PeaceHealth sidelines, excludes. We remain committed to transparent communication, keeping the Nurse Midwifery Birth Center open.

#SaveTheNurseMidwiferyBirthCenter 

Press Contact: lanecofbc@gmail.com
Press Release

More than 250 community members attended the Nurse Midwifery Birth Center's Birthday Party on May 15, 2019.
We came together to celebrate decades of NMBC care and to rally against PeaceHealth closure plan. 

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It's been two weeks since PeaceHealth went public with its plan to close the Nurse Midwifery Birth Center (NMBC). The closure plan and the initial media coverage omitted the consumer group, Lane County Friends of the Birth Center (LaneCoFBC) for the NMBC. Every effort is underway to end the sidelining and exclusion.

The Nurse Midwifery Birth Center serves women and families from the Eugene/Springfield area, Salem, Albany, Lebanon, Corvallis, Sweet Home, Creswell, Cottage Grove, Roseburg, Coos Bay, Reedsport, Grants Pass, Oakridge, and Pleasant Hill. 

PeaceHealth Leadership Missing in Action

PeaceHealth senior leadership’s behavior, at the local and system level, thus far, suggests a strategy intent on ignoring our voice. Instead of using its considerable reach and resources to improve decision making with better information, inclusion, and transparency, senior leadership has backed out of meetings. We were scheduled to meet with PeaceHealth COO Todd Salnas on Wednesday May 15. After we posted our letter in anticipation of the meeting and in accordance with our commitment to transparency, the meeting was cancelled without a reschedule. See here and here for additional efforts on our part to communicate what we know and what we want.

Backing out of meeting with the LaneCoFBC consumer group coincided with PeaceHealth cancelling the community birthday celebration of the NMBC re-opening at its current location 9 years ago and sending security to bar women and children from the property. This is not the considerate or respectful engagement with the community needed or deserved. PeaceHealth senior leadership can change direction at any moment. 

Update as of May 23: Lanecofbc asked to have a few minutes at the Patient and Family Advisory Council's meeting this evening to share our experience. The PFAC coordinator informed us that as an advisory council, they have no influence on these matters. Really? End. 

The more than 250 individuals who attended the replacement birthday party (pictured above), the many community members attempting to convey their concern to PeaceHealth via the Hotline to the Heart phone line and the nearly 6,100 (sure to be more by now) people who have signed the petition in support of keeping the NMBC open deserve better than to be rebuffed and ignored. 

Regarding the Hotline to the Heart phone line, we have heard that messages being left by community members are being deleted without being listened to. We are now encouraging supporters to share their concerns with the PeaceHealth Ethics Consultation Services at 541-222-2262. We also observe that the administrative role for the PeaceHealth NMBC Facebook page is no longer administered by midwives and staff. 

This behavior toward our community needs to stop. Lane County Friends of the Birth Center is ready to get started and now is the time for PeaceHealth senior leadership to come to the table.

Posters, cards, flowers left by women, children, and the community.
These items were left, not delivered, when PeaceHealth cancelled
the annual NMBC birthday party reunion.  The PeaceHealth
security guard was stationed outside all day long.  

Update as of May 21: 
Yesterday, PeaceHealth broke its silence. CEO Mary Kingston emailed Lane County Friends of the Birth Center. The message is also on the PeaceHealth website here. This website also includes links to a fact sheet and FAQ.

As the recognized consumer group for the Nurse Midwifery Birth Center, we have (as have the community) expended considerable volunteer effort to be acknowledged by PeaceHealth. It is unfortunate that this was and will likely continue to be needed. We remain committed to continued momentum for inclusive, holistic engagement. As always, we remain focused on retention of the Nurse Midwifery Birth Center as a nationally accredited freestanding birth center within our system of care.  

In response to CEO Kingston’s message, we have thanked her. We have expressed our desire to have a meeting time scheduled before the end of this week. We conveyed that, consistent with our values and best practice for meeting with senior PeaceHealth leadership, that we will attend this meeting as a consumer board with our co-chairs in lead. We expressed that this should be understandable given the organizational asymmetries and the great difficulty we have encountered to be acknowledged. We also expressed the preference that we meet only with PeaceHealth.

We look forward to the opportunity to move the discussion in its proper direction. Toward this end, we will be prepared to counter the information presented in the second paragraph of the PeaceHealth message to Lane County Friends of the Birth Center and in the fact sheet and FAQ. There are considerable reasons to be concerned about and disagree with this information. We look forward to exploring them. (Press release re this update)

#### END OF UPDATE ####

Media Coverage - Points to Consider Moving Forward

We are seeing improvement in media coverage and growing interest in long-term coverage. To the degree that more eyes can be on PeaceHealth’s behavior and effort to shut us out, we can increase momentum. See the media round-up at the end of this post to get a sense of the depth and breadth of initial press. Below are important points we are not yet seeing but hope to encourage in the coverage. To the degree that they are understood, the fuller and more complete the coverage can become.

Point 1: Birth Center Model of Care. Yes, we are talking about midwifery. Even more fundamentally, we are talking about a care model that centers and does not subordinate midwifery. Empowered midwifery is the backbone of the birth center model. Birth-center based midwifery ensures the needed autonomy and scale for birth center professionals (midwives, lactation experts, nurses, and other critical staff) to practice according to the highest standards for their professions. This is precisely why, since its inception in the 1970s, the Nurse Midwifery Birth Center was able to create and maintain full spectrum care, i.e. planning, prenatal, birth, loss, postpartum, feeding support, baby clinic, and well woman care. This is integrated, not fragmented care typical of other practices.

Importantly, when the birth center model is protected and promoted, we see the kind of maternal and infant outcomes associated with comparator countries, i.e. better results for women and babies. Take a look at this April 2019 report discussing Centers for Medicare and Medicaid Innovation which concludes by calling for the scaling up of birth centers: 

Point 2: Market manipulation. PeaceHealth and Women’s Care are making and then announcing inside deals to destroy a model of care and thus limit women’s choices and access to quality care in this community. PeaceHealth’s presentation of closure as an expansion and increase in quality is disingenuous.

Sidelining the very stakeholders (this consumer group and the NMBC staff) whose role would have been to speak to how and why this plan is wrong headed is a hallmark of insider dealing. We were cut out and now we are being silenced. Insider dealing works this way and it exists to serve a narrow set of interests. The greater good loses. That PeaceHealth already does and Women’s Care likely will seek to secure government funding in the name of serving the community makes their process manipulation that much worse.

Women’s Care, after helping to destroy the birth center, is in position to take the remaining market share left in the breach. We are hearing that it is already making overtures to be contracted for the hire and provision of midwifery services for OHP-funded maternity care at the Lane County Health and Human Services’ Charnelton clinic.

Midwifery care, subsumed by and rented out by Women’s Care, will be qualitatively inferior to midwifery emanating out of an accredited, freestanding birth center. Women’s Care, if contracted, would also perform this role with fewer midwives than currently employed at but facing firing from the NMBC. Inferior care and fewer midwives is what we are looking at, if the birth center model of care in Lane County is broken. Women in our community deserve better.

Readers are encouraged to comment on this post about ideas and ways in which State of Oregon entities charged with maintaining a level playing field for consumers can be encouraged to take a look at what is happening in Lane County.

Point 3: Wonky statistics. PeaceHealth’s first statement to the media provided factually incorrect statistics about births at the NMBC, saying about 50 babies arrive there each year. Misstatements like these frame issues incorrectly and disadvantage public understanding.

Even if PeaceHealth’s statistic were correct and declining numbers were actually the most important driver behind closure, much could be learned by looking at the where and the why for this decline. Women’s Care has a track record of imposing stricter and stricter restrictions on which women can give birth at the NMBC. We would want a close look at how these restrictive policies do or do not align with best practices. A good place to start for this would be with accreditation standards for the NMBC, available via the Commission for the Accreditation of Birth Centers. The result of so many women being “risked out” by Women’s Care’s ever-increasing restrictions is a declining pool of women with access to birth at the birth center. This decline at the birth center creates an increase in hospital births for which Women’s Care benefits financially. 

Returning to the incorrect statistic of 50 babies per year, what we know is that the 1000^th baby arrived at the start of 2019. Between the May 2009 opening and January 2019, we could assume a 117-month period. 1000 /117 = 85 births. State of Oregon preliminary data for the year of 2018 indicate 70. 

Interestingly, 64 VBACs (vaginal birth after cesarean) occurred in Lane County in 2018. Of those, 48 occurred at Sacred Heart Medical Center in 2018. It would be worthwhile to drill further and find out how many of these were attended by NMBC midwives, the only providers in the community who attend out-of-hospital birth and have hospital privileges. This could point to the broader implications of losing a model of care in which midwives have the autonomy to practice according to the highest standards of their profession, which includes evidence-based VBAC support. If the hunch that NMBC midwives are behind the 48 VBACs is correct, it’s reasonable to anticipate that these numbers will plummet should Women’s Care have its way. This would be another loss associated with destroying a model of care.

Round up of Media Coverage Thus Far

The Register Guard wrote an initial article May 8th, which didn't include any quotes from community members or midwives, just from PeaceHealth and Women's Care. The newspaper published a second article on May 16th, which highlighted the Birth Center's birthday party and included quotes from community members as well as PeaceHealth.

The Register-Guard published an opinion piece by Rabbi Ruhi Sophia Motzkin Rubenstein 5/17 and another opinion piece 5/19 by Lynn Kane and Ann Nelson, co-chairs of Lane County Friends of the Birth Center.

NBC16/KMTR did an interview of a current birth center family on 5/14.

KVAL did an interview, too, on 5/14.

KLCC featured a radio spot on 5/11 and another radio spot on 5/16.

IJPR Jefferson Public Radio did a radio spot on 5/12.

Midwifing America devoted a podcast episode on5/18. 

Petition to Save the BirthCenter has nearly 6,000 signatures and counting.

There are many letters to the editor in The Register-Guard. Two online on May 11 by Karen Guillemin and

May 16 by Andy Redick plus one more (not online) by Sara Starlin printed in the paper on 5/16 and another on 5/19 by Tiffany Grantom. 

What Community Members Can Do:

1. Because the PeaceHealth "Hotline to the Heart" patient complaint line has ceased to listen to our messages, we encourage community members to express concern/support for the Birth Center with a call to Ethics Consultation Services at 541-222-2262.
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/).
5. Contact your State and U.S. Government officials to let them know how important the Birth Center is to their constituents. https://www.oregonlegislature.gov/FindYourLegislator/leg-districts.html
6. Follow this blog and our Facebook page "Lane County Friends of the Birth Center" for regular updates and action opportunities as they arise.