Community member speaks to power and reach of NMBC practice

#birthcentercalltoaction to #SaveTheNurseMidwiferyBirthCenter

With special thanks to Melissa Wilberger, DVM, Lane County Friends of the Birth Center shares the following long version of a letter to the editor she has submitted locally. This letter is one of many actions local supporters of the Nurse Midwifery Birth Center practice are taking to communicate the value and importance of PeaceHealth reversing its plan to close the community's accredited, freestanding birth center which practices in three locations (Charnelton Community Health Clinic, the birth center, and RiverBend hospital). Integrated fully within our local healthcare system, the NMBC provides high quality, low intervention care. This full-spectrum care is supported by international and national imperatives to reverse outcomes - cesarean section, low birth weight, preterm birth, latation challenges - which undermine women and babies. Care at the NMBC serves women throughout their lives, i.e. is not limited to maternity care. Of special importance, too, is that NMBC care is also far (far) more affordable to consumers and insurers. 

See the most recent  Call to Action  for more ideas of how to join this community effort. Lane County Friends of the Birth Center remains committed to working with PeaceHealth leadership to correct course. Unfortunately, our multiple requests to begin this conversation have, so far, been fully dismissed. 

Melissa Wilberger, DVM's letter:

Since hearing of the impending closure of the Nurse Midwifery Birth Center, I have had a lot of firsts.  I’ve been participating in my first protesting of anything.  I’ve attended my first protest rally.  I’ve contacted my elected officials for the first time. My husband thinks I’ve gone crazy and I tell my friends I don’t know what has come over me. I walked into the birth center for a wellness visit (again, another first!) and I was overcome with emotions as I considered this seemingly sacred place being closed. This has led to some introspection.  Why is it important?  You see, I’m done having babies, so you would think I could let it go. 

With my first pregnancy, I was seeing a gynecologist who I was quite comfortable with but didn’t do obstetrics.  I requested a referral to midwifery because I had heard it was a good thing.  He sent me to the Nurse Midwifery Birth Center with a high recommendation.  It was love at first visit.  The midwives I met exhibited compassion, a desire to educate, and a willingness to listen.  The birth center was welcoming and I decided I wanted a birth there, where I wasn’t regulated or given routine, but unnecessary, procedures.  The literature I received didn’t strike my heart with terror, unlike quite a few other obstetrician written books, but instead empowered me with knowledge.  The birth classes were predictably awkward but a foundation for all 3 of my births.  My birth plan failed as I went over 41 weeks and I was induced in the dreaded hospital.  The midwives brought the birth center to me. When my baby came out and was swept away to the NICU, I had the midwife by my side picking out the hope.  

After that first child’s scary start, I consented to my husband’s wishes to have hospital births but midwife-led with most my care at the birth center.  I went into each birth confident because I had a midwife at my side.  My point in sharing my story is to illustrate the birth center and midwives give an empowering, calm, assured experience to allow me to be confident and mentally relaxed during birth.  I was able to focus on what was important.  Never was a procedure done without requesting my consent in a non-threatening way.  Over the years, I’ve also uncovered the many research articles establishing that birth center models of care are the best model for low risk pregnancies to decrease maternal and fetal death.  I now rabidly preach to all my pregnant friends and family to go to the Nurse Midwifery Birth Center or find a Certified Nurse Midwife in their area.

In addition, the lactation care I received was amazing and much needed. I didn’t have to go to a foreign place to get help, it was at the birth center.  I used their care for all 3 babies, the final one being the toughest. Because all their lactation consultants are certified, I was able to get the immediate care I desired for my baby’s surgical procedure to help nursing.  They helped my lactation experience be the best it could be for both me and my babies.

Finally, I was blown away with the quality of care during my wellness visit.  I liked my gynecologist previously but his care was overshadowed.  The midwife not only was thorough in her exam but listened intently to my concerns and addressed them all.  I will be returning to the birth center for all my future gynecologic visits, or I’ll return to my lack of preventative health care.

I want all mothers to have access to this amazing, empowering way of approaching women’s health and birth.  So, in closing, Peacehealth has sent a few requests for the Lane County Friends of the Birth Center to join in a discussion of how to improve in-hospital birth risks and a long term care model.  I would say,”Peacehealth, you have one!  It is the Nurse Midwifery Birth Center!  So, please, stop being lazy and begin looking for more permanent options beyond contracting with an anti-midwifery practice of OB-GYNs who are threatened by the growing birth center model of care.”

Sincerely and with hope of the best outcome,

Melissa Wilberger, DVM

Response to "Low Risk Advisory Committee Structure" for in-hospital birth services

Lane County Friends of the Birth Center has received and responded (see below or click here) to PeaceHealth COO Oregon Region Todd  Salnas' recent communication regarding an invitation to participate in PeaceHealth's new or newly developing "Low Risk Advisory Committee Structure" plan for in-hospital birth services.

As a consumer advisory group, Lane County Friends of the Birth Center exists to support community access to an accredited, freestanding birth center. Accordingly, we continue to request the opportunity to work with PeaceHealth leadership. The birth center closure plan will remove affordable, high quality care that is both in demand and in line with public health and maternal health initiatives. The Nurse Midwifery Birth Center practice is well integrated within the healthcare system with excellent outcomes in three service locations (the Charnelton Community Health Clinic Prenatal Clinic, the birth center, the hospital). The birth center practice plays a critical role in the provision of excellent care to women insured through the Oregon Health Plan. 

Copied on our response to PeaceHealth are the Lane County Board of Commissioners to whom we continue to look to for leadership and assistance. 

Friends and supporters, our latest call to action is ready here. 

Page one:

Page two:

Correcting PeaceHealth & Call to Action #1

In this, our twelfth post since PeaceHealth announced its misguided plan to take the Nurse Midwifery Birth Center away from the community, we offer supporters and interested parties a two parter. 

First, is a thoughtful, thorough, and needed response to PeaceHealths' June 7 statement provided to KEZI in advance of our Rally to #SaveTheNurseMidwiferyBirthCenter. 

Second, is our first Call to Action, which invites our community together to speak out loudly and clearly about the importance of preserving our access to the Nurse Midwifery Birth Center for generations to come. Readers can always find the latest action by clicking on a version of this sign on the right margin of this blog. The specifics are also included below. In addition to  #SaveTheNurseMidwiferyBirthCenter , we will use and encourage others to include  #birthcentercalltoaction  to amplify our collective grassroots presence online. 

Before reading, do be sure to look to the right side of this blog to see our growing list of support received thus far from Congressman DeFazio, Commissioners Sorenson and Berney, Rep. Marty Wilde, and Eugene City Councilor Semple as well as Centro Latino Americano, the Oregon Affiliate of the American College of Nurse Midwifery, and the American Association of Birth Centers.  

1st: Correcting PeaceHealth’s June 7 Statement 

In advance of our Rally on June 7, PeaceHealth issued the following statement:

PeaceHealth’s Mission calls us to provide safe, sustainable, high-quality care for mothers and families in Lane County. As our decision to transition Birth Center deliveries to RiverBend has been made, our focus now is on how to offer an integrated model at RiverBend that continues midwifery services through partnerships and that preserves the valued services including prenatal and postpartum care for Lane County women. We are continuing to explore ways to repurpose the existing Birth Center facility to provide enhanced family-centered services for our community. 

Our invitation to the Lane County Friends of the Birth Center leadership continues to be extended and we look forward to including them in our planning process. We value their viewpoint and share their desire to provide Lane County women with a spectrum of birth plan choices. It is our sincere hope that we will work together to make sure all expectant mothers enjoy safe, meaningful and empowering childbirth experiences today and well into the future.

We would like to respond to this statement to provide some clarifying details.

PeaceHealth has invited a representative from the Lane County Friend of the Birth Center to participate in a Work Group that will be tasked with defining and designing the new low risk in -hospital model of care.  We first learned of this Work Group on May 7, during our first conversation with a member of PeaceHealth’s administration, Dr. Scott Foster, Chief Medical Executive for PeaceHealth Medical Group.  We held three informal information-gathering meetings with Dr. Foster on May 7, May 8, and May 15.  These meetings were held during the work day at Coffee Plant Roasters and Friendly Street Market.  To aid in our information gathering, over the past few weeks we have also posed a number of questions via text to Dr. Foster and have received his responses via text.  We have appreciated his responsiveness.

Additionally we have collectively had 5 brief and unscheduled phone conversations with Todd Salnas, COO.  The first one was on May 15 around 11:30am when he called each of our co-chairs to cancel our meeting at 3pm that afternoon.  This was shortly after we posted our statement about the birth center closure on the blog, as well as a post about meeting with Mr. Salnas, so the timing appears to be more than coincidental.  When we pressed for an alternative meeting time he suggested he wouldn’t be ready to meet with us for another two weeks or so.  It’s unclear why he would have scheduled our May 15 meeting if he was not in fact ready to meet with us, unless that had been just for show.

Todd Salnas called us again on May 22. In this phone call we specifically requested that he take a tour of the Birth Center (since, despite already agreeing to close it, he had never actually been to the Birth Center).  We also clearly and specifically requested a meeting in which our larger board could have the opportunity to voice the concerns of our greater community. 

Todd Salnas caucused with his team and responded to us on May 23, via phone, stating the PeaceHealth Administration “only wants to convene with people who want to talk about the future.”   We were frustrated and disappointed to hear this.  We pushed for more details about the Work Group and they still didn’t exist.

On Friday, May 31, Todd Salnas indicated via email that they were working on draft charters for this Work Group and hoped to have something to share with us in two weeks or less.  That was 11 days ago.  

On Wednesday June 12, we called Todd Salnas to get an update on the Work Group process.  We had heard there was a meeting yesterday and wanted to understand the nature of it and the status of our invitation to participate.  The meeting was among the project leadership and they intend to send us a copy of their draft project charter, participant structure, anticipated project timeline and schedule, etc. early next week.  In this call we again expressed our frustration with how PeaceHealth administration is handling this situation and unlike their predecessors have not engaged directly in person with our community in collaborative problem solving to discuss potential ways to keep the Birth Center open beyond August 30.  

In our very first meeting with Scott Foster on May 7, he indicated a desire to have the in-hospital low risk model plan all worked out by the end of June in order to give PeaceHealth time to execute on the plan and be ready to provide these services on Sept. 1.  Considering the current status of the Work Group it’s hard to imagine how a plan could be finalized, let alone executed upon, by Sept. 1. 

The PeaceHealth Oregon CEO has continued to refuse a direct meeting with Lane County Friends of the Birth Center; and while other staff members have offered informal time, they have cancelled all formal meetings without rescheduling. If PeaceHealth truly wants to 'include us in their planning process,' they ought to meet with us, the official consumer group of the Nurse Midwifery Birth Center and be prepared to hear our concerns as advocates for the midwifery-led birth center model of care.

2nd: Call to Action

Following is our first Call to Action correspondence with community members who want to take concrete steps toward ensuring we preserve access to our midwifery-led and freestanding birth center which, among many, many important services, also provides out of hospital birth to women and families. Supporters, any and all action matters and is appreciated. 

Remember to use:
 #birthcentercalltoaction  and  #SaveTheNurseMidwiferyBirthCenter   when posting anywhere online. This way, each of our individual efforts can amplify the collective whole. 

June 15, 2019

Dear Birth Center Supporter,

THANK YOU for your participation in an amazing rally #SaveTheNurseMidwiferyBirthCenter!  

Our vocal and visible presence sent a clear message to leadership at PeaceHealth and to our larger community: WE DESERVE A BIRTH CENTER!  It was incredible to see our community come out in force to insist that families in our region should have healthcare CHOICE, that we are the decision-makers about where our healthcare MONEY goes, and that current DATA supports our knowledge that birth center care improves outcomes for mothers and babies.  Friends of the Birth Center, the consumer advisory board, is proud to advocate with and on behalf of this vibrant and knowledgeable community!

Now we appreciate and invite YOU--our living, breathing, birthing, nursing, parenting community members--to continue stepping in to keep this fight alive!  PeaceHealth would like to wait us out; they are betting that we will lose momentum and get quiet, at which point they can close our Nurse Midwifery Birth Center without consequences to them.  But that’s not going to happen!  If we each take some time and effort over the coming weeks, we can continue to keep our fight in the public eye, and therefore keep PeaceHealth accountable to us and to the public it purports to serve.

To that end, we will send a WEEKLY CALL TO ACTION with specific requests.  If our entire grassroots community steps up to complete these tasks, we will keep our fight in the public eye and force PeaceHealth to engage.  We hope the WEEKLY CALL TO ACTION will make it straightforward, concrete, and easy for Birth Center supporters to participate; any effort you can make is appreciated, and the more we can do the better!

For this week, our focus is on keeping our fight visible to PeaceHealth administration and the media.  

WEEKLY ACTION #1: Call Mary Kingston, the PeaceHealth RiverBend CEO, and demand that she hold a formal in-person meeting with the Friends of the Birth Center - as previous RiverBend administrators have done -  to discuss potential solutions and alternatives to closing the PeaceHealth Nurse Midwifery Birth Center.

PeaceHealth RiverBend administration has refused to accommodate to our repeated meeting requests unless we agree to only talk about the nebulous future in-hospital model.  So now we flood them with calls!  Call every day, if you like.

Here is Mary Kingston’s contact information: (541) 222-2159

You may find it useful to reference this article, in which Mary Kingston discusses her role and values as a healthcare administrator: Mary Kingston RG article

Take video of yourself making your call!  Post it to the Friends of the Birth Center Facebook page,Tweet with ‪.‪@PeaceHealth_Ore and .@LaneCoFBC, or email it to us at lanecofbc@gmail.com.

WEEKLY ACTION #2: Write letters to the editor to the Register-Guard.

This is crucial because, if editors continue to receive letters, they understand that this issue is important to their readers.  Even if your letter does not get chosen for publication, it raises the profile of our concerns, and increases the likelihood that a letter on this topic will get published.  These letters can take many forms.  Our talking points are attached; feel free to use them as inspiration.  

Here are some samples of letters:

RG letter Andy Redick

RG letter Ruhi Sophia Motzkin Rubenstein

RG letter Tiffany Grantom

Here are details about letters to the editor and the address to which they should be sent: https://www.registerguard.com/opinion/contribute-letter

And when your letter is complete, send it to lanecofbc@gmail.com so that we can post it on our blog!  The more letters we have, the more stories we can share, and the more influence we can gain!

WEEKLY ACTION #3: Wear your Save the Birth Center shirt around town!  

This action helps us continue to educate more of our fellow community members.  It also helps us meet one another.  When you see another Birth Center supporter wearing a shirt, make sure to say hello.  Our community grows larger and stronger by the day, and you can help this continue!  Send and post pictures of you & your people in your t-shirts.

Thanks in advance for your efforts!  If you have concerns or are interested in getting involved with our organization in a more substantial way, please be in touch! Everyone in our community can help make a difference!   Let’s do this!

In solidarity,

Friends of the Birth Center

--

Lane County Friends of the Birth Center

Email: lanecofbc@gmail.com

Blog: http://www.lanecofbc.blogspot.com

Facebook: http://www.facebook.com/lanecofbc

Twitter: http://twitter.com/lanecofbc

Hashtag: #SaveTheNurseMidwiferyBirthCenter

Thank you Centro Latino Americano for your Support!

Thank you American Association of Birth Centers for Your Support!

Rally Review

#SaveTheNurseMidwiferyBirthCenter

As planned and promised, Friday’s rally was a large community event. More than 200 birth center supporters turned out. We were pregnant women, partners of pregnant women, young children, grandparents, and, generally speaking, community members of all ages and stages in life who understand the importance of and support women having choice in childbirth setting and care. We were a walking, chanting embodiment of the ideals expressed in PeaceHealth’s mission and values. So, too, was the petition we delivered with nearly 10,000 signatures. If you missed the rally, check out the media coverage and look at our Twitter feed @LaneCoFBC for the blow-by-blow tweets.

Community Shows Up, PeaceHealth Still Deliberately MIA 

There is something really wrong when healthcare providers – looking at you PeaceHealth and Women’s Care – put pregnant women and their families in a profound bind: give up and go away or stand up for what is right. Isn’t standing up for what is right what PeaceHealth and Women’s Care should be doing? What’s worse is these entities behave in ways that suggest their strategy is to out wait us, to wear us down. How cynical. Waiting us out is their strategy for pushing through plans that hurt our community. Doing this on the backs of pregnant women is, in a word, shameful.

As a health care provider, PeaceHealth should be supporting the birth choices of pregnant women. Instead, it creates and persists in a situation in which women are left with no alternative but to go into the street to rally for access to evidence-based, affordable birth care. See “Why We Rally” for more on this as well as our rally talking points. And, then check out the flair and panache with which rallying is done. Click here and scroll down till you see the many fabulous signs.

Federal, State, County, and City Elected officials say: #SaveTheNurseMidwiferyBirthCenter

While we persist, PeaceHealth digs in to wait us out and shut us out. We are incredibly grateful for our elected representatives who have voiced their whole-hearted support for our objective: maintaining and expanding access to midwifery-led care at the Nurse Midwifery Birth Center.

We have support from city, county, state, and federal elected representatives. Why is our representatives’ expression of support met by a wall of silence from PeaceHealth, which is awash in government dollars? How can this lack of accountability and transparency be deemed acceptable behavior?

Left: Eugene City Councilor Emily Semple
Right: Rep. Marty Wilde in red jacket

Special thanks go to Councilor Semple, Representative Wilde, Commissioner Sorenson (letter), Commissioner Berney who emailed to let us know he supports us, and Congressman DeFazio whose response was read out lead at the rally.

See @LaneCoFBC for videos of Councilor Semple and Representative Wilde speaking at the rally point outside of PeaceHealth.

Local Media Coverage

Who else are we grateful to? Our local media. At a time when we are fully ignored by PeaceHealth, we appreciate being able to speak about our concerns publicly. We believe continued attention is warranted. We are concerned PeaceHealth expects the media to move on. Let's hope this does not occur.

The week going into the rally, we appreciated having space in The Eugene Weekly for “Peace Health Shouldn’t Own Birth” and for its retweet of the guest editorial the day of the rally. At the rally, we were pleased to speak with reporters from KLCC, KEZI, KMTR, and KEPW. Coverage here.

Security Barred Our Entrance

Our final thoughts for this post  bring us back to the source of our problem: PeaceHealth leadership. Our purpose for the rally was to present our petition of nearly 10,000 signatures to PeaceHealth leaders. When no one from PeaceHealth met with us at the rally point outside the RiverBend entrance, a small group was sent to go inside for the purpose of providing the petition. This group was barred from entering RiverBend.

Among us were a pregnant mom with a stroller and small children, and another mom with a baby in a carrier. We were met by security outside PeaceHealth’s entrance. After unsuccessful efforts to negotiate our entrance with him, a security manager intervened and permitted our access to the lobby. We were escorted in by security and told we could not take photos. Our request for PeaceHealth leadership to be contacted by security was refused. With no alternative, we presented the community petition to PeaceHealth security. We were reluctantly provided with written confirmation that the petition had been received. Obtaining this receipt required another discussion in which only our unwillingness to leave resulted in being given one. 

Our preference was and remains to be in a proper meeting with PeaceHEalth CEO Mary Kingston to begin the process of reversing the decision to close the Nurse Midwifery Birth Center. Instead, we were told to leave the premises, but not before learning that PeaceHealth leadership had made plans for their PR Manager, and not their CEO, to receive the petition. This is not the approach or presentation described, less than a year ago, in The Register-Guard article introducing CEO Kingston to the community she serves. 

Onward

What we need, as soon as possible, is a PeaceHealth RiverBend CEO capable of understanding and rising to the challenge before her, not ignoring it and the people who raise it. With the ongoing support of community members and leaders and our elected representatives, we will continue forward toward honest and transparent discussion. Toward these goals, we leave supporters and interested parties with the following graph created by a Nurse Midwifery Birth Center father. 

Graph using OHA data by Andrew Coury, 2nd generation NMBC parent.
Andrew was born at the NMBC and hopes to welcome the third generation there.

PeaceHealth leaders' public reason for closing the Nurse Midwifery Birth Center is financial, which they attribute to demographic trends; specifically a lower general birth rate and a higher average maternal age. Even if true... a 4 year old demographic trend? Furthermore, it's not true. Average maternal age is 26 in Lane County (source).

What's the real story in the precipitous drop in birth center births between 2014 and 2018? The real reason far outpaced any demographic change in the overall birth rate. Lane County Friends of the Birth Center believes the real reason rests in risk polices imposed on the NMBC, which served to unnecessarily push women into the hospital. See October 2011 on the graph when Sacred Heart in-house OB/GYN care ended and was replaced with a contract for Women’s Care to provide obstetric consultation. Also important to keep in mind is the neglectful PeaceHealth management policies which de-prioritize the Nurse Midwifery Birth Center and make it vulnerable to the kind of moment in which we find ourselves currently.

#SaveTheNurseMidwiferyBirthCenter

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Market Power - Rally this Friday - Elected representatives showing up. PeaceHealth still MIA.

Come to the June 7 Rally (Press Release)

Market Power & the Bottom Line

Market research shows that women are the healthcare decision makers for themselves and their families. The power of healthcare decision-making starts with pregnancy. This is just the beginning of their decision making power. For decades more, women will make big decisions, which impact the entire hospital system of care. In other words, where women decide to go matters a great deal to the economic health of hospitals and medical practices. Women in this community, since the 1970s, have made it crystal clear that they intend to go to the freestanding Nurse Midwifery Birth Center.

More than 9200 women and people who respect women's choices in care have signed the petition to communicate this preference to PeaceHealth. Marketing folks, no doubt, understand the economic implications of how taking choice from us – against our will – will affect the bottom line for PeaceHealth and, quite reasonably, Women’s Care, the private medical practice whose disproportionate influence results in PeaceHealth’s erroneous closure plan. PeaceHealth leadership needs to reposition itself so that it may properly turn toward the community. Doing so brings it back into mission-consistent action in line with its status as a non-profit hospital. 

Lane County Friends of the Birth Center continues to make every effort to help re-orient PeaceHealth leaders into meaningful engagement so that concrete plans and commitments can be made to preserve the Nurse Midwifery Birth Center. So far, our efforts have not been fruitful. The last several years have seen significant senior leadership turnover. This, no doubt, contributes to a serious and, so far, persistent case of institutional amnesia. 

Below are details for the community's June 7 rally. Following rally details is a round up description of the federal, state, county, and city elected representatives who are showing up for their constituents. That’s not all. We are also pleased to share the American College of Nurse Midwifery Oregon affiliate's letter to PeaceHealth. Read it here. Donors, too, are reaching out to add their voice in support of #SaveTheNurseMidwiferyBirthCenter. More on this soon.

RALLY to Save the Nurse Midwifery Birth Center

Supporters of the PeaceHealth Nurse Midwifery Birth Center will hold a public rally, organized by Lane County Friends of the Birth Center, near the grounds of PeaceHealth's RiverBend Hospital in Springfield on June 7, 2019 at 4pm. This is truly the community’s birth center with over 9,200 people signing a petition in support of keeping it open. We have invited PeaceHealth Administrators to take this opportunity to receive the petition and to begin hearing firsthand from community members. Details are posted on the Facebook page for the Lane County Friends of the Birth Center.

Supporters are encouraged to make and bring signs highlighting the current and future consumer power every woman represents. Women want the Nurse Midwifery Birth Center and, if this is taken away from them, they will go elsewhere. They will take their families, too. Big signs expressing economic power will make a good visual for PeaceHeath and help it to re-orient toward the engagement needed to maintain the community's beloved Nurse Midwifery Birth Center. 

Lane County Friends of Birth Center's Katharine Gallagher &
Eugene City Councilor Emily Semple in front of the NMBC donor wall 

Elected representatives heed our constituent call

While PeaceHealth leaders are, thus far, unwilling to communicate meaningfully with Lane County Friends of the Birth Center, we are delighted with quick and responsive manner in which our elected officials at the federal, state, county, and city levels of government have reached out to us. 

Congressman Peter DeFazio is unequivocal in his support. Read his message here. 

Congressman Peter DeFazio writes:  

I intend to work in Congress to increase access to midwives and birth centers to significantly boost maternal and infant health.

So, too, are Lane County Commissioners Peter Sorenson and Joe Berney fully supportive of our position that the Nurse Midwifery Birth Center is critical for our community and must remain open. Eugene City Councilor Emily Semple is unequivocal, too. We also appreciate the support received from City Mayor Lucy Vinis and State Representatives Julie Fahey and Marty Wilde. Friends of the Birth Center looks forward to continued support and engagement from our elected representatives. 

In closing to our community and supporters.....see you at the rally! Bring your signs and use them to make your economic power clear and understood.