A Labor Without End

Ruth Lubic, a champion of midwifery, surrounded by some of the children born through her D.C. Family Health and Birthing Center. (D.A. Peterson)

"Unfortunately, our model works on an 80-year-old woman bringing in $500,000 a year," says Jolles, 32, who became the center's director last spring and has taken on many of Ruth's administrative responsibilities. "The world can't run like that. She's the only Ruth. I definitely can't do it like Ruth does it."

Ruth is well aware of her own mortality. When she had her condo renovated recently, she ordered the biggest black knobs she could find for her honey-colored kitchen cabinets. "When you get older, your fingers have trouble," she says. She frowns and opens her palms, stretching her fingers. "Before, I made my body do what I wanted it to do. Now I have to listen to it."

Though she doesn't have any major health problems, her mother and sister both suffered fatal strokes in their early 80s, she says. She talks frankly about the need to get the clinic on stable ground before she dies.

"What I don't want to see is, the founder has a stroke, and everything falls apart," she says. "I want the thing to live. It's more important than I am."

TO ENTER THE BIRTH CENTER ON 17TH STREET NE, visitors must be buzzed in. A camera is pointed at the entrance. Last year, four people were shot to death in the surrounding neighborhood, which has long been known as "Little Vietnam" because of the violence. The building that houses the birth center is painted lavender to project a sense of calm. Inside on a cold January afternoon, seven women, their pregnant bellies stretched tight under their T-shirts, have settled on a futon and cushioned chairs. They munch on pretzels and carrot sticks that have been set out. The cozy room isn't well-heated, and the ceiling fan is spinning on full blast. Even so, all the women have their coats off.

When midwife Lisa Uncles walks in, she gasps: "Y'all are hot?"

"You have a room full of pregnant women in here," someone responds, and the group bursts into laughter.

This is the biweekly meeting of women who are due to deliver in March. A couple of them will have their babies in the birth center's bedrooms. The others will be attended by the midwives at Washington Hospital Center.

The logistics of poverty make it hard for women to deliver at the birth center, Jolles says. Most don't have cars or know someone who can drive them there after their labor starts. Cabs can be hard to come by in Northeast and Southeast Washington, especially at night. Many women have to rely on ambulances, which will take them only to a hospital. Some have to give birth in a hospital because of weight problems, diabetes or other health issues that could require a doctor. Others are simply scared of giving birth without painkillers.

That's not the case for Kisha Lindsey, a 26-year-old inventory clerk who is planning to deliver her second child at the birth center. She says she likes the center's informality and treasures the midwives who are "so nice and good, oh my goodness." Their care is particularly meaningful for this birth. Her child's father won't be in the delivery room; he is serving a three-year prison sentence for a crime that Lindsey doesn't want to detail.

Another woman in the group is having her fifth child. Yet this delivery, she tells the other mothers, will be the first "that I'll have someone who cares about me in the room." She is engaged to be married, and her fiance's mother threw her a baby shower, another first for her. It is a marked difference from her last pregnancy; that child's father had threatened to kill her, she said. She still has a court protective order against him and doesn't want her name used because she is afraid of provoking him.

Autumn Wilson listens to the other women with a mixture of fascination and admiration. A 26-year-old yoga instructor, she is one of a handful of the clinic's middle-class clients and the only white woman in this support group. She had her first child at the Maternity Center in Bethesda, but she came here for her second baby because she heard the D.C. center was more intimate.