After childbirth, new mothers often see a lactation specialist while in the hospital. But when new mothers from marginalized communities in Washington, DC, give birth at MedStar Washington Hospital Center, they are often visited by a culturally responsive lactation specialist from Mamatoto Village, a maternal and family health organization dedicated to providing career pathways for Black women and justice-centered perinatal care to transform health and social outcomes for Black mothers, babies, and their families.

At Mary’s Center and 10 other DC community perinatal health providers, expectant and new parents at risk for mental or emotional distress can receive perinatal mental health services on-site or be referred to experts at Children’s National Hospital through the DC Mother-Baby Wellness Program. The initiative also created a virtual training for perinatal and parent-child service providers throughout the city and met regularly to share insights and developments about perinatal health issues.

These partnerships between large medical centers and community-based providers, and many more like them, resulted from the Clark Foundation’s Parent-Child Health Initiative (PCHI). The Foundation aims for all DC families to have the support they need in their child’s first three years of life to ensure a healthy, thriving future. It’s an ambitious goal, but PCHI partners’ innovations are building the foundation for a comprehensive, integrated, culturally responsive support system for families in Washington, DC.

“When we walk into the room, and we say, ‘Hey, I’m here to support you, and I know your journey. I know exactly where you are, and I know the right questions to help you to feel comfortable enough to open up,’” said Cassietta Pringle, Mamatoto Village co-founder, International Board-Certified Lactation Consultant, and Lactation Program Manager, describing the lactation specialists who work on-site at MedStar Washington Hospital Center. “It’s honestly wonderful to see the smiles and the families’ faces change. And then they know there’s no judgment about where they live either.” Mamatoto offers home visits to new parents, and the lactation consultants are often familiar with their neighborhood and community, putting the parents even more at ease.

“Many of Mamatoto’s Lactation Specialists are former clients,” said Aza Nedhari, Mamatoto Village Co-founder and Executive Director, who also spoke of an “erosion” of breastfeeding among Black women due to their need to return to jobs that are not supportive or accommodating to lactating parents. “If we’re talking about improving breastfeeding rates, especially amongst Black women, we have to do so by people who look like them, right?” Nedhari said. “The work we are doing now is hopefully setting the trajectory for family well-being across the life course of infant and child health.”

When the DC-wide Community Network for Mother-Baby Wellness began to convene partners from around the city to improve family health outcomes, perinatal mental health training was a much-discussed topic, said Zavi Brees-Saunders, Program Director for the Clark Parent-Child Network’s Prenatal Neonatal Pillar at Children’s National. “It’s either expensive, hard to access or it’s just inconvenient,” she said, adding that just like the MedStar-Mamatoto partnership, Children’s National trusts the expertise of community health providers in its work with new parents. “Sometimes the partnership also goes both ways. Mary’s Center has more in-depth services for some things than we do, so we actually refer back to them fairly frequently for something they’re able to offer that we’re not. Certainly, for figuring out what works best and what doesn’t, we’re learning from Mary’s Center all the time. They’ve been doing this for longer than us and have been very ready and willing to share any of their expertise related as we’ve built it out.”

To date, DC Mother-Baby Wellness Program has enrolled over 1,000 new or expecting parents, and program partners have conducted more than 10,000 mental health screenings. “At Mary’s Center, identifying emotional or mental challenges is often just the first step in addressing a family’s needs, including external stressors,” said Andrea Agalloco, Perinatal Mental Health Program Manager. “Someone may be having behavioral health concerns, but if they’re also struggling to pay their rent or to figure out how to get the health insurance for their infant and they’re in the postpartum period, and that becomes a stressor for them, Mary’s Center has some ways of helping them to navigate those different stressors,” she said, including referring them to home visiting programs, WIC (Women Infants and Children) and other wrap-around services Mary’s Center offers for support.

The PCHI epitomizes Mr. Clark’s desire to use philanthropic resources to improve the lives of families in Washington, DC substantially. By bringing together perinatal providers across the city, the Foundation strives for the day that they receive the same level of support and resources regardless of where families seek care or where they live.