Leseliey Welch is straightening her bobby pin before she walks to the podium, amber dreadlocks catching the light in a room packed with maternal health decision-makers. She’s got the keynote. She’s got the data. And the data is brutal.
In November 2025, the March of Dimes released its annual report card on birth outcomes across the country’s largest cities. Detroit ranked last. The city posted a 16.6% preterm birth rate, the highest among the 100 U.S. cities with the most births. That’s roughly one in six babies arriving before 37 weeks of gestation. It’s 50% higher than Michigan’s state average, and it outpaces every other major city on the list, including Chicago, Miami, and New York.
Those numbers land differently when they belong to your family.
“I was with my brother when my nephew was born and died on the same day in a local Detroit hospital,” Welch told the audience at the American Association of Birth Centers’ Birth Institute conference. “We are the statistics that we talk about, and that guides this work.”
Welch is the CEO of Birth Center Equity, a national nonprofit that has invested close to $10 million to strengthen 40 community birth centers serving 58 communities across the country. She’s also the co-founder of Birth Detroit, the city’s first and only freestanding community birth center, anchored in the Petoskey-Otsego neighborhood on the west side.
What Birth Detroit Actually Does
Birth Detroit isn’t a hospital. That’s the point. The center offers midwifery-led, culturally centered care outside the clinical infrastructure that has failed Black mothers and babies in Detroit for decades. The organization started providing care through Brilliant Detroit during the pandemic in 2020, and in January 2025 moved into its own building and formally launched full services.
To date, Birth Detroit has supported more than 400 families. The goal is to reach 500 families a year.
Welch spent years in Detroit’s public health system before building this. She served as the city’s deputy director of public health and helped establish Corktown Health Center. So when she talks about structural inequity, she’s not theorizing. She spent years watching the system from the inside.
“Detroit’s persistently high infant mortality rates, particularly for Black babies, aren’t about individual choices or behaviors,” she said. “They’re about structural inequities and the intergenerational trauma of systemic racism.”
The 50 by 50 Vision
Her keynote speech centered on the “Beloved Birth 50 by 50” initiative, which sets a target of having half of all U.S. babies born into the care of midwives by 2050. Right now, midwife-attended births account for a small fraction of deliveries in the U.S. compared to peer nations where outcomes are significantly better.
The initiative is ambitious. Probably the point. Welch framed it as a collective call rather than a partisan one. “Now is the time to state clearly what we are for,” she told the room. “We don’t have to agree on all things to agree on this one thing.”
That framing matters in a policy environment where maternal health funding and reproductive care access face real pressure at the federal level. Community birth centers occupy a complicated space in that fight, offering an alternative model that sidesteps some political fault lines while directly addressing health disparities that cut across all of them.
Why Petoskey-Otsego
Birth Detroit didn’t open in Midtown or Corktown. It opened where the need is. Petoskey-Otsego is a predominantly Black west-side neighborhood that doesn’t get much of the development ink, but it’s exactly the kind of community where the gap between available care and needed care is widest.
Research on birth center outcomes has consistently shown that community-based midwifery care reduces preterm births and improves maternal outcomes, particularly for Black women who face documented bias in hospital settings. The model isn’t radical. It’s just not the default.
Hour Detroit has covered the broader context of Detroit’s infant mortality crisis in depth, connecting the statistical picture to the human stories behind it.
Still, a birth center serving 500 families a year in a city of 600,000 people is a start, not a solution. Detroit’s preterm birth rate didn’t get to 16.6% because of one broken thing. Fixing it won’t happen because of one right thing either. But Birth Detroit is building the infrastructure, training the midwives, and earning the trust of the community one birth at a time.
Welch’s ask isn’t complicated. She wants every baby treated like her baby. In Detroit, that’s a revolutionary act.
