When Texas Children’s Hospital suddenly axed its decades-long midwifery group as part of a five percent reduction of its workforce last year, certified nurse midwife, Titi Otunla, was concerned she wouldn’t have another place to practice.
“It was unexpected,” she said.
Otunla, who previously served as midwife manager and clinical lead at Texas Children’s, was devastated for the many women afraid to give birth, especially in a hospital setting due to Houston’s maternal mortality crisis. She was even more devastated for the women and families who have come to rely on her team’s care and who were upset that the team was being cut.
“I always say there’s more to it than just delivering babies,” Otunla said. “It’s about empowering women to take care of themselves and take care of their families.”
That drove her to seek new opportunities. A physician colleague connected her with Jeanna Bamburg, CEO of the Woman’s Hospital of Texas, and within an hour, she was on her way to securing a new home.
The Woman’s Hospital of Texas officially launched its Woman’s Choice Midwifery group on March 3 with Otunla leading three other former Texas Children’s certified nurse midwives to provide reproductive health, pregnancy, birth and postpartum care.
As certified nurse midwives — registered nurses with specialized, advanced training in women’s care — they also provide routine gynecologic services, menopause management, wellness education and well-woman exams.
“When the opportunity came up, it wasn’t a second thought. It was, ‘Yes, we’ve got to do something,’” Otunla said in an interview with Houston Landing. “It’s needed. Women need choice. There are many women who choose to give birth at home without assistance sometimes and just [need] support. … If women don’t get what they need they’re going to take alternative avenues and (I) just didn’t want that to happen.”
Texas Children’s Hospital did not respond to questions on why it cut the midwifery group, which comprised six midwives, but said in an emailed statement that they are dedicated to providing women and children “exceptional care at every stage of their lives.”
“As a top-ranked pediatric and women’s hospital in the nation, our innovative approach prioritizes the health of children and mothers and features a collaborative working relationship between obstetricians, gynecologists, pediatricians, and a wide range of subspecialists,” the statement said.
The Woman’s Hospital of Texas is now the third HCA Houston Healthcare hospital to offer midwifery services joining its Southeast and Conroe Women’s Care Centers. Other Houston-area hospitals with midwifery services include Houston Methodist Willowbrook and Tomball, Harris Health Ben Taub Hospital, and Memorial Hermann Hospital’s Greater Heights, Southeast and Sugar Land locations.
Midwifery has been associated with improving equity and maternal outcomes for birthing parents and their babies, but the practice remains underutilized and underfunded in the U.S., according to a midwifery workforce study by the American College of Nurse Midwives. The study found that the U.S. has approximately four midwives employed per 1,000 live births, but with more than 3.7 million live births a year, at least 22,000 midwives are needed to meet the World Health Organization goal of at least six midwives per 1,000 live births.
Data from the Texas Department of Health and Human Services shows that there were 76 certified nurse midwives in Harris County in 2024.
“The midwifery group really gives women the best of both worlds,” Otunla said. “They have that midwifery support, that midwifery connection but they have it in an environment where if you need extra help or technology, it’s available.”
Giving women that choice is what motivated Otunla to get it off the ground quickly.
The opportunity came at the perfect time for the Woman’s Hospital of Texas as it had been an outstanding goal ever since Bamburg joined the hospital as its CEO in July, 2022, she said. Over the course of her career, she had started midwifery groups at two HCA Houston hospitals and wanted to fulfill that void at the hospital to give birthing people more options and an additional layer of patient safety.
“I just needed to wait for the right time and the right opportunity, and it presented itself,” Bamburg said.
“They are very well known in the community. They have a tremendous legacy of providing care for women in Houston and the region.”
Bamburg said patients can expect the same quality of care the group has provided for years, just under a new hospital system.
“I wouldn’t change a thing,” she said. “To me they have a different group name and they’re wearing a different team jersey, and I’m super excited to have them on my team.”
Within just a couple weeks the group has already seen nearly 20 patients, the team of midwives said during a recent tour of the office and patient visit space. One of the patients is someone Otunla delivered nearly 20 years ago and is having Otunla deliver his partner’s first child.
“People are starting to hear about us, and we figured that would happen,” said Kendra Oates, one of the midwives.
Unlike many doctor’s offices that commonly maintain frigid temperatures, Otunla said she likes to keep the space cozy and intimate with dim lighting. Woman’s Midwifery Group offices are solely used for prenatal visits and well women’s exams, whereas the group will have its own wing across the street.
“It’s better visually, psychologically and from a space perspective to have them separated and not mixed in,” Bamburg said.
The group will add a fifth certified nurse midwife to the group in May and and eventually round out the team with a sixth midwife. Bamburg’s long-term goal is to eventually expand beyond six midwives, something she’s confident they can achieve since some of the hospital’s tenured labor and delivery nurses are training to become midwives.
“I can’t say exactly how big I’d like to get it,” she said. “But I do want midwifery service to be an important option for patients who choose the Woman’s Hospital of Texas and midwifery care.”
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