When the New York Times reported on the state of New York City’s freestanding birthing centers in 2018, that number was already alarmingly low: there were just three across the entirety of New York State. Freestanding birthing centers—that is, licensed healthcare facilities that operate independently of the hospital system focused solely on providing midwifery to pregnant people during labor and delivery—remain relatively rare. As of 2024, there were just two to serve those who live within New York City’s five boroughs.
In November of 2025, however, Governor Kathy Hochul announced a $5 million capital investment to expand access to affordable maternal healthcare. A cornerstone of the program, which includes an expansion of the state’s child tax credit and new baby benefits, is a capital commitment to establish a new birthing center in the Bronx. This commitment, which is part of a historic expansion of maternal healthcare benefits in the state of New York, marks a milestone in enabling access to affordable midwife-led care for a historically underserved population.
Governor Hochul’s recent $5 million capital commitment is the latest in a series of sweeping policy changes that have begun to transform the landscape of maternal healthcare options to include access to midwifery and doula care. After New York State’s Medicaid program increased the reimbursement rate for midwifery care from 80 percent to 95 percent in 2022, the federal government’s 2024 approval of New York’s State Plan Medicaid Amendment made no-cost doula services available to Medicaid beneficiaries.
Despite growing interest in—and policy shifts in favor of—out-of-hospital births and midwifery-led care overall, freestanding birthing centers remain difficult to establish and sustain in New York. Support for them is a comparably recent milestone in the face of entrenched regulatory hurdles, high operating costs, and reimbursement systems that have historically favored hospital-based care.
Still, incremental policy changes like those in New York State are shaping a more comprehensive maternal healthcare and support framework that directly correlates to safer deliveries and postpartum outcomes for both the parent and baby. While hospitals are optimized to emphasize care pipelines that prioritize efficiency, intervention, and standardization, birthing centers are built around a different philosophy. Theirs centers the partnership and trust inherent to the midwife-birthing person relationship—one built upon continuous and collaborative care designed to support the birthing person throughout every step of the prenatal and postpartum stages.
Doula care, too, has increasingly become part of the broader conversation around maternal healthcare access and outcomes. Doulas’ expertise complements the clinical care of midwifery by offering emotional, physical, and educational support to help birthing people navigate the myriad experiences of pregnancy and birth. Research, such as the studies conducted around the Medicaid Doula Pilot that New York State launched in Erie County in 2018, has consistently linked doula support to improved birth experiences and better maternal health outcomes for Black birthing people and other historically underserved communities. Medicaid-covered doula care reflects growing recognition that community-based systems of care and support can and do play a meaningful role in improving health outcomes.
The Brooklyn Birthing Center, located in the borough’s Bay Ridge neighborhood, has long been one of the few options available to New York City-based families seeking such care. While growing interest in midwifery-led and community-based care has outpaced the expansion of birthing centers in New York City, the Brooklyn Birthing Center recently celebrated a milestone in that direction with the opening of its new prenatal care center in Bryant Park. With the addition of its Bryant Park office, it joins the likes of Maryam Reproductive Health + Wellness (which opened in the Bronx in 2024) in bringing midwifery- and doula-led reproductive care to more New Yorkers.
The addition of offices like the one Brooklyn Birthing Center just opened allows for greater flexibility with the scheduling and continuity of prenatal care, particularly for families who must weigh the consideration of commutes and work schedules. Among patients, doula communities, and media coverage, the Brooklyn Birthing Center has established a reputation for clinically-informed care that prioritizes relationship-building and medical expertise. Its providers oversee prenatal care and education, attend births, and remain involved throughout the process of postpartum recovery. Similarly, Maryam Reproductive Health positions its three-office practice as “a women’s health clinic with a dedicated community space,” going the extra mile with initiatives like the Womb Bus, which offers resources and education such as STI testing, doula consultations, and acupuncture.
As New York continues to expand access to midwifery and doula care, the conversation around that access is also beginning to shift. Increasingly, policymakers are pushing for systems that treat pregnancy and postpartum care as experiences shaped by continuity, education, emotional resources, and community. The next phase of closing the maternal healthcare gap is for the infrastructure for such care to be expanded beyond a handful of neighborhoods and providers to reach across communities.
