The new state law that lifts Michigan’s 38-year-old ban on paid surrogate pregnancy contracts took effect Monday.

Michigan banned the practice after a Dearborn attorney gained nationwide notoriety in the 1980s for arranging surrogate contracts.

Surrogate parenting was new, controversial and misunderstood when it first became an option, said Stephanie Jones with the Michigan Fertility Alliance.

“And I really think people have changed their outlook on this significantly since then and it’s just become more of a norm,” she told Michigan Public Radio. “People have become more aware of infertility and the need for assisted reproduction to grow your family. So, I think it’s just become more palatable over the years and we, of course, want to be able to support people who need this to grow their families.”

The newly effective laws outline the legal rights and obligations of all parties to a surrogate arrangement. That includes automatic parental rights for couples without having to adopt after a child is born.

Advocates say that makes the arrangements enforceable and predictable. But some conservatives and faith groups say the development is not a welcome one.

Michigan Catholic Conference Vice President for Public Policy and Advocacy Tom Hickson said the church believes infertile couples should consider foster parenting or adoption. He said allowing surrogates to be paid will lead to exploiting vulnerable young women.

“That was the No. 1 amendment that we tried to get in was to strike the compensation aspect of this,” he said. “I mean that just really minimizes the dignity of motherhood and childbirth into a sale and delivery mechanism.”

Michigan joins the vast majority of U.S. states in allowing compensated surrogacy contracts.

Editor’s Note: This story is part four of a new four-part series from WDET’s Nargis Rahman called, “Shustho: Mind, Body, and Spirit,” exploring health care and health care access for Bangladeshi women.

Ayesha Tanjum moved to the U.S. about two years ago with her husband, an international student. Shortly after, she learned she was pregnant.  

“It was really tough for me in Michigan, because I didn’t have any friends or relatives around, and I was struggling to make friends,” she said. 

Tanjum said she was having mood swings due to hormonal changes and a complicated pregnancy.

“I had loneliness, frustrations, fear, anxiety, and I was alone. So I had a hyper, hypertension that time. And in the last time, my doctor figured it out that my baby’s baby’s growth is restricted,” she explained. 

Tanjum says she ultimately got the care and support she needed. She also read books to learn more about maternal health and nutrition, and began reaching out to old friends and connecting with new ones. That helped to improve her mental health. 

Speaking about mental health remains a taboo subject for many Bangladeshi women. 

Shuhrat Choudhury is a Bangladeshi American mental health counselor. She says stigma is the biggest reason many women don’t seek care — especially in older generations.

“I would be contacted by their sons, their daughters, their daughter-in-laws, that we need help for our mom or, like the older generation, but they are not OK. Like, they just, it’s that stigma around mental health, they go, ‘I’m not crazy,’” she said.  

Choudhury says younger Bangladeshi Americans struggle with navigating between American individuality and the Bangladeshi culture’s collective family expectations, in which personal boundaries do not exist in the same way in Bangladeshi culture.  

“When I transition to working someone with from our community, I have to find that balance. I just can’t advise them to move out, because you know that’s just not how it works in our culture,” she said. “I might use that terminology, but as long I’m explaining in our culture, it might not be feasible exactly the definition, but maybe a different version of it.” 

Choudhury said affordability is another barrier which can keep people from getting mental health care services. 

“Not a lot of our community members have access to better insurance plans, or they’re not financially stable. That when mixed with that stigma that we’re already trying to overcome, one obstacle on top of it, if it’s not financially feasible, then that just creates more delay in getting that help,” she added. 

There’s also a shortage of Bangla or Bengali speaking mental health professionals.  

“The need is much more than I could have ever anticipated, so I hope that more people join this field, from our community, and there is a need, and we desperately need to fill that.”

– Shuhrat Choudhury, Bangladeshi American mental health counselor

“I have been reached out by people from out of state, like someone in Michigan worked with me and their mom, brother, sister, someone’s like in Texas, but they just can’t find someone Bengali there,” she said.

Choudhury says she didn’t know there was such a need until she entered the field. She says she made that choice, in part, to give back to the community. 

“The need is much more than I could have ever anticipated,” she said. “So I hope that more people join this field, from our community, and there is a need, and we desperately need to fill that.”

Like Choudhury, Fariha Ghazi entered the mental health field to provide culturally competent care. Ghazi is a psychiatric physician assistant in Grand Rapids, who lives in the metro Detroit area and has telehealth options. 

She said she frequently sees Bangladeshi women struggling with anxiety, which manifests as physical symptoms first. 

“When they go see their general primary care provider, they’re often treated for things like stomach pain or acid reflux or, given sleep medication to help with sleep, a kind of root cause of a lot of those physical symptoms, it tends to be what I see being anxiety and trying to get them treatment for it,” she said. 

Ghazi says many women hesitate to discuss their mental health. She takes a creative approach to uncovering their struggles. 

“If someone has children, you know, I’d maybe ask her what are things that she thinks about in terms of her children, so if she’s always kind of like jumping to worst case scenarios, like thinking something bad’s going to happen to her child, or she kind of expresses that in our session, I’ll kind of note that as being, part of her symptoms.”  

Many women are also hesitant to take medication due to cultural taboos surrounding mental health treatment.

Ghazi said there is cultural taboo around taking medications to treat mental health, and part of her role is to explain treatment options and encourage self-advocacy, which she said plays a role in coverage. 

“If someone’s not fully aware of the terminology or what’s out there as resources, they’re not likely to get the health care that they need. They’re also much more willing to just kind of not question medical providers either. They’ll, be more complacent in their care,” she said. 

Choudhury and Ghazi say mental health is a vital part of caring for Bangladeshi women. They see a growing need for more Bangladeshi mental health professionals to serve their community.  

For now, they are using their language skills, cultural awareness, and lived experiences to provide better care. 

Read more from this series:

• Free health clinic aims to close insurance gap for Bangladeshi women in southeast Michigan  
• Bangladeshi women rely on culturally competent care for better health outcomes
• How language access affects health care for Bangladeshi women in Michigan

Editor’s Note: This story is part three of a new four-part series from WDET’s Nargis Rahman called, “Shustho: Mind, Body, and Spirit,” exploring health care and health care access for Bangladeshi women.

The Health Unit on Davison Avenue in Detroit (HUDA Clinic) is the largest free health care clinic in Wayne County. It serves uninsured and underinsured patients helping about 5,000 patients annually.

Nurse Practitioner Joann Harrison says about 30% of HUDA’s patients are Bangladeshi women. She says many struggle with mental health and chronic conditions due to lack of access to regular care. 

“There are problems with hypertension and diabetes. I just see a wide variety of issues, a lot of it has to do with not knowing how to manage or not having the resources to manage issues,” she said. 

Within that care, Harrison says Bangladeshi women are more receptive to female health care providers. 

“I think they’re more open to talk with us. Unfortunately, that’s not always the case that we have female providers available or female translators available, but I do feel that when there is someone present, there is more openness, more freedom to speak with us,” she explained. 

The clinic also provides interpreters and translated educational materials. 

Harrison, who is Black, said she is learning more about Bangladeshi culture, including about food and family values, to better serve her patients. “I’m learning all the time about how to help them, especially the women, to better care for themselves and what issues affect them.”  

Dr. Nashita Molla is a Bangladeshi American physician who volunteers at the HUDA Clinic. Part of her care is educating Bangladeshi women about preventive care. 

“In Bangladesh there isn’t a whole lot of cancer screening, so patients don’t have a PCP that they go to continuously and get colonoscopies every 10 years, or pap smears every three to five years,” she said.

Molla said having more Bangladeshi doctors and health care providers who are women could improve care for Bangladeshi women patients. 

“If I’m not there, or, you know, another female Bengali provider is not there, or then they’re not going to be as open with those other providers. They might not do those tests because they don’t understand why they need those things,” she shared. 

Molla said there’s a need for more free clinics and educational materials in Bengali, such as informational videos on diabetes and hypertension, which are rampant among Bangladeshis.  

“I think it helps if there’s another Bengali female saying, like, ‘hey we gotta cut down the portions of how much they’re eating, and cut down on the fried foods, and it’ll mean a lot more coming from them than it would like any other culture,” she said.

Like some patients served at HUDA Clinic, some Bangladeshi women end up in the Emergency Room for primary care because they don’t have adequate insurance.  

Dr. Farjana Alam is an emergency medicine physician who works at several hospitals in metro Detroit.  

She says socioeconomic barriers contribute to these challenges. 

“Poverty is higher in our people. I’ve seen lack of education is higher. And so I think that also plays into effect with all the health literacy gaps which then leads to like issues with chronic illnesses and not having an overall, as great of a health outcomes as, like other people,” she said.  

Alam grew up helping her immigrant parents navigate the health care system.  As a result, she said she understands firsthand how having limited resources affects one’s health.  

Social determinants of health, factors such as limited English proficiency, inadequate insurance and needing help with transportation can make a big difference in health outcomes, she said. 

“You can’t compare someone like a white female from a family who has all the resources in the world, who has all the money in the world, her health outcomes, to this Bangladeshi female who barely finished school, who has all these financial constraints over her; like you can’t compare those health outcomes,” she said.  

Alam said despite these barriers, Bangladeshi women in metro Detroit are empowering themselves by learning English, learning how to drive, and educating their children to assist them to have better health outcomes.  

Read more from this series:

• Bangladeshi women rely on culturally competent care for better health outcomes
• How language access affects health care for Bangladeshi women in Michigan

Editor’s Note: This story is part two of a new four-part series from WDET’s Nargis Rahman called, “Shustho: Mind, Body, and Spirit,” exploring health care and health care access for Bangladeshi women.

When the pandemic shut down many doctor’s offices, Family Nurse Practitioner Farzana Noor noticed a growing need among Bangladeshi women seeking care at her clinic in Hamtramck. Noor is the medical director at the Children’s Clinic of Michigan.

“It’s hard for them to go elsewhere to a provider who maybe is not Bangladeshi and hope that they have the same level of understanding of what their needs are and everything that they’re dealing with at home,” Noor said.

As a Bangladeshi-American she understands the struggles firsthand of the women who come to the clinic. That’s why she’s working to close the cultural gap in health care.

Many Bangladeshi women are stay-at-home mothers, often prioritizing their families over their health.

“But they’re missing out on their screenings, like pap smears, and they’re missing out on mammograms, and they’re missing out on this routine screening for diabetes and high cholesterol and high blood pressure,” she said.

Noor says language is another way she can connect with her patients. She speaks multiple Bangla dialects and says that can make a world of difference in treatment and care.

“When they’re able to tell me something in their native language, in their first language, versus if they were telling me something in English, it’s a night and day difference and then it’s like, we go from 10% to like, 110%,” she said.

Seeking primary care in the Emergency Room

Dr. Tabtila Chowdhury is a resident doctor at Henry Ford Health in Detroit. She frequently sees Bangladeshi women in the ER. Many arrive with untreated conditions because they don’t have a primary care physician.

“They’ll come in for the headache, but then they’ll be like, ‘Oh yeah, my blood pressure, your sugar’s been high. And then also, in Bangladesh, I used to take this, like, one medication for, like, you know, seizure-like activity,'” she explained, adding that many new Bangladeshi immigrants only have emergency health insurance and do not have a primary care doctor to manage their daily maintenance medication.

Chowdhury says she sees one or two people per shift with similar concerns. She says many times Bangladeshis have atypical symptoms of illnesses, which can put them at further risk.

For example, they might feel stomach pain and acid reflux for heart attack symptoms. Chowdhury sends them for an EKG if they have such symptoms.

Chowdhury says she feels a responsibility to go the extra mile to take care of her Bangladeshi patients.

“I make it a fact when I’m working, I always pick up all the Bengali patients, and I do a much better, more in depth, just like, dive into, their health care because half the time, people can’t even explain what’s going on with them,” she said.

Health literacy, comprehension and advocacy

Rumyah Rafique has had similar experiences at The Health Unit on Davison Avenue, where she’s a medical interpreter. She offers her services to Bangladeshi patients, finding that women are more receptive to female health care providers.

“I usually can tell if a patient is Bangladeshi, and I always let the provider know that if this is a patient that needs interpretation, that I am a qualified interpreter, that I’ve done this type of work, and that I’m more than willing to provide that service for this patient,” she said.

Rafique sees firsthand how cultural barriers can impact care for people with diabetes. According to the National Institutes of Health, South Asian patients are three times more likely to get diabetes.

Rafique says Bangladeshis have a rice-heavy diet, which leads to diabetes.

“Diabetes runs rampant in our communities, and I think that a lot of people don’t understand the concept of rice being a carbohydrate,” she said.

Rafique says having a family advocate in the room is also another important element to health care for Bangladeshi women.

“Our cultures are very communal and very family-oriented, and it’s a little bit different from the Western idea of individualism, and I think that that makes it difficult sometimes for Bangladeshi women who want to have their family as a part of their care,” she said.

Rafique says while women rely on male family members for transportation and interpretation, they need to advocate for themselves, especially when it comes to sensitive topics like reproductive health.

She says that’s not unique to Bangladeshi culture, however, it can be a challenge.

“That balance is really difficult for a patient to navigate, how do I make sure my needs and wants are being heard by my physician, how much I want, say my husband or my brother or my father to be a part of my care, versus, those things to remain private,” she explained.

Bangladeshi-American health care workers like Noor, Chowdhury and Rafique are stepping up to provide culturally competent care and bridge the gap, by understanding the sensitivities and the lifestyles of Bangladeshi women.

However, they also say there should be more health care education for non-Bangladeshi providers to create culturally sensitive services for this population.

The non-partisan Congressional Budget Office estimates lawmakers cannot reach spending targets set in the recent budget proposal narrowly-passed by the U.S. House without cuts to the federal portion of Medicaid.

GOP members of Congress are searching for cost savings in order to pay for President Donald Trump’s tax cuts and border security agenda.

Concerns over potential cuts to the joint federal-state entitlement program, which provides medical coverage for roughly one out of every five Americans, sparked nationwide protests this week.

About 100 unionized health care workers and others who say they depend on Medicaid payments demonstrated outside the Warren office of Michigan Republican Congressman John James on Wednesday.

He wrote on X earlier this month that the GOP will always protect Medicaid.

James blamed Democrats for having spent years “burdening a system that will allow for its collapse,” while vowing to ensure Medicaid coverage for those who “rightfully paid into their benefits and our most vulnerable.”

But James’ Democratic colleague, Michigan Congresswoman Rashida Tlaib, argues the GOP is still targeting Medicaid funding.

Tlaib said the threat is so strong it compelled her to take the rare step of joining the demonstration outside James’ office, in a Congressional district miles away from her own.

Listen: Michigan Congresswoman Rashida Tlaib says Medicaid cuts would ‘devastate’ families

The following interview has been edited for clarity and length.

U.S. Rep. Rashida Tlaib: I’m here because Medicaid cuts would devastate so many of my families in my district. If John James could just join us and choose to help the families in the community he represents, the Macomb and Oakland County residents that rely on Medicaid. Especially parents with special needs kids and the huge number of mothers who depend on prenatal care through Medicaid. I’m here to urge him to choose the people that elected him, not Trump or Elon Musk. All of us will have his back if he chooses to do the right thing. We just need three to four Republicans to join us and we’re hoping that Congressman John James changes his mind and doesn’t cut Medicaid.

Quinn Klinefelter, WDET News: What do you mean specifically by needing three or four Republicans to join you?

RT: It’s the difference between Democrats and Republicans in the U.S. House and Congress. The Republican majority is very small and we know that many of our Republican colleagues have constituents who depend on Medicaid, including one in California where over 60% of his residents rely on it. So this is not about Republicans or Democrats, it’s really an issue of access to health care coverage for those that are ill or those that have special medical conditions. John James’ district is one that would be hit very hard if Medicaid cuts were to go into effect. Yet he voted to approve the House Energy and Commerce Committee cutting $880 billion in costs over the next decade. That committee oversees health care, Medicare, Medicaid, the Affordable Care Act. He did it with no hesitation. We’re here to remind him this would actually devastate his community, not just communities like mine.

QK: There had been talk for a long time that politicians should stay away from entitlements, period. That wasn’t something you touched. But now, when Republicans say they’re trying to find cost savings and that there’s not many other places to look except entitlements, what is your reaction?

RT: Have they looked at the Pentagon budget, the Pentagon budget that hasn’t passed seven audits in a row? You’re talking about almost 15% of the federal budget coming from the Pentagon budget. The defense contractors, the military defense complex, has been draining our public tax dollars. If they can’t pass an audit, why didn’t you start there if you’re talking about efficiency? Why would you go to Medicaid and the Department of Education and so many of these vital, important services for our families? Without the food assistance, without Medicaid, without special education programs through our public education system, their lives would be devastated. You have folks that are gaslighting the public and saying that this is supposed to be some sort of cost-saving. It’s not. It’s them wanting to deteriorate any sort of public programs that help our families so they can privatize. And if you listen to the public, they would have told you, “Don’t touch Medicaid.” You promised not to touch it and you did. You voted for an almost $1 trillion cut to health coverage.

QK: You mentioned during your speech here that your phones have been blowing up with calls from people. After the recent stopgap funding measure was passed by Congress, there were some people who said they didn’t think Democrats were “standing up” enough against President Trump and the Republican majority. That Democrats should take other actions beyond what they’re doing right now. Again, what’s your reaction those kind of comments?

RT: I mean, I’m here. I’m doing everything I can, even if it means me having to join John James’ residents here or pushing back against billions of dollars in cuts for veterans’ health care in that so-called temporary budget, the Continuing Resolution. There’s health care coverage, there’s veterans care, there’s vital services that are literally on the chopping board within weeks of Trump becoming president. And this is not a choice that we should be giving Americans. We should be listening to them and understanding that if we really want to care for them, let’s figure out other ways. Let’s fix our health care system, if that’s really your true intention to find efficiency and waste. When we can organize our residents, transformative change comes from them. They can move the institution. We can put our organizing hats on, join our residents and try to give them a bullhorn. And that’s what we can do with the power of our letterhead, the power of our vote and the power to organize.

Tonight on The Detroit Evening Report, we cover the state’s efforts to form a new advisory committee of former Medicaid recipients to share their experiences; Detroit’s 67th annual St. Patrick’s Day Parade and more.

Subscribe to the Detroit Evening Report on Apple Podcasts, Spotify, NPR.org or wherever you get your podcasts.

Former Medicaid members sought for new committee

The Michigan Department of Health and Human Services is recruiting former Medicaid recipients from across the state to join its new 15-member Beneficiary Advisory Council. The group will be tasked with identifying barriers to accessing Medicaid services, addressing the social elements that affect health for recipients and making policy recommendations to MDHHS leadership.

Those selected to serve on the committee may receive compensation for their time and reimbursement for childcare and respite services. Applications are due by 5 p.m. on April 14. Questions about the application can be emailed to MDHHS-BAC@michigan.gov.

Related: Michigan Health and Hospital Association CEO says protecting Medicaid protects Michigan

MESP College Savings Program celebrates 25 years

The Michigan Education Savings Plan’s 25th anniversary is this year and it’s offering new benefits to celebrate. The ‘5-29’ savings plan lets people put money aside for college, vocational training and some other educational expenses. Starting next month, those funds can also be used to cover apprenticeship costs and to repay up to $10,000 of student loans. The new benefits align Michigan 529 programs with many national savings programs and are made possible by state legislation passed last year.

Michigan Ukrainian refugees in limbo

Thousands of Ukrainian refugees who migrated to Michigan to escape the war are bracing for possible deportation, after recent reports that the Trump administration will revoke their legal status.

President Donald Trump announced last week that he will soon decide the fate of the roughly 240,000 Ukrainians who fled the conflict, following a Reuters report announcing his administration’s plan.

Detroit’s annual St. Patrick’s Parade returns

Corktown will host the 67th annual Detroit St. Patrick’s Parade this Sunday, March 16, beginning at 1 p.m. at 6th Street and Michigan Avenue. The parade, which features floats, marching bands, pipe and drum bands, and so much more, has brought together people to celebrate Detroit’s rich Irish heritage for over half a century!

Do you have a community story we should tell? Let us know in an email at detroiteveningreport@wdet.org.

Medicaid funding has been in the headlines recently as the Trump administration has said they aim to cut “waste, fraud and abuse” from the program. This week on MichMash, host Cheyna Roth and Gongwer News Service’s Zach Gorchow spoke with Michigan Health and Hospital Association CEO Brian Peters about how vital Medicaid is in the state.

Also, another Democratic candidate has entered Michigan’s 2026 gubernatorial race. Michigan Lt. Gov. Garlin Gilchrist has thrown his hat in the ring as a contender for the seat. Roth and Gorchow discuss how Gilchrist fares against his competition. 

Subscribe to MichMash on Apple Podcasts, Spotify, NPR.org or wherever you get your podcasts.

In this episode:

• How Congress’ decision on Medicaid could affect Michigan
• Michigan’s two Medicaid programs
• Michigan Lt. Gov. Garlin Gilchrist entering 2026 race for governor

Earlier this month, U.S. House Republicans adopted a budget plan instructing the House Energy and Commerce Committee — which oversees Medicare and Medicaid funding — to cut spending under its jurisdiction by $880 billion.

Roth pointed out the confusion around what exactly could be cut, as the latest budget resolution calls for cuts so significant there is no way Medicaid could not be severely impacted.

Peters says Medicaid has become a critical component of the health care ecosystem, both in Michigan — where roughly a quarter of residents are covered by Medicaid — and nationally.

When Michigan expanded Medicaid to residents with an annual income at or below 138% of the federal poverty level — known as the Healthy Michigan Plan — many Michiganders got access to health care they may have not been able to afford otherwise.

“[Medicaid] allows people to access care in such a way that they can potentially nip health care problems in the bud, in other words, seek primary care, preventive care, prenatal care….so that we don’t have health care issues that continue to worsen,” Peters said.

Peters noted that while both the House and Senate are considering how to approach the suggested cuts, he doesn’t see Congress coming to an agreement yet based on what has been put forth in either chamber.

“We are in the second inning of a nine inning baseball game here; this process is very early, but at the end of the day, we are ensuring that [our] voice is heard,” said Peters. “That voice is saying very loudly: We cannot slash and burn the Medicaid program.”

–WDET Digital Editor Jenny Sherman contributed to this report.

More from WDET:

• Detroit Evening Report: State program aims to improve mental health services for Medicaid, Medicare patients
• Detroit Evening Report: State waives Medicaid waiting period for green card holders
• Detroit Evening Report: Gilchrist declares candidacy for governor; panel to highlight women in hip-hop, design + more