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UMass Memorial Health declared that closing its birthing center in Leominster is unavoidable, in response to the state Department of Public Health designating the center as an “essential service.”
UMass Memorial’s 17-page letter, dated Tuesday and prepared by Husch Blackwell for UMass Memorial HealthAlliance-Clinton Hospital, cited a decline in the local birth rate, to less than two births a day, combined with a shortage of staff and inability to hire additional personnel.
“Financial support alone is not enough to maintain the program,” according to the letter, signed by Rebecca Rodman, senior counsel at Husch Blackwell LLP. “New OB/GYNs are primarily taking jobs in a setting like the Medical Center in Worcester.”
UMass Memorial assured the state that it “will identify possible disproportionate effects of the closure of the services on marginalized communities” after the closure of the maternity unit, at UMass Memorial HealthAlliance-Clinton Hospital — Leominster Campus.
Increased training in fetal, maternal health part of plan
Integral to the plan is the reliance on existing staff, local obstetricians and emergency transportation providers to step up in case of emergencies. The center proposes extensive and continued additional education and training, as well as relocation of certain services to nonhospital settings.
The training would encompass fetal assessment, labor and delivery, preeclampsia and eclamptic seizures. In addition, if an emergency presented at the hospital’s emergency department, a staffer trained in maternal and fetal medicine would be mandated to accompany the laboring woman to the closest birthing center.
The letter describes the practice as common to hospitals that do not provide maternal and obstetric care. It also points out that a pregnant woman experiencing contractions is not necessarily an emergency situation. Once evaluated, they can, and many times are, transported to adequate hospital facilities.
In addition, certain services would be reallocated to local providers. Those could include antefetal testing, which is now performed at the birthing center. Local providers would also be given fetal heart monitors.
Practicing clinicians will be allowed to apply for birthing privileges in Worcester and once granted could perform deliveries there.
UMass Memorial indicated it would work with local transportation providers to ensure transportation for those patients who lack access to a vehicle. It has also developed Community HELP Platform, encompassing 193 service organizations for Central Massachusetts, to enable residents to find the resources they need.
Opponents not impressed
Community United to Save OUR Birthing Center — a coalition of residents, local officials, caregivers and advocates that oppose the closure — dismissed the UMass Memorial response as “a callous and disingenuous plan to deprive Northern Worcester County residents of local access to safe maternity care.”
The organization said the plan “fails to address or adequately respond to any of the concerns cited by the state Department of Public Health that based its finding of the center being an essential service on testimony provided by residents, public officials, nurses, physicians and advocates at public hearing on August 9.”
The group maintains that the letter fails to address “how UMass can ensure access to care (and) provide health care equity for the most vulnerable residents impacted.”
The plan, according to the group, calls for vulnerable mothers to take nonexistent public transportation or call 911 for an ambulance so that “they can deliver enroute on the side of the road, or in an overcrowded hospital emergency room — or to die trying. It is heartless and it is absurd.”
Travel times to other birthing centers could stretch to hour
In a chart provided at the top of the UMass Memorial letter, travel time between Athol and the Leominster campus, a 27-mile trip, is 30 minutes at noon. The trip to one of the four regional birthing centers available to an Athol resident ranges from 21 to 50 minutes, or up to an hour during peak travel times.
Opponents questioned UMass’s findings.
“They actually state that travel during peak and nonpeak hours to UMass Memorial in Worcester and Henry Heywood Hospital in Gardner are the same as they are from Leominster and Fitchburg,” said Eladia Romero, a board member with the Spanish American Center, who serves as a co-chair of Community United to Save OUR Birthing Center. “We know that’s not true and if they are willing to lie to DPH and the community about it, then they know it’s a major issue that will impact our community members.”
The UMass Memorial letter notes that only about 1% of Massachusetts births occur outside of hospitals, and 60% of those are planned.
But pregnancy emergencies do occur.
Since the planned September closing was announced, Romero said, nurses working in the unit have reported numerous instances where expectant mothers presented to the hospital just minutes from delivery. She questioned whether these women would have arrived at an alternate birthing center in time to deliver safely there.
NAACP weighs in
The Worcester chapter of the NAACP has joined the fight to prevent the closure of the center.
“As part of that effort, we today sent letters to UMass Memorial Health CEO Eric Dickson and Governor Maura Healey, urging UMass Memorial Health and the Healey administration to heed the concerns of the community impacted by this decision and to take whatever steps are needed to preserve this vital service,” said Fred Taylor, president of the Worcester chapter.
The letter cites the “disproportionate effect on marginalized communities including … Black communities, and Hispanic/brown communities.”
“We have also heard from advocates and caregivers here in Worcester who report that there is no way the UMass Memorial can safely and effectively absorb the 500 – 700 families who will impacted by this decision, thereby jeopardizing the quality and safety of maternity care throughout all of Worcester County.”
In its letter, the NAACP states that its opposition “is given more urgency with the release of a department of (Department of) Public Health report that shows a dramatic increase in the rate of serious complications and maternal child deaths from labor and delivery in our state. Black women consistently experiencing the highest rates of maternal mortality, more than double the rate for white, non-Hispanic women. This is the very population identified by DPH as most at risk by the Birthing Center closure.”
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