The $434 million hospital, Cedar Hill Regional Medical Center GW Health will bring the long-awaited return of comprehensive maternal care in Southeast D.C.
By Jenna Portnoy Jenna Portnoy is the local health reporter for The Washington Post.
Mia Mack delivered her first daughter via Caesarean section after 17 hours of labor at MedStar Washington Hospital Center. A few days after surgery, she went home, but the baby wasn’t quite ready.
So, fresh off major abdominal surgery, Mack slid behind the wheel and drove to the hospital — a 30-minute drive, without traffic, across town from her home —every day for a week to see the newborn, against her midwife’s advice to rest.
“As a new mom or a mom, period, you’re going to go every day,” Mack said.
Her second baby, another girl, is due next month.
For pregnant people who want to or must deliver their babies in hospitals — instead of at home or in a birthing center — there are zero options to do so in two of the city’s poorest areas, Wards 7 and 8, where one-third of D.C.’s children live.
That is about to change. A new $434 million hospital, Cedar Hill Regional Medical Center GW Health, is coming to Congress Heights next year, bringing with it long-awaited and much-needed comprehensive maternal care east of the Anacostia River.
Plans include labor and delivery rooms to bring new Washingtonians into the world and obstetrician gynecologists to treat patients during and after pregnancy. The full scope of care is vital to improving maternal mortality outcomes in the District, which are on par with national statistics and reflect stark disparities by geography and race.
About half of the births in the District are by Black people, but they account for 90 percent of pregnancy-related deaths, according to city data from 2014 to 2018, the most recent years available. About a third of births in the District are by White people, but they account for none of the pregnancy-related deaths, the data shows. Newer figures will come out next year, officials said.
One in seven pregnancy-associated deaths occurred in pregnant people in Wards 7 and 8, compared with none for residents of Wards 2 and 3, the data shows. (A pregnancy-related death occurs from a pregnancy complication, while a pregnancy-associated death occurs regardless of the cause.)
With the hospital prepared to open in as little as three months, elected officials, community health-care providers and residents are pressing hospital leaders to explain not only what clinical services will be offered but also how they will meet patients’ complex social needs in a culturally competent way.
Prenatal care won’t be as effective if patients can’t access healthy food or a safe place to sleep, clinicianssay.
Anthony B. Coleman, chief executive of Cedar Hill hospital, referred questions about operations to a spokeswoman for George Washington University Hospital, whose parent company will run the hospital. The spokeswoman declined to answer questions about how the hospital will gain the trust of patients in the community it was built to serve.
Coleman has spoken about the plight of Black women.
“I obviously came from a woman, a Black woman, who I love very much,” he said this fall at a meeting of the Anacostia Coordinating Council. “I have a Black sister and a Black daughter, and so when I come to Ward 7 and 8 and I talk to people, I see my family. … We have to see it that way because we are our own community, and if we don’t force people to speak to our needs like we’ve done with this hospital, nobody else is going to care.”
Jaren Hill Lockridge, chair of the Ward 8 Health Council, said she knows firsthand what research shows: giving birth close to home is healthier for the pregnant person and the baby.
Lockridge drove an hour each way to Sibley Memorial Hospital in Northwest Washington every two weeks and then every week to see a maternal fetal medicine specialist for her high-risk pregnancy with her now 6-year-old twins. The girls were also born at Sibley. At a recent D.C. Council hearing on Cedar Hill, she wanted to know one thing: “When can we have babies in Ward 8 again?”
“I take it really personally as a mother, as a wife, as a daughter, as a person that takes care of the regular folks,” she said. “I don’t have people who work for me. It’s just us trying to figure out how to connect dots in the health-care community. … We have questions that have not been answered.”
Residents have reason to be skeptical. The only hospital east of the river, the public United Medical Center, has been plagued by problems for years and closed its labor and delivery rooms in 2017 after damning reports about mistakes hospital staff made while treating pregnant women and newborns, The Washington Post reported.
In one case, staff did not take steps to prevent HIV transmission from a mother to her newborn. In another, they did not properly treat an obese woman who was pregnant and came to the hospital with trouble breathing.
Babies are still delivered in UMC’s emergency department when there is no other option. The hospital will close once Cedar Hill opens.
Mayor Muriel E. Bowser (D) has said she wanted to build the new hospital to ensure that such failures never happen again and to absolve the city of the financial and other responsibilities for delivering health care.
Since the District took over UMC in 2010, taxpayers have spent more than $300 million on operations and capital costs, a financial sinkhole that sent city officials in search of a more sustainable option. They tapped Universal Health Services, the corporate parent of GW University Hospital, the academic medical center in Foggy Bottom.
“Everybody said we couldn’t do it,” said Wayne Turnage, deputy mayor for health and human services. “Wouldn’t happen. You wouldn’t find an operator. And we did. We not only found an operator, we found an operator of one of the best hospital systems in the country.”
D.C. will cover Cedar Hill’s losses in the first 10 years up to a total of $25 million, and the corporate parent can buy Cedar Hill outright in 10 years’ time, Turnage said. In exchange, the company will pitch in $75 million for the hospital, urgent care and a forthcoming freestanding emergency department, he said.
The deal represents a once-in-a-generation opportunity for the city to make good on promises to the predominantly poor and Black residents east of the Anacostia River who have been marginalized by the nation’s legacy of systemic racism in transportation, employment and housing, D.C. officials say.
Mia Mack, 29, the pregnant Southeast D.C. mother, recalled the birth of her 8-year-old daughter Sage with a shy smile. A week after her due date, doctors induced labor and she pushed for 17 hours before both Mack and her baby’s heart rates started to drop. An emergency C-section was her best option, they told her.
A midwife from Community of Hope stayed by her side through the birth and afterward.
Certified nurse midwives, physicians and care coordinators at Community of Hope, a federally qualified health center with a clinic less than two miles from the new hospital, have worked hard over many years to build trust with patients through compassionate care and arranging for newborn necessities like car seats and bassinets. When it’s time to deliver, they generally meet mothers at MedStar Washington Hospital Center.
“She was great,” Mack said of her midwife. “She talked me through the whole thing, I was crying and everything. She was like, ‘You’re fine, you’re going to be okay, you got this.’”
D.C. Council member Christina Henderson (I-At Large), chair of the health committee, urged Coleman in a letter this fall to work with providers in Wards 7 and 8, like Community of Hope, to ensure a smooth transition when Cedar Hill opens. Doctors in the neighborhood have urged hospital officials to establish policies around admitting privileges and plans for patient care after discharge.
Kim Russo, chief executive of GW Hospital, has said such partnerships are critical to creating a true continuum of care, including preventive care. A governing board must be named and other criteria met before credentialing with community providers can happen, she said.
“[Cedar Hill] is a hospital,” she said at the council hearing. “It is not the only solution. It’s not a silver bullet.”
The maternal care facilities, however, are set, Coleman said. The hospital will have four labor and delivery rooms, two C-section rooms and 14 post and antepartum rooms, for observation and recovery. Children’s National Hospital will run the pediatric emergency department, nursery and neonatal intensive care unit.
Hospital officials declined to say whether a maternal fetal medicine physician will have hours at Cedar Hill. Those specialists treat pregnant people with high-risk pregnancies due to complications such as age, history of hypertension or miscarriages. A maternal fetal medicine doctor sees patients once a week at the Community of Hope clinic in Ward 8, but otherwise patients east of the river have limited access to that care close to home.
At the hospital groundbreaking in early 2022, city officials said they anticipated that 2,500 new Washingtonians would be born at Cedar Hill in its first year. Hospital officials said they have a plan to spread the word before opening day, including an open house.
Mack, whose daughter is due in January, said she hasn’t heard anything about the new hospital and is focused on managing the joys and discomforts of growing a baby.
At Mack’s 28-week appointment, midwife Cassandra Burrell burst in cracking jokes: “Feel my hands. Are they too cold to touch your belly? My last lady jumped off the table.”
She gently placed her hands on Mack’s belly and used a handheld fetal monitor to feel around for the heartbeat. Humm, went the machine.
“Hey boo!” Burrell said to Mack’s baby. “What you doing? She said, ‘Minding my business.’”
As the baby grows, kicks and jabs will shift to rolling movements, she said. Humm. She asked Mack about mood changes and asked her to fill out a routine depression screening. Humm. The trauma of the stabbing death of her daughter’s father could resurface any time. Mack works full time as a certified nursing assistant and is in school to be a medical assistant.
The baby could be upside-down, sideways, or — Whoosh whoosh. Whoosh whoosh. The heartbeat filled the room, strong and steady.
“There she is,” Burrell said. “130 [beats per minute]. Perfect.”
