What Whole-Family Perinatal Care Makes Possible

Pregnancy and birth are not just medical events. They are deeply human experiences, shaped by culture, community, history, and care. Yet for too many families in the United States, birth has become disconnected from dignity, trust, and support, with devastating consequences for parents, babies, and communities.

Forward With Families begins from a simple truth: health and well-being are inseparable from the conditions in which families live, give birth, and raise children. Nowhere is that more evident than in perinatal care. When care is fragmented, impersonal, or rooted in systems that do not fully see or respect families, outcomes suffer. But, when care is whole-family, community-held, and grounded in respect, families thrive.

Across the Ascend Community, leaders are leaning into this shift and restoring birth as a relational, family-centered experience that strengthens health and well-being from the very beginning.

Beloved Birth: A Whole-Family Model in Practice

Birth Center Equity offers a powerful example of what whole-family perinatal care can look like when it is rooted in community and guided by values. Family-centered, midwife-led, and community-held, the model honors the inherent dignity and worth of all people – before, during, and after birth.

Co-founded and led by Ascend Fellow Lesliey Welch, Birth Center Equity integrates culturally responsive midwifery and doula care with mental health support, lactation services, parenting education, and deep community connection. This approach reflects a core Forward With Families principle: families are not problems to be managed, but partners to be centered. Birth Center Equity holds birth within the context of family life, acknowledging the social, emotional, and economic realities that shape health outcomes long before and long after a baby is born.

Why Midwifery Matters for Families and Communities

The United States is facing a maternal and infant health crisis. Despite vast medical resources, outcomes for birthing people and babies – particularly Black families – lag behind those of other high-income nations. Families know this crisis is not only about access to care, but about how care is delivered and who holds it.

Midwifery-led care offers a proven, family-centered response. Research consistently shows that midwife-led models are associated with:

• Lower rates of preterm birth and low birth weight
• Fewer unnecessary medical interventions
• Higher satisfaction and trust among families
• Stronger continuity of care across pregnancy, birth, and postpartum

Birth Center Equity situates midwifery not as an alternative, but as a cornerstone of healthy systems – one that aligns clinical excellence with cultural humility, community leadership, and whole-family well-being.

The 50 by 50 Vision: A Call to Reimagine Birth Care

Birth Center Equity is advancing a bold national vision: 50 by 50, a goal that by 2050, 50 percent of babies in the United States will enter the world with the care of midwives. This vision responds directly to the reality that current birth care systems are failing too many families and communities.

The 50 by 50 goal recognizes that strengthening families’ health requires rebalancing systems toward care models that are relational, preventive, and rooted in dignity.

This vision aligns powerfully with Forward With Families commitment to lifting up integrated solutions proven to work for families. Midwifery-led, community-based perinatal care connects health to housing stability, nutrition, mental health, and economic security – not as add-ons, but as essential components of care.

Forward With Families: Health & Well-Being From the Start

Forward With Families aligns leaders across sectors around solutions that families can feel in their daily lives. In the perinatal space, that means:

• Investing in community-based, midwife-led models like Beloved Birth
• Valuing parent and community leadership as essential expertise
• Integrating health care with the broader systems families rely on
• Advancing policies and funding that support whole-family care
  

Across the Ascend Community, leaders are adapting these approaches to the local context, sharing lessons, and building momentum toward systems that work better for families. 

What This Moment Demands

The way a society cares for families during pregnancy and birth reveals what it values. Whole-family, midwife-led, community-held care shows us what is possible when dignity, trust, and connection are treated as central to health – not peripheral to it.

Birth Center Equity offers more than a model. It offers a path forward with an approach families and communities are already demonstrating what works. Now is the time to move this approach forward – and at scale – to make it the norm.