Background Materials:
On behalf of Lane County Friends of the Birth Center, Dr. Thomas N. Ewing has invited physician and provider colleagues in Lane County to add their name to an open letter addressed to the community. The letter voices support for the continued operation of the Nurse Midwifery Birth Center in its current form as a freestanding, outpatient facility offering the full complement of services women value. If you are a Lane County physician or provider colleague, you are welcome to join letter. Click HERE to do so.
Dr. Ewing is a long-time supporter and advocate for the Nurse Midwifery Birth Center. He played a critical leadership role, as PeaceHealth Chief Medical Group Officer, during the construction and 2010 re-opening of the Nurse Midwifery Birth Center in Springfield. A family physician for more than 30 years, he currently serves as the vice president of medical services for Planned Parenthood of Southwestern Oregon.
July 23, 2019
An Open Letter to the Community:
We have had the collective privilege of practicing in Lane County for decades. The health and wellbeing of our patients and the larger community is of utmost importance to us. We do not support PeaceHealth’s plans to close the Nurse Midwifery Birth Center. We are supporters for continued access by women and families to the Nurse Midwifery Birth Center in its current form as a freestanding, outpatient facility offering the full complement of services women value.
We agree with PeaceHealth Doctors Robin Virgin and Scott Foster in their editorial published May 30th that all Lane County women need to have access to a range of affordable, safe, birthing options. Equally important is the ability to make an informed choice about where and how to give birth and that the care received, regardless of setting, is empowering and respectful. Women in this community consistently demand out of hospital birth in the freestanding Nurse Midwifery Birth Center. For this reason, we urge PeaceHealth to not only keep the Nurse Midwifery Birth Center open but to look for ways to expand this evidence-based and fully integrated model of care.
The PeaceHealth Nurse Midwifery Birth Center is a nationally-accredited birth center staffed by Certified Nurse Midwives (CNMs), who are registered nurses with masters or doctoral degrees. This model of care has been endorsed by the American College of Obstetrics and Gynecologists and the Society for Maternal Fetal Medicine Specialists (source) and is associated with a wide variety of improved clinical outcomes including fewer cesarean births, and fewer infants born prematurely or with low birthweight source. As doctors Virgin and Foster point out many women today are making different choices about when to give birth than their mothers and grandmothers, including having babies later in life. Women can have healthy pregnancies and low-risk births well into their 30s or beyond. The average age of first birth in Lane County is 26 (source here), which is not associated with increased risk.
The Nurse Midwifery Birth Center midwifery program is fully integrative. The midwifery team practices at the Birth Center, the RiverBend Hospital, and the Lane County Community Health Clinic (CHC). The midwives provide outstanding bilingual and bicultural prenatal care at CHC. The midwives are the only practice in town providing both out-of-hospital and in-hospital birth and they do not limit the number of women served on the Oregon Health Plan.
In 2018 the PeaceHealth Nurse Midwives cared for hundreds of families providing over 3,500 clinic visits and attending 388 hospital births and 70 birth center births. The cesarean rate was 15% compared to 39.6% for Sacred Heart Medical Center – RiverBend when midwife assisted births are not included. Multiple national and international organizations including the World Health Organization and American College of Obstetricians and Gynecologists have called for efforts to reduce the cesarean rate.
Studies done in the United States have not been able to differentiate between different types of planned out of hospital births (for example between births at a free-standing birth center vs home births) this is true for the study recently published by researchers at Oregon Health and Sciences University referenced by Doctors Virgin and Foster. The study authors recognized this limitation of their study. They concluded that, based on European research showing out-of-hospital birth can be a safe option, the U.S. health system could benefit, not from eliminating out-of-hospital options, but from improved integration between out-of-hospital and in-hospital providers. This sounds a lot like the current model of care at the Nurse Midwifery Birth Center which women and families in this community demand.
In addition to serving this community as physicians and other healthcare professionals, some of us were also donors to the capital campaign which built the current Nurse Midwifery Birth Center alongside Sacred Heart Medical Center – RiverBend. We remain committed to the long-term investment we made with PeaceHealth to ensure safe, evidence based birth options, including out of hospital, at the Nurse Midwifery Birth Center.
Sincerely,
Thomas N. Ewing, M.D
And the 30 undersigned:
AlexAnn Westlake CNM
Annie Snyder DNP, CNM,NMNP
Anonymous
Anonymous
Catherine B Kordesch MD
Christine Heritage, CNM
Cindy Kaufman, MS, CNM
Debbie Fuerth, MD
Debbie Jensen BSN, M.Ed., IBCLC
Desiree Larson, RN
Diana R Beck MS, CNM, FACNM
Dorothy Shannon, CNM
Dr John B Holtzapple III, RN, MD
Hilary Prager NMNP MPH
Holly Russell, RN, CLC
Jeremy T Brown, MD
Jimmy Unger, MD
Jude Hales RN, IBCLC
Kanya DelPozzo, CNM, IBCLC
Kirsten Camerer
Linda Frison, MD
Maggie Muellner CNM/NP
Mary Carpenter, CNM, FNP
Matthew Calzia, BSN, RN
Michele Peters-Carr, CNM
Monique Carroll, DO
Rana Halabi, PhD, RN, CPNP
Victoria SkellCerf, MD
Vern Katz, MD
Wendy Lang FNP
