The writer is executive director and co-founder of Mamatoto Village and a Groundswell Fund grantee partner.
Recently, the D.C. Department of Health closed the maternity ward of the city's only hospital east of the Anacostia River. You would think that maternal-health advocates, including me, would be more upset about this news, but we aren't. United Medical Center was failing women long before the shutdown.
We have two Districts now, and they are drifting further and further apart. In one, women and babies are virtually assured to survive childbirth. In the other, the struggle to find secure housing, food and jobs complicates pregnancy, putting women at greater risk of suffering injury or death during childbirth or in the postpartum period.
We need to go beyond UMC and address the District’s citywide perinatal-health crisis and policies that for generations have allowed resources to flow into one part of the District while starving the other.
Unfortunately, this situation is not unique to the District. The rates of death during childbirth are increasing nationwide. And in the District, we face two intertwined problems: underfunding of city hospitals serving black, Latina and immigrant women and homelessness resulting from development and gentrification.
Nearly 7,500 people are homeless in the District today. And new mothers are particularly vulnerable to housing insecurity as housing needs change quickly with a newborn, and workplace discrimination makes finding or keeping employment a challenge.
Mamatoto Village in Northeast serves hundreds of women of color and their families every year, supporting them through pregnancy and birth and into motherhood. One of the biggest problems we see facing black women who come through our doors is homelessness and insecure housing.
Rents around the District are skyrocketing. Luxury apartment buildings are booming across the city. Black residents seem to be most affected by gentrification, but housing resources to help them are dwindling. When a pregnant or new mother's basic needs for housing, food, safety and security are not met, her stress is amplified. Pair that with subpar maternity care, and we have a recipe for adverse perinatal outcomes for mom and baby.
Closing UMC's maternity ward was a Band-Aid on an ax wound. As former D.C. Council member David Catania said, "It's time to acknowledge United Medical Center is beyond redemption on its own."
Wherever women of color do give birth, they should be treated with dignity and respect and provided culturally empathic care. Women entrust hospitals with the well-being of their babies and their own physical and emotional health.
The District has a responsibility and must be held accountable for the type of care provided and the resulting outcomes. Women of color have the same rights as all other women to obstetrical care that centers on mother and baby, accounts for the social issues that affect the mother’s health and does not devalue her based on economic disadvantages.
Mamatoto Village delivers preventative health and perinatal support services to expectant and new mothers in high-need areas. We coordinate care and help mothers navigate services throughout the city. We also help meet the needs of mothers with limited social-support systems, hard-to-reach mothers and those with complex emotional, psychological and social needs. Critical pieces of our efforts to improve perinatal health outcomes are coordination with primary-care providers, bridging gaps in communication and instilling lasting health knowledge.
We have to face the music on what decades of underfunding have done to D.C.’s black residents. We have to rebuild hospitals that have been neglected for too long and consider sustainable, innovative models that we could replicate throughout the District. A large part of that is improving maternal services and delivery care for mothers in need.
Despite the challenges, we hope for equal investment across the District. We hope the systems and services our communities need most are justly prioritized. We hope the lives of women of color and their babies will be seen as valuable and deserving of evidence-based care. Finally, we hope that resources will be appropriately reallocated to UMC to reposition it as a health-care system that exhibits excellence, professionalism and expertise.
When we collectively see the delivery of safe and respectful health care as a human right for all District residents, we can make our city one of the best places to give birth.
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