Patients, providers protest plan to end St. Mary’s midwife program
Hospital says new ‘update’ to come about controversial birth care decision
Sharon McCutcheon | Unsplash
Patients, midwives and childbirth experts have rallied behind nurse midwives at a Madison hospital, pushing back at the hospital’s plan to cancel its nurse-midwife program at the end of this year.
St. Mary’s Hospital told its four certified nurse midwives last week that the hospital was “unable to sustain” the program and would discontinue it effective Jan. 1, 2022.
By Monday, when the hospital’s intentions became public, opposition galvanized, with organizers planning a rally at the hospital for Sunday afternoon and sending email messages to executives at St. Mary’s and at SSM Health, the four-state group of Catholic hospitals and health care systems that owns St. Mary’s.
Late Wednesday, an SSM Health spokesperson said the hospital would have an update announcement on Thursday. A member of the midwives team said the hospital had scheduled a meeting Thursday morning, but there were no details late Wednesday afternoon.
Options for birth
Midwives are health care professionals who provide primary care during pregnancy and delivery, typically as an alternative to a medical doctor. A certified professional midwife (CPM) is licensed in Wisconsin to attend home births. A certified nurse midwife (CNM) provides those services in a hospital setting.
Midwifery “appeals to a lot of people who have a very real, reasonable distrust of the medical system,” says Eileen Zeiger, executive director of the Wisconsin Association for Perinatal Care.
Some expectant parents might opt for home birth with a community midwife, she adds. Others might choose birth in a hospital, but with a certified nurse midwife rather than an obstetrician. Hospital midwives provide “this important bridge between multiple levels of care,” between the home birth community midwife and the hospital obstetrician.
“I would really hope SSM Health understands their responsibility to the community and the role that midwifery health care plays in equitable perinatal care,” Zeiger said.
UnityPoint Meriter hospital has Madison’s largest certified nurse midwifery program, staffed by three different provider groups, one of which is part of UW Health. (UW Hospital has no labor and delivery or post-partum services.)
St. Mary’s Hospital launched its CNM program in March 2018, said Jessica Vaughan, one of the four certified nurse midwives currently on staff, who is serving as a spokesperson for the team.
In an interview Wednesday, Vaughan said the team was called into a meeting with hospital management last Thursday evening, Sept. 30. “We were informed the current practice model was not sustainable and would end,” she said.
After the decision to cancel the program at the end of this year became public, patients and midwifery advocates mounted a campaign to urge the hospital to reverse course.
“I am due in January with my first baby & am currently under the care of the SSM Midwives,” wrote Claire Baker in an email to top executives of the hospital that she later shared with reporters. “I was absolutely crushed [Oct. 2] to learn that I will no longer have the option to deliver my baby with the SSM midwives.”
By Tuesday the advocates had organized a rally at the hospital for Sunday from 3 to 5 pm. “SSM Health has made a very poor decision” in cutting the program, said Margaux Riewe in an email message to news outlets announcing the rally. Riewe, whose due date is Jan. 6, 2022, said she and 100 other pregnant women would have to find alternative care as a consequence.
Connie Lambeth, a doula who provides non-medical care and support for mothers before and after birth, told the hospital’s management in an email message, “I currently have a family that I’m supporting who was planning on giving birth in early-mid January with the SSM Midwives.” That family “is currently scrambling to find care with a medical care provider who will be low intervention and will still catch their baby in hospital since they are open to pain medication for their birth.”
Lambeth later shared the message with news outlets.
As complaints such as those began to come in, St. Mary’s announced Tuesday that it would retain the midwifery program “until a new sustainable model is in place.”
In a statement they issued in response, Vaughan and her colleagues said they were “happy that SSM Health [administration] is listening to the outcry from their true stakeholders: the patients and the community, and that they are realizing that they underestimated the value of comprehensive and individualized midwifery care within a complex medical system.”
They noted that there was not yet a specific plan, and they urged the administration to “come up with a plan that permanently keeps access to full scope midwifery at SSM Health” in time for the next insurance open enrollment deadline later in October.
St. Mary’s followed up Wednesday by scheduling a new meeting with the midwives team for Thursday morning. A spokesperson told the Wisconsin Examiner that “we expect to have additional updates” on Thursday.
Vaughan said that before being told the program was ending, neither she nor her three colleagues had received any indication from St. Mary’s management that the program was on the verge of cancelation.
Since the St. Mary’s program began, its practitioners have provided care for 364 births, according to Vaughan, a member of the team since early 2020. The program recorded 139 births in 2020 and has recorded 98 so far this year, and it has been on track to care for 25 to 30 births each month in January, February and March.
“It doesn’t make sense to us that they would cut the program now as it’s growing and our schedules are full,” said Vaughan. She and her colleagues asked for the data to support the hospital’s reasoning for closing the program. “They have declined to involve us in those conversations,” she said.
In a statement to the Wisconsin State Journal Monday, a hospital spokeswoman said that St. Mary’s was “not seeing the number of births needed” to maintain the CNM program because many patients opting for midwifery “choose to deliver their babies with community-based midwives” who attend home births.
Vaughan said that argument didn’t make sense to her and her team, however. Home births are “less than 1% of all births,” she said. “A lot of our patients seek out hospital-based care because they don’t feel comfortable with home birth. They want the high-touch, low-tech care we provide with the amenities of the hospital.”
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