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Midwife Seeks to Reduce Infant Mortality With Unique 'One Stop Shop' - 2003-02-25

At 76, most people have retired. But Ruth Watson Lubic, a midwife, is far from done with her life’s labor. The winner of a MacArthur Foundation grant, given annually to people who are visionary creators in their fields, Ruth Lubic is working to reduce infant mortality in inner city America.

Most Sundays, New Yorker Ruth Watson Lubic kisses her husband goodbye and heads out for her workweek, four hours south in Washington, D.C. In 1993, the 76-year-old nurse-midwife received a so-called “genius” award from the MacArthur Foundation: $375,000, to use any way she chose.

Ruth Lubic used the money to build her dream: a one-stop birth, health and daycare center in the inner city of the U.S. capital. It’s a poor area, where despite recent improvements, health officials say the black infant mortality rate remains twice the national average. That’s one reason Ruth Lubic chose Washington for the center. Another motive was political, she explained to a visitor in 2000, during a tour of the center when it was under construction.

“The Congress is here,” she said, “and we’re eager to be in a place where the Congress will come and see and maybe make it possible for this to happen in multiple other places.”

Ruth Lubic found partners in two established Washington programs: Dolores Farr, then head of the Healthy Babies Project, and Travis Hardmon, who runs a city-wide daycare organization.

And late in 2000, Ruth Lubic’s vision was realized, when the District of Columbia Developing Families Center celebrated its opening for business, offering health care for children from the time they’re born until they’re 21 years old, and pregnancy care and delivery by midwives in home-like bedrooms.

“This is for labor and birth if the mom decides she wants to birth here,” she told a dubious male visitor, pointing to a rocking chair with a removable half-seat. “Sit down, Allen, isn’t that great?”

There’s also daycare for babies as young as six weeks. “And so we have this one-stop shop,” Ms. Lubic said during a tour of the sunny daycare area, where several caregivers ministered to a handful of young babies. “I think that element [daycare] that’s available here to neighborhood women, is an attraction. Because maybe they don’t know what a birth center is. Maybe they’re not so sure about midwives, as opposed to doctors. But they know they’re going to need daycare.”

Ava Harris became one of the Center’s first clients. She was healthy and expecting her first child at 24, when she visited the Center for pregnancy care and childbirth classes. But most of the Center’s clients have high-risk pregnancies, and give birth at local hospitals, attended by the Center’s midwives.

“A comparatively small percentage of the women we see are even eligible for birth in the out-of-hospital Center,” Ruth Lubic explains. “And that says something about their health. In low-income areas, you often see high rates of hypertension, diabetes, obesity, asthma.”

So, why establish a midwifery center in a poor neighborhood? Ms. Lubic says that it’s about making health services accessible, and giving clients a sense that they’re in control of their health. Women who are treated with respect tend to keep their prenatal appointments – and they also come back after delivery: for health care, day care and family education.

“They want to improve their outcomes,” she says. “They want to feel that they’re upwardly mobile. We see ourselves as change agents to help that to happen.”