The comprehensive program is spearheaded by Amy Lowell and will include wraparound services designed to improve Cleveland’s maternal and infant mortality rates, which are among the worst in the nation.
This year, MetroHealth launched a comprehensive midwifery program aimed at giving women more control over their pregnancy journeys.
Spearheaded by Amy Lowell, CNM, MSN, a certified Nurse Midwife with nearly three decades in the field, this initiative seeks to provide women with more holistic, personalized care throughout their pregnancy and after they give birth. “Midwives view pregnancy as a natural life event, not a medical diagnosis or illness,” Lowell explains. This approach helps to build trust and foster a sense of partnership, encouraging women to be active participants in their care, she said.
Raised in Shaker Heights and trained in New York, Lowell brings with her a rich background from working in diverse locations like Hawaii and Florida before she returned to her hometown of Cleveland. “I’ve delivered thousands of babies, but this program’s first baby, a boy born in August, was special,” she reflected, noting the significance of establishing a program that can make a broad impact.
For Lowell, leading this program is not just a professional accomplishment — it’s deeply personal. She herself chose midwives for the births of her three children, each born in a hospital setting. “I had all three of my children caught by midwives in a hospital,” she shared. This experience shaped her approach, blending the calm, supportive care she experienced with the security of a hospital environment. She described a commitment to empowering women, by giving them the knowledge and support they need to feel confident in their healthcare decisions.
Lowell first learned about midwifery while studying abroad, where she met a midwife who explained the role to her. This encounter became an “Aha!” moment, sparking her interest and setting her on the path to become a midwife. Although she hadn’t originally planned to pursue nursing, this experience inspired her to enter the field, ultimately dedicating her career to supporting and empowering women through midwifery.
Lowell’s midwifery program emphasizes options for women. According to her, “We want women to feel comfortable making the decision that’s best for them, not based on societal pressure.” Patients can choose from a spectrum of care, including prenatal visits, labor support, postpartum care, breastfeeding education, and general gynecological services for women across all life stages, from adolescence through menopause. With many of these services, being covered by grants and donations.
The Unique Role of Midwives
Unlike obstetricians, midwives are not surgeons but work alongside physicians for cases that need additional medical interventions. “Our goal is to provide expert care for low-risk pregnancies and offer the best of both worlds through collaboration with physicians,” Lowell said. When situations arise that require medical intervention during labor, the midwife and physician co-manage the case to ensure the patient’s safety and comfort.
MetroHealth’s birthing rooms are designed to provide a home-like, calming environment while offering the full support of a hospital setting. Recently renovated and equipped with features like labor tubs and showers, the rooms allow mothers more flexibility and comfort in their birthing experience. Although not a traditional birthing center, the rooms blend a comforting atmosphere with essential medical equipment nearby.
The program also expands MetroHealth’s services beyond pregnancy. Midwifery translates to “with women” and this extends from adolescence, with contraceptive counseling and education, to getting older and managing menopausal symptoms. She describes how women can turn to midwives not only for birth-related services but for a range of general gynecological needs, allowing them to build continuous and trusting relationships over time.
Addressing Black Maternal Health Disparities
This initiative is particularly timely given Cleveland’s high Black maternal mortality rates. Black women in the U.S. are three times more likely to die from pregnancy-related complications than their white counterparts. In Cleveland, where maternal and infant mortality rates are among the highest in the nation, according to the Ohio Department of Health, this disparity is stark, affecting generations within the community.
MetroHealth’s midwifery program aims to be part of the solution, providing culturally sensitive care with doulas (a trained birth worker who provides physical, emotional, and informational support to a person before, during and shortly after childbirth. Unlike midwives, doulas do not perform medical tasks but instead focus on guiding and comforting mothers, helping them make informed decisions, and advocating for their wishes in various birth settings) and community health workers.
Through strategic partnerships, they also offer wraparound services addressing social and economic factors, like healthcare bias, misinformation, economic inequality and access to healthcare, that impact Black maternal health. The program is grounded in education and bias training, equipping staff with tools to recognize and counteract unconscious biases.
“We’re approaching this issue from all angles by providing unconscious bias training for all our disciplines,” said Kimberly Green, vice president of Women and Children’s Services. By integrating resources like clinical vignettes, which is basically role-playing based on scenarios and situations that have really happened in our area, these different vignettes are done with the multidisciplinary team, theyre accessed and they debrief and learn how they can do better ., MetroHealth strives to ensure that its midwifery and maternal care program meets the needs of Cleveland’s diverse community.
Building Community Through Centering Pregnancy
Beyond individual care, MetroHealth offers “Centering Pregnancy” sessions, which allow expecting families to build a support system. Patients attend group prenatal sessions, where they engage in discussions on topics from postpartum care to breastfeeding. “The group setting creates bonds,” Lowell noted, “so families feel less alone in their journey.”
The Centering Pregnancy program has been shown to reduce preterm birth , a 2020 study in the “American Journal of Obstetrics & Gynecology” reported that CenteringPregnancy participants had a preterm birth rate of 7.9%, compared to 12.7% for those in standard care, indicating a significant decrease in preterm births among program participant, a significant concern in Cleveland’s communities. By giving families the tools and education they need, the program aims to improve maternal and infant health outcomes.
A Career Dedicated to Women’s Health
For Lowell, returning to Cleveland a few years ago to work at University Hospitals was an opportunity she couldn’t pass up. Her career had taken her through varied settings, from rural hospitals in Hawaii to urban centers in New York City, where she gained unique perspectives on the needs of diverse communities. She witnessed the transformative power of giving women the information and autonomy they need to make the best choices for their families. Her dedication to empowering women, especially those from underserved communities, now shines through.
Through the midwifery program, Lowell and her colleagues aim to create a more inclusive model of care for Cleveland’s mothers. They hope to ensure that every woman, regardless of background, receives the resources and support she needs. In Green’s words, “It’s about providing the community with options and support systems that go beyond pregnancy.”
The MetroHealth midwifery program is currently operating at the Cleveland Heights and Brooklyn Heights locations with presence at the main campus. Lowell wants to expand to more locations across Cleveland so people don’t have to go far to access services.
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