Cooley Dickinson and Nurse-Midwives - Mothering Forums

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#1 of 3 Old 04-13-2007, 01:49 PM - Thread Starter
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I just got this in an email and thought I would pass it along to everyone here. I know this has been discussed a bit in another thread but thought it deserved its own. Is there any kind of formal plan for dealing with this in the works yet? What can we do about this?

P.S. Notice the language differences between OB and CNM. The OB refers to "delivering" babies while the CNM refers to "catching" babies. Interesting...


NORTHAMPTON - A decision by a local medical practice could end midwife-assisted births at Cooley Dickinson Hospital by mid-June.

Doctors at Hampshire Obstetrical and Gynecological Associates, the oldest ob-gyn practice in the city, told their four midwives this week that the practice would no longer provide midwife-assisted births, although it will continue to offer pre- and postnatal care from midwives.

Hamp-OB, as it is known, is the only group at Cooley Dickinson to offer midwife-assisted births. The decision means women seeking such deliveries would be unable to get them in Hampshire County. Instead, they would have to travel to Holyoke Hospital, Franklin Medical Center in Greenfield or to Mercy Hospital or Baystate Medical Center in Springfield, all of which have thriving midwife practices, say those in the birthing community.

Dr. Jay Sprong, an obstetrician with Hamp-OB, said the decision came as part of a periodic evaluation of the practice. He said the main factor was the overall trend of a declining birth rate, which means there won't be enough births to keep all five physicians and four midwives at Hamp-OB busy enough.

Deliveries at the practice are divided equally between the midwives and doctors, he noted, and have declined by about 15 percent over the past few years. He said the decision is strategic, not financial.

"There are too many of us trying to provide the same service," said Sprong. "We had a great relationship with the midwives - we enjoyed it. It was a tough decision to come to, but we thought looking forward, it was what we had to do."

Also, he said, none of the doctors in 61 Locust St. practice wanted to stop delivering babies. "We still enjoy doing deliveries," he said.

On the other hand, he said, reducing the size of the midwife portion of the practice wasn't feasible because it's a 24-hour service. To cut the numbers of midwives available to attend deliveries wouldn't work.

He said patients have been notified of the decision, announcing that midwife deliveries will stop as of June 15. This will give patients time either to switch care to one of the doctors, or to find another midwife practice, he said.

Midwife Pamela Drexler-Lopez, who has worked at Hamp-OB since 1996, said she and the other midwives at the practice were surprised and saddened by the decision.

"It may be that some of us stay and work only in the office, but I think a midwife likes a full-scope practice," said Drexler-Lopez. "We like seeing women in the office and seeing them postpartum when they come in with their babies, but an enormous part of what we do is provide support in labor and catch babies."

She said the midwives she works with haven't yet figured out their next moves.

"This is all so sudden," said Drexler-Lopez. "I have the sense that the hospital is going to look pretty closely at this. I don't think anyone wants to see midwifery go away completely. There's just no future in that."

Cooley Dickinson Hospital spokeswoman Christina Trinchero said between Oct. 1, 2005, and Sept. 20, 2006 (the hospital's fiscal year), there were 229 births delivered by midwives, compared to 643 by physicians. Carol M. Smith, the chief nursing officer at Cooley Dickinson, said the hospital is reviewing what she called "an independent decision by an independent obstetrical group that is a valued member of our medical community."

"We are evaluating its impact on our services ... Currently, we are investigating how we might continue midwifery services to the Valley. We understand the importance of midwifery services to expectant mothers and to our obstetrical services," she said in a statement released Friday by Trinchero.

Trinchero said Smith is out of town and the hospital was not prepared to comment further.

News of the decision by Hamp-OB traveled fast among midwives and others in the natural childbirth community.

"I'm completely appalled," said a longtime area midwife Debra (Bert) Ames, who practiced for 12 years at the former Kaiser Permanente, whose midwives delivered at Cooley Dickinson before she left to work at Baystate.

Vicki Elson, a local independent childbirth educator for 22 years, said there is concern over losing midwives at Cooley Dickinson.

"All the other hospitals have midwives," she said. "These midwives are an incredibly valuable community resource, and we have to find some way to hang on to them."

She noted that Cooley Dickinson has a childbirth center, which, in her mind, is a term that doesn't quite fit if there aren't midwives. "It would be just an obstetrical wing otherwise," she said. "It just wouldn't be the same without the midwives."

Ames said she hopes a solution can be found to fill the void.

"It's an opportunity for the hospital to embrace midwifery," she said. "As a community member, I want my hospital to offer services to women."

Drexler-Lopez said she, too, hopes Cooley Dickinson can find a way to offer the service because she believes it is good for the hospital.

"A community hospital where women come to have their babies really roots them there," she said.

Meanwhile, Drexler-Lopez said she wonders if part of the problem has been the requirement Cooley Dickinson has that all midwife-attended births have the consulting obstetrician on the premises for the birth, which is not a policy at other hospitals.

"That's huge - that means you have double coverage and it means a midwife is not nearly as cost-effective," she said. "This has been an impediment at times."

Sprong said his practice, which helped create that policy in 1981, never thought it was a problem.

"It's double staffing, but we still felt it was the safest," said Sprong.

"There is no belief, however foolish, that will not gather its faithful adherents who will defend it to the death." -Isaac Asimov read.gif


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#2 of 3 Old 04-13-2007, 08:05 PM
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Wow I am shocked by that news, especially coming from the Noho area! Though I can't say having your baby in Greenfield would be a bad thing! They are fantastic there!!!!!

It seems that is bucking the current trend of increasing the services provided by mid-wives. I think they should look at why people are going elsewhere to begin with as I am sure the birthrate in the community isn't down, just the number of births at their hospital.

I'd be curious to see what this does to their "numbers"
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#3 of 3 Old 04-13-2007, 08:58 PM
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"He said the main factor was the overall trend of a declining birth rate, which means there won't be enough births to keep all five physicians and four midwives at Hamp-OB busy enough."
Wouldn't it be great if enough women boycotted the practice so there aren't enough births to keep the 5 physicians in practice either? Oops, did I say that out loud...:
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