is nearly ready to welcome new life.
The Federal Way Birth Center officially opened over the weekend after more than a year of work, drawing dozens of friends, family and supporters into the 3,000-square-foot space to celebrate with cake and sambusas. Hopes for the center are wide-ranging — but all relate to improving health outcomes and reducing birth complication rates, particularly among Black and brown families, said center owner Faisa Farole, a licensed midwife who has worked around childbirth more than 20 years.
The new birth center is the first one in the state owned and run by a Black midwife, she said. Birth centers are free-standing health care facilities separate from hospitals and licensed by the state Department of Health, and are generally used by midwives to deliver babies.
“It’s historic, but it’s also sad there haven’t been any others in the past, considering Black and brown women’s status in this maternal health crisis,” said Farole, who also runs her own practice and a separate doula nonprofit, Global Perinatal Services.
In the U.S., the rate of deaths among people giving birth has jumped the last several years, according to the Centers for Disease Control and Prevention. They’re highest among Black women — almost three times as high as the maternal mortality rate for white women in 2021. Black babies are also more likely to die, The Associated Press reported.
These trends are reflected in Washington, which has disproportionately high death rates among Black and American Indian/Alaska Native birthing parents, The Seattle Times reported earlier this year. Pregnancy-related deaths hit an all-time state high between 2018 and 2020.
Meanwhile, hospital labor and delivery services are shrinking, often among the first cut as health care systems throughout the region face financial strain.
Farole is determined to find solutions.
In the past couple years, the state has proposed funding and training for doulas, as well as doctors, nurses, midwives and other providers who can help bolster pregnancy and birthing health resources, especially in vulnerable communities. The legislation has followed a growing sense of acceptance of community midwives and doulas in medical spaces — especially during the pandemic, when hospitals were so full of COVID-19 patients that the number of births in homes and birth centers rose, Farole said.
But some stigma around independent, out-of-hospital midwifery still exists, she added, despite research that shows midwifery can lead to better birth outcomes for those who are low-risk.
“The [research] shows that midwifery is the answer for saving Black lives and giving women satisfactory care that they enjoy being part of, as well,” she said.
Her new birth center, tucked away from a busy street, is equipped with three full birth suites — all with beds, tubs and bathrooms — exam rooms, a couple teaching areas and an office. While birth centers don’t carry the wide swath of medical resources hospitals have, they do have oxygen, IVs and some medicines and antibiotics just in case, Farole said.
Near the back of the center, an area for expecting families to wait and unwind is supplied with games and floor cushions, while a larger room in front is set to be used for classes and support groups.
Farole hopes the birth center can flourish into a “hub” — where community organizations can provide childbirth and lactation education, where aspiring midwives can train, and where families can find wraparound support before, during and after pregnancy, she said.
Farole is still waiting to receive some final permits from the state Department of Health but hopes to start delivering babies out of the Federal Way Birth Center in early 2024. Until then, she can use the clinic space for prenatal and postpartum visits.
“This is just a drop in the bucket,” Farole said. “I have a lot of plans for the center.”
Lakisha Hubbard, a new mom in Des Moines, has visited the birth center a couple times since having her baby in late September. She had hoped to be one of the first to deliver there, but her daughter, Adijah, arrived nearly a month early.
The early date meant a birth center delivery was off the table; community midwives generally only take “low risk,” healthy patients and deliver at birth centers for those between 37 and 42 weeks pregnant.
Anyone delivering before 37 weeks no longer qualifies — in addition to anyone who develops preeclampsia, insulin dependencies or other complications — and is redirected to the hospital.
Hubbard and her husband ended up going to Providence Swedish on Seattle’s First Hill, where Farole, an independent provider, wasn’t authorized to deliver.
On the way there, Hubbard tried to keep her anxiety at bay. She knew the alarming statistics on Black birth complication rates.
When Hubbard met Farole years ago, she already knew she didn’t want to deliver in a hospital. She wanted her birthing experience to be natural and “more of a homely experience, but not in my home,” she said.
She was healthy, and her pregnancy was initially considered to be low-risk, so a birth center delivery offered a “happy medium,” she said.
“I didn’t want to use medication because I wanted to be able to listen to what my body was saying, versus listening to a machine or what a physician is saying,” Hubbard said.
To her relief, she met little pushback to her birthing plan and labor preferences at Swedish. She was even able to request an in-house midwife to deliver her baby, which not all hospitals offer.
“I couldn’t have asked for anything better, other than delivering at a birthing center,” Hubbard said.
She was also aware no one on her hospital care team was Black, which she had wanted to avoid.
“It’s important to have a diverse team working with you in health care,” Hubbard said. “Having that representation in general is very important given the population in South King County.”
That also includes finding caregivers with shared religious beliefs, she added.
In her case, the fact Farole is Muslim, like Hubbard and her husband, was a huge added benefit to working with her, she said.
“When it comes to religion, not everyone understands where you’re coming from or will support it,” Hubbard said. “You can get a lot of pushback from that.”
While Farole primarily works with families in King and Pierce counties, she sometimes has patients drive over an hour to see her from other parts of the state. Many are from immigrant or refugee communities, like Farole, who immigrated with her family to the U.S. from Somalia in 1993.
“I know what it’s like to come into a new place, to not know the language,” she said.”
On Sunday, Hubbard stood smiling among a group of Farole’s co-workers and supporters, as the midwife cut the gold ribbon tied in front of the center and pulled the door open.
She hopes to see support for other low-cost pregnancy and postpartum resources throughout the state, especially for families of color and including those for fathers and co-parents, she said.
“Even though they’re not the ones carrying or having to nurse, their role is super important,” Hubbard said. “It takes a village, and the village also needs support and resources.”