Public Health

Midwife Works Hard For Moms And Babies In Washington

There are so many ways to make a living, but one of the most challenging may be working to reduce infant mortality in the inner city.

Take a look at a typical day for Lisa Uncles, a certified nurse-midwife who's the acting clinical director of the Family Health and Birth Center in Washington. She's one of three people profiled in an NPR multimedia feature called "The Way We Work" for Labor Day.

A Baltimore native, Lisa Uncles used to be a chemist. She entered nursing school while living in the US Virgin Islands and later earned her midwifery certificate from the Frontier School. She's a "Frontier midwife," she says proudly.

Uncles spends her days shuttling between the birthing center, located in one of the poorest neighborhoods in the northeast part of the city, and nearby Washington Hospital Center, where she has admitting privileges. About 70 percent of patients give birth in the hospital, mostly by choice, Uncles says. No epidurals are used at the birth center.

The center has been tracking how the mothers and babies do since it was founded in 2000, and the results look promising. The clients have far fewer premature births, low birth weights, and cesarean sections as compared with the city's African-American population overall. Uncles says this translates into major cost savings. Most of the women are on Medicaid.

As the Washington Post reported back in 2007, the center has had its share of financial woes. Its founder, the 82-year-old midwife Ruth Lubic, continues to be a driving force.

She chose the nation's capital as the site because she knew it would be a challenge. Washington's infant mortality rate is well above the national average. If Lubic could achieve good results with mothers and babies here, she figured she could convince lawmakers, insurance companies and others that it could be done elsewhere.

Now, nearly a decade into her crusade, she's still at it, advocating for their model of care, and pushing for changes to the health-care system that would make it easier to replicate across the country.

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