Real Midwives of D.C. In Washington, natural birth is big business

The three dozen parents-to-be at the George Washington University Medical Faculty Associates building on a recent Tuesday night fill the lobby’s waiting room seats and overflow onto office chairs that have been dragged into the room for the occasion. By all appearances, it’s a high-end D.C. crowd: Suits and spectacles, ages that range from the middle years of childbearing to the late ones. There’s copious note-taking about birth outcomes, labor options, and this particular practice’s set of rules—No sugar! No processed foods! Daily exercise!—for natural childbirth.

Welcome to “Meet the Midwives” night at one of Washington’s newest, most talked-about labor-and-delivery operations, a place where the admissions process can be as coveted as that of the most pedagogically up-to-date preschool.

Midwifery once evoked images of giving birth at an organic farm, but GW’s Wisdom Midwifery works in a hospital setting—low-tech and high-touch, sure, but just steps away from cutting-edge medical expertise. In an age that fetishizes slow food and iPhones, it’s a potent combination.

In its 16 months at GW, the practice has grown from one nurse-midwife delivering 10 babies a month to four of them delivering 30, the maximum their time-intensive model can handle. There are plans to hire a fifth midwife. Meanwhile, there’s a waiting list out to July, and most months already have the maximum of 10 people on the list. Some women say they call Wisdom the day they find out they’re pregnant.

Tonight, the pitch is simple: Instead of being hooked to an IV in a hospital bed, Wisdom’s moms can labor in an aqua tub, take warm showers, receive massages, and move around into different birth-facilitating positions (one of the midwives pops into a squat to demonstrate). Rather than discussing epidurals, there’s talk of raising natural oxytocin levels through yogic heart-opening. And there’s a promise that the midwife—“birth provider,” in 2011 terminology—will be on hand through it all, rather than simply arriving for the big finale.

“We’re in the business of giving women what they want,” says Whitney Pinger, GW’s director of midwifery services. “They don’t want to fight to get what they want. We are their birth plan.”

Among a network of holistic-minded mamas who chat in Washington’s yoga studios and childbirth education classes, Pinger doesn’t even need to use her last name. In online maternal message boards, her work gets described in capital letters. “I absolutely LOVE her. Whitney is amazing in every way,” gushed a member of DC Urban Moms in a recent comment. The 51-year-old certified nurse midwife is a veteran of the local scene. After running programs at Washington Hospital Center and Georgetown University Hospital, she came to GW last year, arriving like the LeBron of the up-market natural childbirth community.

You’d imagine Pinger’s practice appeals to those expecting mothers who admire her collaboration of crunchy and clinical. But at the Foggy Bottom medical center, she’s also demonstrated her standing among hospital administrators. They’ve come to see her as a practitioner who brings the sort of devoted following that allows a new practice to grow with little formal advertising.

Pinger is thus a pretty good example of how midwifery has become a significant business. She sensed the demand after she started Wisdom as a pilot project at Washington Hospital Center. It grew beyond what the facility could handle, so she looked for another home. GW bought in. (Since the move, the practice has officially been known as Midwifery Services at George Washington University Hospital.) In addition to the medical and teaching benefits, the logic went, a practice like Pinger’s also promised to bring new patients into the GW system—patients that are educated, privately insured, and likely to be making their family’s medical decisions for the next 18 or so years. That’s the sort of stuff that can make a calculator-wielding hospital administrator go all touchy-feely.

Pinger’s argument at the open house is simpler: “We have amazing outcomes,” she tells the expecting couples. “Among the best in the country.” About 95 percent of her clients deliver vaginally, 80 percent without any intervention. Wisdom’s cesarean section rate is approximately 5 percent, vastly lower than the nation’s rate of 33 percent.

It’s not just Pinger. Midwives across the area say they’re having a moment. Though the percentage of births they handle remains small—nationally, they do just 8 percent of the country’s annual 4 million births—midwives beyond Pinger’s cadre report a new interest in their service. Pinger’s former employer, Washington Hospital Center, didn’t have room to accommodate Wisdom last year, but has brought on two full-time and three part-time midwives since Pinger left; its new service can accommodate 30 women a month. “Midwifery has gone mainstream,” says Ursula Sabia Sukinik, a local doula, midwife assistant, and childbirth educator. (Full disclosure: I took a childbirth class with Sukinik earlier this year.)

In fact, demand right now seems to outpace supply. At the “Meet the Midwives” session, a woman asks about her chances of getting off the wait list. Her due date is March 30. But March, a popular time for births, has been full for months. “I’ll call myself April,” she says. It’s hard to tell if she’s joking.