The Family Health and Birth Center--a nurse-midwife-managed center in Washington, DC.

The Family Health and Birth Center (FHBC) is a family- and community-centered collaborative partnership designed to address the needs of women and families in the geographic area known as Ward 5 in Washington, DC. This community is predominantly low-income and African American; however, in recent years, a growing Latina and middle-income white population have sought out FHBC's services. Based on the midwifery model, FHBC provides prenatal care and midwifery-supported and -attended births in the freestanding birth center or at the nearby Washington Hospital Center. Through the collaborative partnership housed in a former supermarket and known as the Developing Families Center (DFC), FHBC works closely with the Healthy Babies Project and the United Planning Organization's Early Childhood Development Center. The aim of these partnerships is to provide midwifery-supported prenatal and birthing care within a framework of understanding the social context of health care. Together, the DFC/FHBC collaborative partnership provides a comprehensive system of health care for this predominantly underserved population. The purpose of this article is to highlight the FHBC--our perspective on the history of the founding of this center as a nurse-midwife-led model of care. Included in this issue is a comparative case study conducted by Palmer et al at the Urban Institute that systematically contrasts the care provided by three different models of maternity care serving low-income African American women in Washington, DC. Using qualitative methodology, the study analyzes the content and delivery of care, and the cost-effectiveness of FHBC as compared to a large city hospital and a federally qualified health care center. Study findings indicate that the combined elements of nurse-midwife-led maternal and child care with a focus on the social and educational context of pregnancy, birth, and infant/toddler better meet the needs of the population than do the comparison models.