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Why New York Lags So Far Behind on Natural Childbirth

Jennifer Adair decided to leave the city to have her baby. “I loved my obstetrician, but as I got into my third trimester, there was a lot more talk about medical interventions,” said Ms. Adair, an assistant professor at Fairfield University who lives in Inwood. At 31 weeks, she switched to a midwife, but since she was so far along, her options were limited. A doula suggested that she consider giving birth in New Jersey.

“I found the level of care there was exactly what I wanted,” said Ms. Adair, who delivered at Pascack Valley Medical Center in Westwood, a short drive over the George Washington Bridge. The hospital doesn’t have a separate birthing center, but it does offer midwifery care, and Ms. Adair gave birth without medical interventions. “My insurance was accepted, and unlike the hospitals I saw in New York, you were guaranteed a private postpartum room at no extra charge.”

For those who would like to stay in the city, there is, perhaps, a new option. Two years ago, Jamee Gidwitz planned to give birth at Mount Sinai East on Fifth Avenue. But after touring the hospital, she said, she grew fearful that the staff there wouldn’t support her choices. When she told her doctors at Village Obstetrics, who are affiliated with Mount Sinai East, they suggested that she be the first of their patients to try a new model of care they were offering.

The doctors, George Mussalli and Jaqueline Worth, were opening Village Maternity, a private midwifery practice. It was to be a separate business from Village Obstetrics. Dr. Mussalli and Dr. Worth would continue delivering babies at Mount Sinai East, but Village Maternity midwives would deliver babies at Metropolitan Hospital, a public hospital in East Harlem.

Located on First Avenue and 97th Street, Metropolitan is a part of New York City’s Health and Hospitals Corporation. The majority of its patients are part of its pre- and postnatal clinic, which serves mostly lower- and middle-income women with either no insurance or public insurance.

There are several reasons Dr. Mussalli and Dr. Worth chose Metropolitan. The hospital has midwives on staff, and Dr. Mussalli did his residency there. Moreover, unlike most private hospitals in New York, Metropolitan offers private postpartum rooms at no extra cost.

“As private hospitals have gotten busier, the city’s hospital system hasn’t enjoyed the same increase in their volume,” Dr. Mussalli said. “It is a leftover reputation from the 1970s, when people wanted to avoid city hospitals. But I know firsthand that the city system has changed.”

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