For at
least the third time in its history PeaceHealth is once again attempting to
close our beloved Nurse Midwifery Birth Center.
The Lane County Friends of the Birth Center have been in conversation
with PeaceHealth administration as well as the midwives, and just like the last
time PeaceHealth threatened this closure, we are committed to transparently
communicating with our community.
What we know right now:
*While the
media are reporting that this is a decision made by PeaceHealth due to low
volume, we were told by a PeaceHealth senior administrator that this is not merely a financial issue. The crux
of the matter is that Women's Care decided in late March 2019 that they would
not renew their contract to serve as the collaborating physicians for the PeaceHealth
certified nurse midwives. The following week Women's Care explained that they
intended to hire some midwives to build out a model of care for low risk
clients in the hospital, but would not be supporting out-of-hospital
births. The current contract between
Women's Care and PeaceHealth expires at the end of the summer and PeaceHealth
has announced that the Birth Center will be closing no later than August 31.
*While
PeaceHealth is claiming that the "The difficult decision to close the
Birth Center was reached only after a thorough discernment process," PeaceHealth
neglected to involve any of the women and practitioners who will be most affected
by the Center's closure in these conversations. The Birth Center midwives were
not involved in these contract discussions, and were only officially notified
of this decision just last week on May 7, the same day the news was announced
to the rest of the PeaceHealth leadership and providers. Neither did PeaceHealth elect to consult the
Birth Center's long-standing consumer group, the Lane County Friends of the
Birth Center, which exists to fulfill a national accreditation requirement. This
does not reflect PeaceHealth's core value of collaboration between all parties
to promote the health of the community, and is yet another example of women not
being allowed or empowered to make decisions that affect their own bodies.
* There is
no concrete plan in place to "transition" the midwives. All Birth Center staff, including the 10 Birth
Center midwives, and also the nurses, lactation consultants, and office staff,
are being laid off no later than 8/31/2019. Women's Care has recently posted
job openings for certified nurse midwives, but has said they are only
interested in hiring 4-5. Even if they did decide to hire some of the Birth
Center midwives, this would still be a reduction of midwifery services for our
community, and would be physician run rather than a true birth center model of
care.
* In
January 2019, the Birth Center celebrated 1,000 births in its current location.
It is easy to do the math and realize that 1,000 babies divided by the nine
years that the new Birth Center has existed is a much larger number than the
average of 50 deliveries a year PeaceHealth is reporting. This does not include
the hundreds of women who also deliver at the hospital with the same
exceptional care from the midwives. Furthermore, the birth center model of care
is about much more than birth, and any birth statistics do not include the many
other families who received compassionate care from the midwives through well-woman
care, pre-conception and contraceptive counseling, or healing from a miscarriage.
*The
midwives do not need to be more fully integrated into maternity care at
PeaceHealth--they already are! The Birth Center is the only obstetric practice
in town that already has providers with both hospital and out-of-hospital
privileges and can provide continuity of care for families whatever their birth
needs and preferences. What the Birth Center does need, and what is in the best interest of the safety, best
outcomes, and patient satisfaction of families in our community is
collaborative physicians who are fully supportive of the Birth Center model of
care for low-risk women (which, according to the World Health Organization,
should be about 85% of us), something that the American College of Obstetrics
and Gynecologists recognized in their January 2015 statement on levels of
maternity care[i]
and their February 2017 committee opinion on minimizing interventions during
labor and birth.[ii]
* Women's
Care already has a large market share of the deliveries which take place at
River Bend. If Women's Care were to take
over the birth center births, the combined impact would not be an “expanded model
of obstetrics care for women,” but rather gives Lane County women fewer options about when, how, and with
whom they give birth, a clear contradiction with PeaceHealth's stated value of
respecting each individual's differences and choices.
*The Birth
Center midwives provide all the prenatal care for the Community Health Clinic,
and are the only obstetric practice in town that will not limit the number of
women on the Oregon Health Plan or turn anyone away regardless of their ability
to pay. Closing the Birth Center would mean less equitable access to quality
care and is in direct contradiction to PeaceHealth's stated value of the just
distribution of resources.
*PeaceHealth
states that they intend to create a "long term sustainable care model to
better serve Lane County mothers and families." In fact, there is no need
to create this model because PeaceHealth's Nurse Midwifery Birth Center has
been serving our community since the late 1970s, and already participates in a
long-established and internationally-respected model of care, which is backed
by years of research.[iii] The most recent example is
the Strong Start Study (2018), sponsored by the Center for Medicaid and
Medicare Improvement, in which PeaceHealth's own Nurse Midwifery Birth Center
participated.[iv]
The five-year study followed over 45,000
women in 217 provider sites across 23 different states, the District of
Columbia, and Puerto Rico; many of whom had social and medical challenges that
placed them at risk of experiencing poor birth outcomes. When comparing three
different maternity models, all of which received the same enhanced services
for this study, the researchers found that women receiving birth center care
had significantly lower rates of pre-term birth, low birth weight, and cesarean
sections. Notably, all three of these things have been identified as key national
objectives for increasing maternal, infant and child health.[v] The data show that our birth center is
already providing a model of care that provides an important corrective to the
challenges related to social determinants for the health of mothers and
families in our community.
*At the
Birth Center, birth is not the final event of maternity care, and many families
choose the Birth Center for the full suite of evidence-based lactation services that are offered. Here too the PeaceHealth Nurse Midwifery Birth
Center has led the way in our community by becoming one of the first ten
facilities in the nation to achieve the World Health Organization's Baby-Friendly designation for comprehensive
excellence in breastfeeding support in 1997. The U.S. Surgeon General's Call to
Action to Support Breastfeeding says that breastfeeding is the single most
important thing a woman can do to protect her baby's health and also her own
health,[vi] and the Birth Center helps women achieve
their breastfeeding goals with 24/7 support, outpatient lactation services (no
longer offered by Riverbend), and weekly well-baby clinics--all for no extra
charge.
*Regardless
of the other parties involved, nine years ago PeaceHealth made a public
commitment to the community to protect and promote the birth center model. This
included asking nearly 200 individual donors to believe that they were investing in a long-term commitment
to a sustainable care model by contributing building funds through the Sacred
Heart Medical Foundation. PeaceHealth needs to be held accountable for breaking
this commitment, especially as it relates to their core value of ethical and
responsible stewardship.
Right now the top priorities for
Lane County Friends of the Birth Center are:
1)
Insisting on meetings with key PeaceHealth decision makers. As in years past, we will summarize and report
out what we learn in these meetings in order to maintain a record and be
transparent with our community.
2)
Obtaining and disseminating accurate information. This includes both making sure
that PeaceHealth has accurate information about the history of and continued community
support for the birth center model, and also includes our pledge to be
transparent with the community we represent.
What community members can do:
1) Call the PeaceHealth
"Hotline to the Heart" patient complaint line to express
concern/support for the Birth Center. 1-866-222-6822
2) Make public comments on
the Register Guard article and any forthcoming media.
3) Share your stories and our
posts on social media using the hashtag #SaveTheNurseMidwiferyBirthCenter We will make sure to share your stories with PeaceHealth
decision makers as well.
4) Write letters to the Editor at
Register Guard (https://www.registerguard.com/opinion/contribute-letter) and the Eugene Weekly
(https://www.eugeneweekly.com/category/letters/).
(https://www.eugeneweekly.com/category/letters/).
5) Follow this blog and our
facebook page "Lane County Friends of the Birth Center" for regular
updates and action opportunities as they arise.
Lynn Kane
Co-Chair,
Friends of the Birth Center
Mother of
Two Birth Center Babies (2010, 2012)
Ann Carney
Nelson
Co-Chair
Friends of the Birth Center
Mother of
Two Birth Center Babies (2012, 2015)
Such important facts for the community to know. Thank you so much for your dedication and commitment to preserving this invaluable resource.
ReplyDeleteThis is an extremely well thought out and researched blog post. I agree with your points at every turn and will follow closely. Thank you for shining light into the dark recesses of this unfortunate decision and process to close the exceptional and beloved Nurse Midwifery Birth Center.
ReplyDeleteDesiree Larson, RN, past IBCLC
(aka Nelson)