Saturday, December 26, 2009

Too many Lane County babies dying

Before Thanksgiving, the Register-Guard published Tracking infant mortality | Why is the rate so high in the United States? This editorial explores the connection between inadequate health care and the nation's high infant mortality rate. According to the CDC and as reported in the New York Times, the United States trails 29 nations, tying with Poland and Slovakia, in infant mortality.

Some of the reasons for high infant mortality in the United States include:
  • High rates of premature birth
  • Excessive use of cesarean section and labor-induction drug
  • Lack of health care and social support, particularly among poor and minority women
  • Infertility treatment practices

While the Register-Guard has covered Lane County’s unbelievably high rate of fetal-infant mortality in the past, no mention was made in this editorial. The following opinion piece was submitted by Katharine Gallagher, member of Lane County Friends of the Birth Center, and published on December 6th. The quoted rate of 9.5 deaths per 1,000 births should have been identified by Katharine as the fetal-infant mortality rate, which includes both fetal (24 weeks gestation and 500 grams) and infant deaths (through the first year of life). This rate was incorrectly identified as the infant mortality rate, which includes only infant deaths.

Too many Lane County babies dying | The infant mortality rate here is higher than it is statewide, nationwide and in Poland and Slovakia
By Katharine Gallagher
For The Register-Guard
Appeared in print: Sunday, Dec 6, 2009

Readers of The Register-Guard’s Nov. 25 editorial “Tracking infant mortality: Why is the rate so high in the United States?” may have been surprised to learn that the United States ranks 29th among nations for infant mortality — tying with Poland and Slovakia, and trailing countries of considerably lesser means. These readers will be shocked to learn that Lane County’s most recent 2007 infant mortality rate (9.5 per 1,000 live births) is higher than the mediocre rates in Multnomah (7.4 per 1,000), Clackamas (6.7) and Washington (6.4) counties; higher than that of Oregon statewide (7.9), and higher even than U.S. rates (9.3).

Put another way, babies born in Lane County start life at greater risk than they would in Poland or Slovakia. Why is the infant mortality rate so high here? More importantly, what are we doing about it?

While national infant mortality rates are a compelling indicator of the health care system’s failures, limiting our consideration to the national context suggests we can wait for federal policymakers to make things better. This is shortsighted.

Infant mortality rates have long been accepted as the most sensitive indicator of a community’s overall health, as well as a barometer of social and economic well-being. The death of an infant is a seminal event demanding a ground-level examination of the resources available to local health and human service departments and their capacity to effectively deploy them. Equally important, it is a call for civic engagement.

After more than a decade of too-high avoidable fetal and infant mortality rates, we need a new approach. The Lane County Public Health Department recently established the Healthy Babies, Healthy Community Initiative to encourage a community-led response among public, private and nonprofit organizations, researchers and community members. Initiative participants support adopting a local Fetal Infant Mortality Review Program. FIMR is a national network of community-based, action-oriented programs with a record of success.

The goals of the FIMR program are to support grieving mothers and to prevent avoidable future mortalities. When a fetal or infant death occurs, FIMR is notified. If the mother is willing, she participates in an interview with qualified professionals. Mothers’ stories help renew local commitment to finding and solving community-specific problems contributing to infant mortality. Most importantly, FIMR puts mothers and families in touch with professionals able to provide bereavement support.

Once family needs are being met, prevention moves to the forefront. Information is collected and analyzed. Sources of data — stripped of information that identifies the family, health care providers and institutions — include the mother’s interview, medical records, birth and death certificates, coroner’s reports, and records from health and social service agencies. A qualified case review team identifies the most prevalent factors and makes recommendations for improvements. Participants in the Healthy Babies, Healthy Communities Initiative would then translate these recommendations into a transparent, systematic community action plan and implement it.

The initiative anticipates receiving results of the first data analysis of fetal and infant mortalities from the Lane County Public Health Department after the New Year.

Analyzed data is essential to understanding our current local context. Are the infants we lose born at term? Do they survive past the critical first month? What is the mother’s age? What kind of support did she receive before, during and after giving birth?

With this information, we can act to reduce fetal and infant mortality. Without it, we are operating in the dark, facing another decade of avoidable tragedy.

Lane County’s fetal and infant mortality rates are not set in stone. We can, we must, insist that avoidable mortalities occurring in our midst cease. The Healthy Babies, Healthy Community Initiative is a positive development. To meet its potential, it must have a funded, functioning FIMR program. Since 2007, the $150,000 FIMR funding request to facilitate data analysis and case review has gone unanswered.

Elected officials, civic leaders, and community members have demonstrated the collaborative action necessary to build state-of-the-art courthouses, hospitals, stadiums and athlete learning centers. When we see this same level of commitment directed toward solving the problem of fetal and infant mortality, we will begin charting a better course for our most vulnerable babies and families. Financially, the funding requirements are a pittance compared to the costs of these new facilities. The return on investment, however, is beyond compare.

Friday, November 27, 2009

Giving thanks for the new PeaceHealth Nurse-Midwifery Birth Center

The Thanksgiving holiday is a good time for reflection. Lane County Friends of the Birth Center is thankful that out-of-hospital mother-baby and well-woman services will soon resume at the new PeaceHealth Nurse-Midwifery Birth Center. We are grateful that newly pregnant women will have the option of giving birth at the new facility.

We appreciate PeaceHealth’s commitment to maintaining community access to a freestanding birth center. The Fall 2009 PeaceHealth Health Update includes a construction site report from the summer. Construction is humming along toward the anticipated Mother’s Day 2010 completion. Compare the Health Update photo and those taken during our September tour with the following shots taken last week to see how much has been done.













During construction, Birth Center services have temporarily relocated to the second floor of the PeaceHealth Medical Group Downtown Eugene clinic. In addition to prenatal and birth services, the Birth Center provides women, babies and families with a drop-in well-baby clinic, extensive lactation support, childbirth education, centering groups and well-woman appointments.

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If you are unfamiliar with freestanding birth centers, you may find this FAQ helpful.

Sunday, October 4, 2009

Birth Center Site Photos & National Midwifery Week

October 5th kicks off National Midwifery Week (see end of message), a time for celebrating the contributions midwives make to the health and wellbeing of women and families.

Here in Lane County it's especially fitting to observe this week through sharing news and photos from Friends of the Birth Center’s recent tour of the site of the future PeaceHealth Nurse-Midwifery Birth Center. Knowing midwives, lactation consultants and support staff will soon be offering birth center-based services for women, babies and families is cause for celebration!

Since the June 30th groundbreaking, much has been done to put and keep construction on track for on-time completion in May 2010. This is great news as women and families are eagerly anticipating renewed access to this well-loved community resource!

Many thanks to PeaceHealth and especially to Phil Farrington, Director, Land Use Planning & Development, for offering last Friday’s site tour – we greatly appreciated the opportunity.

Here are a few photos from the tour…..


In honor of National Midwifery Week, feel free to leave a message of thanks for the Birth Center midwives and staff on our Facebook site. Click here.



Friday, October 2, 2009

100% reimbursement for Certified Nurse-Midwives in Health Care Legislation

National Midwifery Week (October 4-10) is special this year. Not only are we preparing for the opening of the new PeaceHealth Nurse-Midwifery Birth Center but the news out of Congress points to the likely passage of legislation guaranteeing equitable reimbursement for certified nurse-midwives (CNMs) under Medicare. As of last night, it is now included in both the House and Senate health care reform bills. CNMs currently receive 65% reimbursement for the same services provided by other healthcare providers.

Watch C-SPAN’s clip of Sen. Kent Conrad’s introduction of the provision last night:




It appears that the only thing between CNMs and 100% reimbursement under Medicare is President Obama’s signature. Let the National Midwifery Week celebrations begin!

Monday, August 24, 2009

Cozmic Pizza Benefit a great success

Thanks to everyone for coming out for the Birth Center Benefit Concert Sunday evening! A good time was had by all and we raised $307. These funds have gone into the Birth Center Campaign Donation fund.

Many thanks to Kate Downing of the Low Tide Drifters for organizing the benefit!!!


Construction Update

Earlier this month, Friends of the Birth Center received a positive construction update from PeaceHealth. We are looking forward to a site tour in September. In the mean time, here are the highlights:
  • Major site work and building excavation are complete
  • On-site stormwater drainage facilities have mostly been installed
  • The foundation has been poured
  • Framing and the installation of underfloor plumbing and electrical systems are well underway
At this rate, babies conceived at the end of August
could be born at the new Birth Center!!!






Monday, August 17, 2009

Aug 23 Birth Ctr Benefit Concert at Cozmic Pizza

Come out for the Birth Center!

Sunday, August 23rd at Cozmic Pizza in Eugene

6pm bi-lingual children’s music with Bryan Reed

7pm The Low Tide Drifters

8pm Mollasses

$5 donation for adults, kids listen free.

Wednesday, July 15, 2009

Groundbreaking

On June 30th, Friends of the Birth Center joined PeaceHealth for the much anticipated groundbreaking ceremony for the Nurse Midwifery Birth Center. Following are photos from the ceremony.





Construction is underway and in ten months’ time, approximately the time it takes to gestate a baby, Friends of the Birth Center looks forward to joining PeaceHealth, donors and community supporters for very special spring (Mother’s Day?) 2010 grand opening.

Tuesday, July 14, 2009

Birth Center farewell party



On June 21st, the Birth Center hosted a six-hour open house farewell party for families and friends.

With music by the Low Tide Drifters on the porch and dance from Luminessah, Birth Center staff, families and friends spanning its 28-year history in Eugene, visited and drifted through the house in which they welcomed children.

Special thanks to The Divine Cupcake, Capella Market and Liz Gibson for donating cupcakes, appetizers and gorgeous floral arrangements.

During construction of a new freestanding facility, nurse midwifery services are temporarily relocated to the second floor of the PeaceHealth Medical Group Downtown Eugene clinic.

If you were unable to attend or already miss the old Birth Center, here are some photos...



And, if you're already ready to stroll down memory lane, here are photos of the Birth Center as many of us will remember it for years to come..



Update on services and costs following June 10 Q&A meeting

On June 22, PeaceHealth CEO Mel Pyne responded to concerns raised at the June 10 Q&A meeting about services during the interim construction period of the new Birth Center. Mr. Pyne made the following points.

Interim Services
Hospital leadership is working with Birth Center midwives to ensure an optimal experience for mothers and families on the Labor and Delivery unit at Sacred Heart Medical Center.

Costs

PeaceHealth Patient Financial Services department will provide one-on-one consultations to Birth Center mothers and families. For eligible families, there are resources available to mitigate the financial impact of the higher cost of a hospital birth. (Patient Financial Services can be reached at (541) 686-7191.)


Friends of the Birth Center appreciates the ongoing communication as we embark on the short-term interim period.


Monday, June 15, 2009

June 10 Q&A Outcomes and Rec re Costs

PeaceHealth hosted a June 10 Q&A meeting for pregnant women and families affected by the temporary relocation of Birth Center services during construction of a new facility at Sacred Heart, RiverBend.

With the exception of the pregnant families facing unexpected costs, the Q&A meeting paved the way for stakeholders –expecting women and their families, Friends of the Birth Center and community supporters, and PeaceHealth– to move forward through the interim period. Following are key take-away points and a recommendation for shielding expectant families from unexpected cost increases resulting from interim plans for services. Attendees also received a very helpful FAQ from PeaceHealth.

Facility update
  • PeaceHealth secured additional days at the current location. Services continue through July 8. Many thanks to PeaceHealth, as additional days mean some families will still be able to birth out of the hospital.
  • In light of the current economy, PeaceHealth is pursuing a rebid on the new facility. Incurred savings provide resources for restoring facility features previously trimmed.
  • Building permits are in place and construction could begin early to take advantage of summer weather.

Interim services
Birth Center and Labor & Delivery staff provided informative and reassuring descriptions of birth services inside the hospital. Mothers, many in their third trimester and anticipating out-of-hospital birth, appreciated hearing Birth Center and L&D staff talk about their decades-long relationship serving Birth Center mothers at the hospital.
  • Many birth center and hospital protocols are identical - mother’s preferences for monitoring and discharge can, in theory, be met.
  • Birth Center and L&D staff described the interim period as an opportunity to expand the number of Sacred Heart nurses trained to support midwifery-assisted birth. (Friends of the Birth Center has suggested PeaceHealth explore expanding its Baby Friendly designation to include Sacred Heart Medical Center. Many other top-rated hospitals have earned this prestigious designation.)
  • Birth Center staff are using and adding to prenatal education opportunities to work with women who had anticipated out-of-hospital birthing
  • Women and families are welcome to tour RiverBend’s birth suites. Online sign up: www.peacehealth.org/birthtours
  • Women and families are also encouraged to email feedback and questions to birthcenterphor@peacehealth.org
Hearing how Birth Center and L&D staff are collaborating to anticipate, reassure and support women who wanted an out-of-hospital option was one of the most positive outcomes of the open-format Q&A discussion. This was especially helpful for women who expressed concerns about being rushed through labor or viewed with irritation by hospital staff for wanting a non-interventionist approach.

Costs

Concerns over unanticipated costs were foremost among those in attendance. The majority of questions dealt with how and why costs for birth services would increase during the interim period. Expecting families asked that the original cost estimates be honored. PeaceHealth’s suggestion that each patient negotiate a payment plan for increased charges with Patient Financial Services was met not well received. As one pregnant woman soon to give birth stated: “I’m not asking for any handouts, I’m simply asking that I be charged the price I was quoted when I chose this service.”
  • Out-of-pocket payers are likely to be billed as much as $4,000 more than anticipated for a normal birth (See FAQ, page 2)
  • Women were directed to call Patient Financial Services at (541) 686-7191. Charity care and payment plans were suggested solutions to anticipated bills.

Recommendation
Friends of the Birth Center sincerely hopes PeaceHealth will find a way to honor cost estimates provided to expecting families who, in good faith, selected the Birth Center with the stated preference of an out-of-hospital birth. Births that would have occurred at the Birth Center, which result in low-risk, non-intervention, and early-discharge eligible outcomes would be extremely helpful. This would be a significant reciprocal good-faith act for the relatively small and finite number of families impacted by the strategic decision to preference sale of the current facility over informing them of the potential loss of the out-of-hospital birth option. Families, especially uninsured, out-of-pocket payers, would be protected from exorbitant, unanticipated medical bills.

Moving forward
Friends of the Birth Center takes seriously PeaceHealth’s description of us as a community partner and we believe that our contrasting perspectives are a valuable part of an ongoing, constructive relationship, cemented by shared long-term goals.

We appreciate CEO Mel Pyne’s continued accessibility and leadership and are hopeful that cost issues, especially for out-of-pocket payers, will be resolved.

Sunday, June 14, 2009

Eugene Sustainability Commission supports PeaceHealth efforts to relocate Birth Center to RiverBend

The City of Eugene Sustainability Commission recently sent a letter to PeaceHealth expressing appreciation for its efforts to relocate the Nurse Midwifery Birth Center to RiverBend.

The Sustainability Commission is a policy advisory group to the Eugene City Council and City Manager on the development of programs or actions to enhance sustainable practices within the community and city organization.

The future of the Birth Center aligns well with its mission and work:
The Sustainability Commission works to create a healthy community now and in the future by proposing measurable solutions to pressing environmental, social and economic concerns to the City of Eugene, its partners and its people.

Birth Center ahead of national efforts to effectively deliver preventive health care

Recent editions of Time and The New Yorker magazines explore the roles of cost, incentives, outcomes and the importance of preventive care within the health care delivery system.

The New Yorker: The Cost Conundrum


For 28 years, the PeaceHealth Nurse Midwifery Birth Center has provided accessible, affordable and outstanding mother-baby care in line with current efforts to emphasize preventive health care. At the June 2nd news conference announcing construction of the new Birth Center at RiverBend, Friends of the Birth Center offered the following description:
Among the finest in the nation, the PeaceHealth Birth Center provides affordable, accessible services with phenomenal outcomes in line with national and international standards for excellence in mother-baby care and breastfeeding. Along with being a well-loved and valued part of our community, the Birth Center is ahead of national efforts to better deploy limited health care resources.

Unique for providing a continuum of services before, during and after birth, the Birth Center model of care provides need-blind service and an emphasis on client-provider partnerships, education and prevention. Its emphasis on normalcy and healthfulness yields fewer billable procedures than the medical care model. Families, employers and insurers including public programs funded by taxpayers, appreciate lower costs, especially today. Savings continue postpartum through the Birth Center’s 24-hour breastfeeding consultation service and a weekly well-baby drop-in clinic. This upfront investment means fewer visits to the doctor and missed days at work.

The foundation of Birth Center care is its out-of-hospital setting. This critical feature promotes and protects the non-medical space in which women who use it want to give birth and initiate breastfeeding. Because the Birth Center exists within the health care delivery system, many women believe they receive the best of both care models. Consumers describe it as an incomparably valuable and necessary option for establishing family.

Thursday, June 11, 2009

Monday, June 8, 2009

Consumer Q&A with PeaceHealth re Birth Center Services During Construction

Women and families affected by the upcoming temporary relocation of Birth Center services are invited by PeaceHealth to attend an information meeting on Wednesday, June 10 from 5p.m. to 7p.m. in the auditorium of Sacred Heart Medical Center University District located at 1255 Hilyard Street in Eugene.

The temporary relocation coincides with last week’s announcement by PeaceHealth that construction of the new Nurse Midwifery Birth Center at RiverBend begins July 13. During the 10-month construction phase, pre and post-partum services will be moved to the second floor of the PeaceHealth Medical Group’s Downtown Eugene clinic at 1162 Willamette. All midwife-assisted births will take place at Sacred Heart Medical Center at RiverBend.

During a May 26 interim-planning meeting at which Friends of the Birth Center was invited to comment, PeaceHealth agreed to develop a FAQ sheet addressing the following concerns:
  • Communicate why the interim plan does not include out-of-hospital birth
  • Why there was a delay in communication with current clients
  • Acknowledge commitment to sustaining all services
  • Commit to securing full re-accreditation including the freestanding birth center accreditation and the UNICEF/WHO Baby Friendly designation
  • Describe plans to engage Birth Center moms, past and present, in developing interim practices
Friends of the Birth Center anticipates these concerns being addressed at the June 10 meeting. Per feedback from expectant mothers, we have also asked PeaceHealth to address questions about costs. Birth Center clients, especially out-of-pocket payers, are concerned about incurring unanticipated expenses as a result of the interim plan. We hope pricing estimates will be honored for women who, in good faith, have already initiated care.

Friends of the Birth Center appreciates PeaceHealth’s commitment to provide information about interim services. We believe the June 10 meeting will assist women, who until last week anticipated out-of-hospital birth and breastfeeding services, to determine the best course for their continued care.

In the months since Friends of the Birth Center formed and began working with PeaceHealth, much has been accomplished to secure the long-term future of the Birth Center. Despite and especially because of significant concerns about interim service delivery, we value and look forward to continuing the community/client-provider partnership with PeaceHealth.

Tuesday, June 2, 2009

PeaceHealth announces July 13 groundbreaking and 103% fundraising goal reached

PeaceHealth hosted a news conference this morning. Two important pieces critical to relocating the Birth Center were announced: (1) groundbreaking will occur on July 13 and (2) the fundraising goal of $750,000 has been reached, in fact 103% of the goal has been raised. Fundraising efforts continue, allowing for features cut from the original proposal to be restored. Coverage: The Register-Guard, KEZI and KLCC.

Following topics include:
  • Friends of the Birth Center’s comments at this morning’s news conference
  • June events honoring the Birth Center
  • Coverage last week

Friends' comments at the news conference
I’d like to begin with words of thanks…
In January, the newly formed Friends of the Birth Center contacted PeaceHealth CEO Mel Pyne about the Birth Center’s behind-schedule relocation to RiverBend. Mr. Pyne responded with an invitation to meet.

At this February meeting, he assured us of his personal commitment to continuing PeaceHealth’s birth center-based midwifery model of care. The other PeaceHealth leaders in the room also made assurances of their commitment for relocation.

Impressive strides in fundraising and progress toward selling the current facility were quickly made. At the May dedication of this uniquely beautiful site, PeaceHealth described Friends of the Birth Center as a valued community partner in the sacred purpose of serving women and children through relocating the Birth Center.

While we remain deeply concerned by the interim plan for Birth Center services during construction, we sincerely appreciate Mr. Pyne’s continued accessibility and responsiveness. Without his leadership, we would not be here today.


Now, I’d like to say a few words about the Birth Center…

Among the finest in the nation, the PeaceHealth Birth Center provides affordable, accessible services with phenomenal outcomes in line with national and international standards for excellence in mother-baby care and breastfeeding. Along with being a well-loved and valued part of our community, the Birth Center is ahead of national efforts to better deploy limited healthcare resources.

Unique for providing a continuum of services before, during and after birth, the Birth Center model of care provides need-blind service and an emphasis on client-provider partnerships, education and prevention. Its emphasis on normalcy and healthfulness yields fewer billable procedures than the medical care model. Families, employers and insurers including public programs funded by taxpayers, appreciate lower costs, especially today. Savings continue postpartum through the Birth Center’s 24-hour breastfeeding consultation service and a weekly well-baby drop-in clinic. This upfront investment means fewer visits to the doctor and missed days at work.

The foundation of Birth Center care is its out-of-hospital setting. This critical feature promotes and protects the non-medical space in which women who use it want to give birth and initiate breastfeeding. Because the Birth Center exists within the healthcare delivery system, many women believe they receive the best of both care models. Consumers describe it as an incomparably valuable and necessary option for establishing family.

I’d like to close with a few words about the interim period…

While Friends of the Birth Center acknowledges and genuinely appreciates the commitment PeaceHealth has made towards the new Birth Center facility, we remain concerned about the interim plan. We are concerned because it results in lost accreditations, cuts staff and reduces services while at the same time increasing costs for families. And, it brings women into a setting for birth and breastfeeding that they do not want.

We have been roundly assured this interim period will not serve as a pretext for keeping the Birth Center inside the hospital. PeaceHealth has also assured us staffing, services and accreditations will be restored once construction is complete in 10 months time.


During this period our organizing principles remain (1) preserving the integrity of the Birth Center model of care and (2) ensuring continuity of care for women currently served. Toward these ends, we appreciate PeaceHealth’s invitation of continued partnership toward developing the very best interim circumstances possible.


Ten months from July 2009 puts us at Mother’s Day 2010 – our greatest hope is to join PeaceHealth for a Mother’s Day grand opening of the new Birth Center where we now stand.


Thank you.


June events honoring the Birth Center
Come to the following events to learn about interim services, support the future Birth Center and celebrate / say goodbye to the current site of the PH Nurse Midwifery Birth Center

Consumer Q&A with PeaceHealth
When: Wednesday, June 10 5-7pm
Where: Auditorium of Sacred Heart Med Center University District at 1255 Hilyard St, Eugene
What: Opportunity for consumers to ask questions about services during the construction

Benefit for Nurse Midwifery Birth Center Facebook invite
When: Sunday, June 14, 1pm to Monday, June 15, 2am
Where: Diablo's Downtown Lounge (959 Pearl Street, Eugene)
What: All day benefit including BBQ, silent auction, bingo and karaoke, on into the evening with local bands and fire dancing by the always fabulous Tribe of Eve! Minors welcome til 9pm...
Cost:$5 suggested donation
Help: If you have items to donate for the silent auction, please contact Annie at annie@badmotivator.net

June 21 Birth Center "Farewell" Party Facebook invite
When: Sunday, June 21, 12pm to 6pm
Where:
Current Nurse Midwifery Birth Center (511 E. 12th Avenue, Eugene)
What: Birth Center staff will host an open house to honor all of the families from the beginning of the Birth Center in the 80's to the present day!
Help:
Donations from food providers are welcome and greatly appreciated! Please contact Emily at midwifeemily@gmail.com

Coverage last week:
Women unhappy about hospital’s plans to close nurse midwifery center

Interim birth center plan needed

Gap Ahead in Midwife Birthing Services?

Tuesday, May 19, 2009

Preserve services and continue care during construction

May 19, 2009

Mr. Mel Pyne
Chief Executive Officer
PeaceHealth Oregon Region
P.O. Box 1479
Eugene, OR 97440

Dear Mel:

On behalf of the Friends of the Birth Center steering committee and the many women who have contacted our group, I am writing to express profound concern over the process and direction of interim planning for the Birth Center. The plan, as I understand it, fails to preserve the practice’s model of care and to maintain continuity of care, criteria critical to the Birth Center’s long-term viability.

With assurances of our involvement in interim planning, Friends of the Birth Center left the April 10 meeting with you confident of a process that would result in transparency and integrity. We indicated reluctant willingness to support a plan in which out-of-hospital birth services might cease temporarily so long as all other remaining services remained intact. Chris Miles told us to expect an invitation to join interim planning before May. We received no invitation or follow up. After the May 9 dedication, you responded to our follow up inquiry that Chris, Kitty and Kathy would soon be in touch to set up a meeting. No contact was made. Chris did attend the May 14 campaign meeting. There she made additional assurances of an upcoming meeting. While I learned of plans for this meeting, I received no invitation. When I followed up, the meeting was cancelled and pushed to next Tuesday.

June 30th, the date Birth Center staff are to vacate the current location, is fast approaching and interim planning no doubt continues internally without us. At the May 14 meeting, Chris briefly and with little follow-up detail described a scenario in which Birth Center births would move inside the hospital and a reduced staff would work out of the PHMG downtown clinic. Reduced staffing would be felt in diminished birth and postpartum lactation services for which the Birth Center is a respected, in-demand center of excellence. Such a plan undercuts the very long-term goals inherent in our recent, outstanding short-term efforts thus far to relocate the Birth Center.

Dismantlement, as an organizing principal, dramatically and significantly increases facility and provider costs born by families and insurers, including taxpayer funded OHP. The Birth Center facility fee is approximately $2,000 as compared to a hospital facility fee of $8,000. It would also appear that physicians would gain financially as they would collect a provider fee from women who are pushed to bring their births inside the hospital. How could this not create a disincentive for the hard work of reassembling a dismantled staff and rebuilding a scattered clientele at the end of construction? Accordingly, we see dismantlement as a catastrophic blow with the potential to fully undermine birth center-based midwifery, a model of care touted and much loved in this community for its affordability, access and truly excellent outcomes.

Pregnant women and new mothers using the Birth Center have no idea where their next prenatal appointment will be or where they will birth their babies, or where or if they will receive the stellar lactation services for which the Birth Center is revered. We should all try to imagine how upended a woman in her third trimester or newly breastfeeding must be feeling right now. All of us, regardless of the complexities involved, have an absolute obligation to these women who, in good faith, initiated care with the understanding that the Birth Center model of care would be there for them.

Please direct interim planning to serve women and families. A temporary out–of-hospital space in which the Birth Center model of care remains intact, ready to relocate post construction and in which women receive continuity of care is best. We are aware of a vacant, potentially code-appropriate building around the corner from the current Birth Center site. If this cannot work, we would like consideration of the SHMC Foundation’s RiverBend house.

At the May dedication, we joined PeaceHealth in commitment to the sacred purpose of serving women and children through relocating the Birth Center. Let us protect and preserve it with an effective interim plan. Otherwise, the community's opportunity to have the finest program of its type in the nation will slip through our fingers. We look forward to hearing from you and to participating in next week’s interim planning meeting.

Sincerely,
Katharine Gallagher
Spokesperson

The Steering Committee of the Lane County Friends of the Birth Center
Renee Bailey
Krystal Box
Eden Cronk
Brooke DeWitt-Boyer
Katherine Fisher

Katharine Gallagher
Karen Guillemin
April Hartley
Kirsten Hughes
Kathy Lynn
Jena Price
Eleanor Vandegrift

cc: Mel Pyne, CEO, PeaceHealth Oregon Region
Tom Ewing, PHMG Medical Director for PeaceHealth Internet Services
Phil Farrington, Director, Land Use Planning & Development
Liz Gibson, SHMC Foundation Campaign Chairperson
Chris Heritage, CNM, Birth Center Midwife, SHMC Foundation Campaign member
Cindy Hunter, CNM, Birth Center Midwife, SHMC Foundation Campaign member
Vern Katz, MD, SHMC Foundation Board Member
Rick Kincade, MD, PHMG and PeaceHealth Oregon Region Board Member
Kathi Levell, Executive Director of Planning for PeaceHealth Medical Group
Randy Lewis, MD, SHMC Foundation Campaign Physician Chairperson
Rueben Mayes, Executive Director of SHMC Foundation
Chris Miles, Chief Operating Officer
Michele Peters-Carr, CNM, Employee Campaign Co-Chair
Kitty Schiffer, Patient Care Executive for Sacred Heart Medical Center
PeaceHealth Oregon Region Board
SHMC Foundation Board
Lane County Friends of the Birth Center blog (http://www.lanecofbc.blogspot.com)

Thursday, May 14, 2009

Birth Center interim planning - preservation and continuity of care are key

Lane County Friends of the Birth Center appreciates and looks forward to joining PeaceHealth to develop an interim plan for the period in which Birth Center services will be affected by construction.

There are two organizing principles we believe essential to sustaining the integrity of the Birth Center in the short- and long-term. They are (1) preserving the practice and (2) ensuring continuity of care. We advocate an interim out-of-hospital arrangement; and yet we recognize that making this work poses significant challenges for PeaceHealth. Whatever the outcome of interim planning, utilizing the two organizing principles defined below will provide an outcome that truly serves PeaceHealth, the Birth Center practice and its clientele.


Preserving the Birth Center Practice
Affordability & Access
Facility fees at the Birth Center are one quarter of hospital facility fees.

Excellence
The Birth Center has earned and maintained prestigious licensure and accreditation. Both would be lost inside the hospital.

(1) Commission for the Accreditation of Birth Centers (CABC)
(2) Baby-Friendly designation from UNESCO and WHO

Outcomes
The Birth Center is a national leader in breastfeeding – possibly the nation’s top leader.

The CDC publishes national breastfeeding initiation rates. Recently, the Northwest and Hawaii had the highest rates; Oregon was tied for the highest rates in the Northwest; Lane County had the highest rates in Oregon and the Birth Center without a doubt has the highest rates in Lane County.

Transparency
Families will be most well served, if they understand how their care will be affected. Communicating clearly about the final interim plan will enable them to make informed decisions about their care. Transparency is key to the Birth Center maintaining and growing its clientele.

A timeline including groundbreaking, construction and a grand opening would be invaluable to clearly communicating the bright future everyone anticipates.

Ensuring continuity of care for mothers, babies and families
Prenatal
Prenatal appointments
Childbirth education classes
Breastfeeding classes

Birth
Midwives and nurses with expertise in non-medicalized / natural birth
Lactation consultants specially trained to assist in breastfeeding initiation
3-day home / hospital visit for breastfeeding and early mother-baby care
Midwives authorized to discharge mother and baby

Postpartum
Weekly drop-in well baby clinic and lactation support
24-hour lactation support service
6-week post-partum appointment


We genuinely appreciate the opportunity as community members and consumers to join interim planning. While the process is rife with considerable challenges, we remain confident that an excellent, workable plan is within reach.

Stay tuned and please continue to send your feedback at lanecofbc@gmail.com.

Wednesday, May 13, 2009

Birth Center Dedication

On Saturday, May 9th PeaceHealth hosted a dedication ceremony for the new Birth Center.

As members of the community, Lane County Friends of the Birth Center's steering committee attended. For most of us, it was the first opportunity to fully appreciate the generosity PeaceHealth has shown in dedicating such a uniquely beautiful space. Mel Pyne, CEO, PeaceHealth Oregon Region was our host. His kind words conveyed a level of commitment in which we feel great confidence and appreciation. The morning was a true celebration of the future Birth Center, all the more special for falling on Mother’s Day weekend. Thank you!



video

Click here to watch the video online with the option of full-screen viewing.


The following comments were offered during the dedication by Katharine Gallagher on behalf of Lane County Friends of the Birth Center:

Strong and capable mothers are essential to our community. When women thrive, we all prosper. The Birth Center facilitates this connection between individual women and the well being of our community.

Thru respectful, humane partnership, Birth Center midwives, lactation consultants, nurses and support staff nurture and inspire women on their journey to motherhood.

Because so many of us, mothers and fathers, get our start away from the support and generational wisdom found within extended family, the Birth Center becomes our second home before, during and after our babies arrive. We learn early on that its door is always open and it’s just a phone call away, no matter the time, the day or the question at hand.

The Birth Center honors our community every day in every thing it does to cultivate and send strong mothers, empowered fathers and healthy, beautiful babies out into the world.

Friends of the Birth Center, comprised of community members, deeply appreciate Mel Pyne’s leadership and PeaceHealth’s commitment to the Birth Center.

Wednesday, April 29, 2009

Results from The Birth Survey offer consumer info on maternity service

The CIMS Transparency in Maternity Care Project: The Birth Survey is the first ever consumer ratings website dedicated solely to providing feedback on obstetricians, midwives, hospitals, birth centers, and home birth services. The consumer reviews include overall ratings and recommendations for birth facilities and care providers, and also a seven-item set of questions on providers’ interpersonal and communication skills, facility intervention rates (select states only), and information on finding good care. A national average of ratings is also displayed to provide comparison with individual ratings. Click here to read CIMS’ press release.

Locally, the PeaceHealth Nurse-Midwifery Birth Center received 13 ratings, the most ratings for a birth services facility. The Birth Center received an average rating of 4.5 stars out of five. One Hundred percent of respondents would recommend the Birth Center to family and friends. View results for The Birth Survey at www.thebirthsurvey.com.

Monday, April 20, 2009

Birth Center Status Update - Things are looking good!

On April 10th, Lane County Friends of the Birth Center steering committee members met with Mel Pyne, CEO of PeaceHealth’s Oregon Region. Last week, post-meeting communications continued. We are now able to offer an update. Please feel free to share feedback at lanecofbc@gmail.com.

Campaign Update

PeaceHealth continues to progress toward its two conditions for building the new Birth Center. The PeaceHealth Sacred Heart Medical Center Foundation has reached 90% of the $750,000 goal and the outlook for the sale of the current facility continues to be positive. Progress made since the beginning of the year reflects an extraordinary degree of energy and creativity on the part of PeaceHealth.

Celebrating Progress
During Mother’s Day weekend, PeaceHealth will host an intimate dedication or blessing at the site of the future Birth Center at RiverBend. A public groundbreaking will be scheduled to coincide with the start of construction, most likely in July. With Mel Pyne and other PeaceHealth leaders, donors, Birth Center staff and the LaneCoFBC steering committee in attendance, the May event is an important precursor to the public groundbreaking.

Interim Planning

As momentum builds for relocation, LaneCoFBC anticipates the possibility of the Birth Center becoming “homeless” at some point during construction. We brought this up during the April 10 meeting. While aware of our preference for a temporary freestanding facility, PeaceHealth views this as unrealistic due to difficulties in meeting the numerous code requirements including fire, safety and ADA.

Should the Birth Center become homeless, PeaceHealth would most likely move its services and staff inside the hospital. LaneCoFBC expressed deep, heartily felt concerns that any moves inside not become pretext for staying inside. We were roundly reassured that this would be a short-term plan necessitated only by construction of the new Birth Center. We were further assured the Birth Center services that families anticipate receiving before, during and after a baby’s arrival would continue. The one exception would be out-of-hospital birth. Once the new Birth Center is ready, all services will move to the new facility.
LaneCoFBC asked to participate in the interim planning process and appreciates the positive manner in which we have been welcomed. Following are two items we hope to see included:
  • Designated Birthing Rooms. Designated Birth Center birthing rooms would significantly improve the difficult situation of temporarily interrupting out-of-hospital birth services. This space, through its furnishings and staffing, could come as close as possible to providing the setting and model of care women anticipate receiving at the Birth Center.
  • Informational Meeting. Should it become necessary to execute the interim plan, it would be extremely helpful to present it to the families using the Birth Center. This kind of meeting would let them know what to anticipate as they plan for a baby’s arrival.
If you have ideas or concerns, especially if you are currently using Birth Center services, please do not hesitate to share them with LaneCoFBC at lanecofbc@gmail.com!

Sunday, April 12, 2009

Recap of April 10 Meeting with Mel Pyne, PeaceHealth CEO

Steering committee members of the Lane County Friends of the Birth Center met with Mel Pyne, PeaceHealth Oregon Region CEO and members of his executive management team on Friday, April 10th. The meeting was productive and positive. Perhaps the best news was learning that fundraising efforts have secured 90% of the total $750,000 goal. PeaceHealth is confident of reaching 100%. A decision has not been made about a Mother’s Day groundbreaking.

Members of the steering committee feel good about the direction of the campaign and the positive manner in which our desire to collaborate on the Birth Center’s relocation to RiverBend has been received.

Sunday, April 5, 2009

April Newsletter

Birth Center Campaign Update
Mother’s Day Groundbreaking
PeaceHealth is within reach of meeting its two conditions for building the new Birth Center in time for a Mother’s Day groundbreaking. The conditions are completion of fundraising and sale of the current building.
  • More than 87% of the $750,000 fundraising goal has been reached.
  • The current building is listed and enjoys interest.

When recently contacted by Lane County Friends of the Birth Center (LaneCoFBC), Mr. Mel Pyne, CEO of PeaceHealth’s Oregon Region, concurred that a Mother’s Day groundbreaking looks promising. Members of the LaneCoFBC steering committee will meet with Mr. Pyne on Friday, April 10th. Stay tuned.

WineStyles Birth Center Benefit
PeaceHealth’s Foundation hosted two successful benefit receptions for the Birth Center in March. Birth Center families, friends and supporters especially enjoyed seeing the midwives and staff in attendance. Many thanks to the Foundation’s Rueben Mayes, Matt Favreault and Linda Starr!

Outreach

Do you know community leaders with whom Lane County Friends of the Birth Center should be in touch? Please contact lanecofbc@gmail.com with suggested introductions.

Because local leaders having varying degrees of familiarity with the Birth Center, LaneCoFBC seeks to have them understand the Birth Center’s key public health role as a cost effective, evidence-based and accessible model for care. In addition to offering a much-in demand form of maternity care, its services are critical to Lane County’s ongoing efforts to lower the local infant mortality rate – above the national average and Oregon’s highest.

Recent Blog Entries

Local Events & Good News

Breastfeeding Presentation: Encouraging Words are Not Enough
Sunday, April 19 from 2 to 4pm
If you read The Atlantic Monthly’s recent piece “The Case Against Breastfeeding,” you won’t want to miss this advance preview of a presentation for the upcoming 2009 Healthy Start Statewide Training conferences. Join Lane County Friends of the Birth Center to learn about and discuss the following breastfeeding-related issues:
  • Preventable problems influencing earlier-than-planned weaning
  • Contributing factors and potential solutions
  • CDC recommendations for evidence based breastfeeding care
  • Baby Friendly, a gold-standard designation from UNICEF and the World Health Organization
  • How the Birth Center’s Baby Friendly practices effectively support women

Presenters:
Debbie Jensen, RNC, IBCLC
Desiree Nelson, RN, IBCLC.

Sacred Heart at RiverBend, Conference Room C/D
From the main hospital lobby, take stairs up to the second floor; go left at stairs, then left along the balcony. Conference Room C/D is at end of this hall.

Follow up questions:
Desiree at desiree.ann.nelson@gmail.com

Lane County’s First Annual Healthy Babies Award
The Public Health Department’s Healthy Babies, Healthy Communities Initiative has established the Healthy Babies Award. This award will be given annually to recognize efforts in Lane County that help reduce fetal-infant mortality and increase infant health in our community. Any agency, organization, medical professional or individual from Lane County is eligible. Nominations are due no later than April 17, 2009. Click here for nomination information, including access to the form. 


Oregon Breastfeeding Coalition

Announcing the launch of the Breastfeeding Coalition of Oregon website: www.breastfeedingOR.org

African Birth Collective’s Red Tent Event

April 19 from 10am to 5pm
EWEB Conference Room, 500 E. 4th Avenue

Suggested donation: $10 to 15
  • Silent Auction. Gift Certificates and artwork for local artists
  • Slideshow about African Birth Collective’s work in Africa
  • Red Tent Story Sharing of birth and transformation to be documented for the BOLDACTION.ORG oral history library
You are also invited to donate any of the following items for "Mama Baby Packs" going to clinics in Senegal:
Onesies
Receiving blankets
Toothbrushes
Soap
Socks
Hats

Follow up questions:
Kaya Skye at 541.951.9995


Support the Birth Center:
Watch the Birth Center Tribute video - more than 500 people have viewed it online so far!

Join the more than 850 people who have signed our online petition

Make a contribution to the Birth Center campaign

Find us on Facebook

Join our email distribution list – send an email to lanecofbc@gmail.com

Thank you!

April is Cesarean Awareness Month

Observers of Cesarean Awareness Month seek to shed light on the impact of cesarean surgery on mothers, babies, and families worldwide. Used appropriately, cesarean section can be a lifesaving surgery. US rates, however, are at least 31.8%, more than double the 15% maximum recommended by the World Health Organization and double the rates in 1996.

To learn more about cesarean awareness, support, and education:
• Visit the International Cesarean Awareness Network (ICAN) website

Additionally, following are two interesting pieces exploring implications for the skyrocketing rates of cesarean birth:

Sarasota Memorial can help reduce high C-section rates

Need for transparency increases as Cesarean section rates rise

Saturday, March 21, 2009

Birth Center Helps Families Gracefully Clear Hurdles to Breastfeeding

The Atlantic Monthly recently published “The Case Against Breastfeeding” which The Today Show covered. While incorrect (see below), the article’s assertions that scientific evidence barely supports breastfeeding is important because it reveals the often disheartening challenges many women and families in our society face when trying to breastfeed. Given the article’s tone and the ensuing coverage and online discussion, the need for compassionate and sensitive discourse could not be greater or more obvious. It is also important to take stock of our local options and, once again, we have much to be grateful for in the unique services found at the PeaceHealth Nurse Midwifery Birth Center.

Disheartening Hurdles to Breastfeeding
Whatever one’s feelings about breastfeeding, most people can agree on one thing: breastfeeding in the United States is a challenge for most women. Here are a few of the institutional and cultural hurdles women and families must clear to establish breastfeeding:

  • The US, alone among industrial nations, provides no paid maternity leave.
  • Most expecting women, who themselves were unlikely to have been breastfed, are encouraged to breastfeed but given no pre-baby lactation education. The majority are unaware that “most hospitals perform poorly on breastfeeding support.”
  • Before their milk fully comes in, mothers and babies leave the hospital with no routine follow-up breastfeeding support.
  • Unnecessary breastfeeding complications often ensue requiring the aid of a lactation consultant, a service generally not covered by health insurance.
  • Neither the American College of Obstetricians and Gynecologists nor the American Academy of Pediatrics requires doctors to be trained in basic breastfeeding support including referring patients to lactation consultants or support groups.

For a more thorough explication of these challenges and the misplaced resentment they understandably spark, read "Case Against Breastfeeding" Overlooks Big Dirty Secret."

Birth Center Helps Families Gracefully Clear Hurdles to Breastfeeding
The PeaceHealth Nurse Midwifery Birth Center is among the 3% of 3,000 maternity centers in the US to earn the "Baby-Friendly" designation, the gold-standard protocol proven to result in breastfeeding success. After mom, dad and baby go home from the Birth Center, they receive an in-home visit where questions and concerns about breastfeeding, infant care and post-partum recovery are addressed. Families are then encouraged to use the free, weekly drop-in Baby Clinic to see lactation consultants, weigh their baby and connect with other parents. Not only does breastfeeding get off to a good start but life-long friendships are also nurtured right along with babies!

The extraordinary value of Birth Center’s “Baby Friendly” designation shines brightly in the Birth Center Tribute video as well as in the 28 heart-felt testimonials offered by Birth Center moms, dads, grandparents and supporters. These letters were written recently to convey to PeaceHealth the importance of ensuring the Birth Center’s future by relocating it adjacent to the new hospital at RiverBend.

Evidence for Breastfeeding is Scientific
The Academy of Breastfeeding Medicine issued a press release detailing the evidence basis for breastfeeding.

President of the American Academy of Pediatrics also submitted the following letter via email to the editor of The Atlantic Monthly.

In the article, "The Case Against Breast-Feeding" by Hanna Rosin, the author skims the literature and has omitted many recent statements including the 2005 statement of the American Academy of Pediatrics which supports the value of breastfeeding for most infants. This policy references every statement with scientific evidence from over 200 articles which meet scientific standards for accuracy and rigor. The statement was meticulously reviewed by the Section on Breastfeeding, the Committee on Nutrition and numerous other committees and approved by the Board of Directors of the Academy. Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries, a study released by the Agency for Healthcare Research and Quality (the AHRQ Report) strongly supports the evidence of benefits demonstrated in the breastfeeding research. The evidence for the value of breastfeeding is scientific, it is strong, and it is continually being reaffirmed by new research work.

The American Academy of Pediatrics encourages women to make an informed decision about feeding their infants based on scientifically established information from credible resources.

David T. Tayloe, Jr., MD, FAAP
President
American Academy of Pediatrics