In the United States, maternal health challenges remain significant nationwide, with chronic conditions such as hypertension, diabetes, depression, and more increasing the risk of severe maternal complications. Mary’s Center, a Community Health Center in Washington, D.C., confronts these challenges through rapid response, innovation, integration, patient-centered care, and service workers such as doulas and midwives. These strategies not only improve outcomes for mothers and children but also strengthen families and communities.
In 1988, in a basement in Adams Morgan, a neighborhood in Northwest Washington, D.C., a visionary nurse named Maria Gomez launched Mary’s Center with a simple yet powerful goal: to ensure immigrant women fleeing violence and poverty had access to prenatal care. What began with a $250,000 grant from then DC Mayor Marion Barry to serve 200 pregnant women has evolved into a thriving network of five full-service community health center sites across DC and Maryland.
Today, Mary’s Center supports over 65,000 individuals annually, regardless of insurance status, while remaining steadfast in its commitment to provide high-quality care for the entire family with an emphasis on maternal and child health. There are layers of components that make Mary’s Center organization distinct from others, and that starts with community understanding.
Jessica Laycock, Communications Manager at Mary’s Center, shared, “We were founded to fill a void in care for women and children. And we’ve stayed grounded in that, but we’re always evolving, finding new ways to bridge ongoing gaps in care.” Mary’s Center is a Federally Qualified Health Center (FQHC, also called a Community Health Center) that provides integrated services, focusing heavily on maternal and child health (MCH). Pregnant women are prioritized, children are safeguarded, and families are embraced.
Rapid Response at Mary’s Center
A key strategy that positioned Mary’s Center at the forefront of leading the MCH charge in DC is being able to have a rapid response at times of uncertainty. Mary’s Center staff sprang into action and contacted patients in the district via text messages about the expected changes to take place within the DC Healthcare Alliance (HCA). The DC HCA Program is a locally funded program designed to provide medical assistance to District residents who are not eligible for Medicaid. DC HCA serves low-income adults who have no other health insurance and are not eligible for Medicare.
Some expected changes to take place within DC HCA included, but were not limited to, timeline changes, eligibility criteria updates, and freezing DC HCA enrollment for adults over the age of 26 at current levels, which affected pregnant women’s access to care. DC HCA initial eligibility and coverage cuts took place on September 30, 2025, when adults aged 21 and older with incomes above 138% of the FPL would lose their coverage. In Washington, DC, pregnant women can receive comprehensive Medicaid coverage, known as DC Healthy Families, for prenatal care, labor, delivery, and postpartum services for 12 months after delivery if their household income is at or below 319% of the Federal Poverty Level (FPL). While DC HCA has not entirely sunset yet, eligibility changes will force people out of the program, the majority of which already do not qualify for Medicaid.
Maternal and Child Health Innovation at Mary’s Center
The second strategy Mary’s Center pursued was innovative partnerships, such as grant-funded programs that provided pregnant women with transportation services through Uber to their doctor appointments. It allows expectant parents to have a reliable way to get to their appointments, making it possible for D.C residents to attend routine check-ups and their prenatal and postpartum services. As Mary’s Center saw a lot of success related to fewer no-show appointments and patient outcomes, there was unfortunately a lack of sustainable funding to keep this initiative for patients. This is a common challenge for many health centers that use limited grant funding to support essential patient services, and health centers need an increase in federal funding to support important patient activities.
Integration, Patient Centered Care, and Service Workers
The third strategy Mary’s Center utilized to confront the challenges in maternal health in the District of Columbia is their commitment to integration, patient-centered care, and service workers such as doulas and midwives. Beyond clinical services, Mary’s Center is committed to providing integrated and patient-centered care that supports pregnant women’s full life experience. From language access, primarily English and Spanish, to behavioral health integration, Mary’s Center model of care ensures patients, such as pregnant women, are treated as a whole person and not isolated conditions.
Research shows that first-time mothers giving birth at medical centers where midwives were on their care team were 74% less likely to have their labor induced, 75% less likely to receive oxytocin augmentation, and 12% less likely to deliver by cesarean than their counterparts at medical centers without midwives in attendance. Childbirth Service workers, such as doulas, CPMs, and midwives, have the ability to lower rates of cesarean births, induction, and episiotomy, higher rates of breastfeeding initiation, and greater patient satisfaction.
What’s Next for Mary’s Center?
Despite their innovation, Laycock points out that federal barriers continue to pose challenges in the maternal health space in both Washington, D.C., and Maryland. In Washington, D.C, the city budget remains subject to congressional oversight and approval. Still, efforts persist to ensure health centers are recognized and included as a critical part of the solution to addressing gaps in maternal health across the district. “The threshold to prove the value of Community Health Centers is higher than that of hospitals,” she says. “We’re not always seen as essential, even though we are.”
Mary’s Center works to ensure that pregnant women, new parents, infants, and children up to age 5 receive services they need by providing breastfeeding counseling, nutritional education, and healthy food access through an eWIC card system with over 51,000 enrollees, i.e., “Whole-person care is more than prescriptions,” Laycock says. “But without sustainable funding, it’s difficult to keep those roles.”
Looking Ahead
With so many programs and so much need, what keeps the team at Mary’s Center going? Laycock responded with no hesitation that community impact does. Through rapid response, innovation, integration, and patient-centered care, Mary’s Center has and continues to tackle the gaps in the maternal health space. Every year, they track patient outcomes, from healthy birth weights, and use the data to improve maternal health in the district. They seek inspiration from partners in the community and celebrate the word-of-mouth referrals that bring pregnant women and their families through their doors. A center that began with a nurse, a dream, and a grant to serve 200 pregnant women is now a cornerstone for maternal healthcare access in DC and Maryland.
As funding tightens and the political climate tenses, the need for integration, patient centered care and rapid response grows more urgently. Jessica Laycock puts it best, “We’re here to fill in the gaps. And as long as those gaps exist, we’ll keep showing up.” NACHC provides the best resources for health centers across the country for maternal health. NACHC has worked closely with healthcare providers, public health professionals, and researchers across the country to develop comprehensive resources to help health centers improve the quality of pregnancy and postpartum care. This includes collecting patient stories and experiences while receiving pregnancy and postpartum care, establishing goals for care transitions, and continuous quality improvement.
For over 60 years, health centers like Mary’s Center have provided individuals and families across the United States with comprehensive, affordable, community-centered, and high-quality primary care, including a host of healthcare services that support maternal health and family medicine for medically underserved populations prior, during, and post-pregnancy.