[hipmummy]

With a glitch.....we still need to work some things out...Until then...Thank you to all for all of your support.

The Board of Trustees apparently met this morning to vote on the fate
of the North Shore Birth Center. The release sent to the press by the
hospital is below. Details about the "plan" are still vague, though
patients at the NSBC will apparently now receive fetal monitoring akin
to what a patient at the hospital would receive.

--christa

North Shore Birth Center to Remain Open
Northeast Hospital Corporation Board of Trustees Approves Plan to
Continue Services

(Beverly, MA) - The Board of Trustees of Northeast Hospital
Corporation announced today that they have approved a plan that will
keep the North Shore Birth Center open and allow the Center to
continue to provide services to women who are low-risk and prefer a
birth center approach to pregnancy and childbirth.

Trustee members worked diligently with hospital administration and
clinicians to develop and approve a plan that would allow for the
continued operation of the Birth Center on the campus of Beverly
Hospital. The Board recognizes the national trend of birth center
closings due to rising costs and has decided to take a proactive
approach and modify how care will be delivered at the Birth Center.
Patients delivering at the Birth Center will now receive fetal
monitoring during their delivery.

"I am pleased that we were able to find a compromise that would allow
us to keep North Shore Birth Center open to the community," said Dr.
Henry Ramini, President and CEO of Northeast Health System. "By making
this slight modification, we will be able to continue to provide this
valuable service."

In a time when healthcare costs are increasing for all hospital
services, the Board of Trustees continually evaluates the programs and
services provided throughout Northeast Hospital Corporation to ensure
that the highest quality of hospital care is available and delivered
to the community.

"The Trustees believe in the care that is rendered at the Birth Center
and believe that it is a safe birthing alternative for expectant
mothers in our community," said Nancy Palmer, Chairperson of the
Northeast Hospital Corporation Board of Trustees. "We recognize and
appreciate that the Birth Center is a special place for many families
and we are honored to continue to provide this unique birthing
alternative."

The North Shore Birth Center (NSBC) became the first freestanding
birth center in the northeast when it opened in 1980. It is a nurse-
midwifery practice, in collaboration with OB/GYN physicians, situated
on the campus of Beverly Hospital. The Certified Nurse Midwives
(CNMs) at the birth center also provide GYN care. The NSBC's CNMs
attend births at both the Birth Center and Beverly Hospital.

 

[jessjgh1]

thanks for the update!

 

[Bryson's Mommy]

Thank you so much for the update. I wonder though, do you think they mean continuous EFM?

 

[hipmummy]

We are not sure. If that is the case then a patient has a right to deny it, because it is proven it does more harm than good.

 

[MAMom]

Quote:

Originally Posted by hipmummy We are not sure. If that is the case then a patient has a right to deny it, because it is proven it does more harm than good.

I know this is all speculation at this point, but even though all woman of course have the right to deny any test/procedure/treatment for any reason, if the hospital is requiring EFM to birth in the birth center, then I would think anyone who denied it would become ineligible to birth in the birth center.

=================
Mama to DS 5/03 & DD 2/06

:

: ICAN "You never know when you're making a memory." ~ Rickie Lee Jones

 

[jessjgh1]

So that's a pretty serious 'restriction' then, because EFM pretty much makes natural birth pretty difficult and painful since it requires you be lying still on your back, right?
Or do they allow some kind of occasional monitering? And if so, how occasional.

(And I can't imagine if you show up to the birth center and then deny EFM they can really deny you and force you to go to the hospital... not sure how that would work).

Jessica

 

[woodchick]

I had an unmedicated birth at Beverly Hospital (not the Birth Center) and had External Fetal Monitoring.

I don't know if it was because DH and I were adament about my getting up, but the EFM was very intermittent. It was strapped on for 20 minutes when we arrived at 9pm, again several hours later and then again just as DD was born.

For us it wasn't an issue. I was up and around, in the tub, on the birthing ball, birth stool, etc. the rest of the time. I would assume (and could be wrong) that they wouldn't expect more monitoring at the Birth Center.

Caveat: we did end up with an internal fetal monitor for the last 1/2 hour before DD was delivered due to distress- that was real and severe. She was taken to Boston via ambulance at 5hrs old and stayed in the hospital 2 weeks. Up until 30 mins before delivery our Labor and Delivery was very gentle and peaceful.

ETA: I also wanted to say that I am 100% in favor of the Birth Center remaining open in it's current state. I only make the comments above to make a comparison to my experience at the adjoining hospital.

 

[MAMom]

Quote:

Originally Posted by jessjgh1 So that's a pretty serious 'restriction' then, because EFM pretty much makes natural birth pretty difficult and painful since it requires you be lying still on your back, right? Or do they allow some kind of occasional monitering? And if so, how occasional.

The hopsital did not, in their press release, specify what kind of "fetal monitoring" (intermittent or continuous) or with what type of device (sorry, I wrote EFM in my previous post). Fetal monitoring is already done at the birth center with a doppler (and most home birth midwives also monitor the baby's heartrate intermittently with a fetoscope or doppler).

However, perhaps they used the terminology "fetal monitoring" to be vague on purpose, because that could encompass doppler, EFM, internal monitoring.

The quote from the press release is "Patients delivering at the Birth Center will now receive fetal monitoring during their delivery."

Quote:

Originally Posted by jessjgh1 (And I can't imagine if you show up to the birth center and then deny EFM they can really deny you and force you to go to the hospital... not sure how that would work).

Yes, unfortunately, I believe that it does. The EMTALA (Emergency Medical Treatment & Labor Act) prevents hospitals from denying care for women in labor, but I don't believe it would prevent them from saying it was out of the scope of care for the birth center (especially since the hospital is a gurney ride across the lot). It would then be the woman's choice to transfer to the hospital, or to leave.

=================
Mama to DS 5/03 & DD 2/06

:

: ICAN "You never know when you're making a memory." ~ Rickie Lee Jones

 

[toastqueen]

I received this last night:

Today delegates from the Campaign to Save the North Shore Birth Center finally met with Dr. Ramini and Beverly Hospital Executives. The meeting had been rescheduled twice by the hospital.
Attending the meeting from the Campaign were Interim Steering Committee Members Mira Clark, Rebecca Hains, Amy Kreydin, myself, Christa Terry, and Lead Researcher Nicole Altieri.
Representing Beverly Hospital were Dr. Ramini, Interim CEO, Chip Payson, VP External Affairs, and Pauline Pike, Executive VP and COO.

We presented a new open letter , urging that fetal monitoring at NSBC continue to be done by handheld Doppler, and highlighting the significance of retaining accreditation by Commission for the Accreditation of Birth Centers (CABC). Please see the full letter below.

Unfortunately Beverly Hospital remains insistent on beginning the use of electronic fetal monitoring (EFM) at the North Shore Birth Center, even though this will terminate NSBC's accreditation with CABC.

Please stay tuned; we will share more details from this important meeting over the weekend.

Sarah Shamel
On behalf of the Campaign to Save the North Shore Birth Center

December 18, 2008
An Open Letter to Dr. Henry Ramini, the Administration, and
the Board of Trustees of Beverly Hospital
On Monday afternoon, December 15, the Steering Committee for the Campaign to Save the North Shore Birth Center learned that the Northeast Health Systems Board of Trustees had voted to keep the North Shore Birth Center open, but with the added stipulation that North Shore Birth Center ("NSBC") patients will now "receive fetal monitoring during their delivery." The continued operation of the North Shore Birth Center, a valuable resource to the community and a distinguishing feature of Beverly Hospital, is something we can all celebrate. However, the proposed new requirement for fetal monitoring is a cause of confusion and, potentially, of great concern among the community supporting the NSBC.
The Steering Committee calls your attention to the fact that NSBC does already practice fetal monitoring. There is nothing new about NSBC monitoring the fetus; they do so by means of a handheld Doppler, which is recommended as the best practice by the American Association of Birth Centers and many leading academic studies. We are concerned, however, by this new hospital proposal, not only because it mistakenly implies that fetal monitoring at NSBC is somehow inadequate, but also because we have reason to believe that the hospital may be making reference to controversial and clinically-questionable practice of Electronic Fetal Monitoring ("EFM"). A statement attributed to Beverly Hospital's Director of Media Relations Heather Jones in a recent Gloucester Times article further supports this understanding (copy attached): She notes that the decision will likely cause the loss of NSBC's accreditation with the Commission for the Accreditation of Birth Centers ("CABC"), under whose nationally-recognized accreditation and quality standards, the routine use of EFM is not allowed.
The Campaign to Save the North Shore Birth Center remains resolute in our insistence that the North Shore Birth Center remain open as a CABC-accredited birth center, where patients can receive the standards of care deemed best for a birth center setting.
On Patient Outcomes
On behalf of this community and in the best interest of patients, the Campaign is unwilling to accept the Hospital's proposal of fetal monitoring at NSBC unless the Hospital is simply referring to the current practice of fetal monitoring by hand-held Doppler. If intermittent hand-held monitoring will satisfy the criteria of fetal monitoring set by the Board of Trustees in the December 15th decision, then we will gladly accept that decision. Electronic fetal monitoring has not been shown to improve outcomes for mother or baby (see Milbank report, pp. 48-49). Worse, it has been shown to lead to unnecessary interventions such as vacuum extractions and C-Sections, thereby increasing risk and compromising outcomes.
Why Accreditation Matters
Instituting EFM at NSBC will result in loss of the center's CABC accreditation. The highly esteemed accreditation by CBAC is recognized as a mark of quality to consumers as well as third-party payers. CABC uses current research to set the best practices of care in a birth center setting. Consumers seeking a birth center are choosing not merely the physical setting, but also a specific model of care. CABC accreditation assures consumers that this model of care is met at NSBC. Furthermore, in order for NSBC to continue to be a viable birthing option for North Shore families, births at the center must be covered by the major insurance companies. Birth Center accreditation facilitates insurance approval.
An Invitation
The Campaign invites Beverly Hospital's Board of Trustees to demonstrate to the community how the proposed Electronic Fetal Monitoring would be in the best interest of NSBC mothers and unborn babies, rather than the comfort level of the hospital's administration and risk management staff, or the hospital's bottom line. Our experts and research assure us that it is not a necessary or beneficial practice for the mother-baby dyad and, in fact, can lead to unwanted and expensive outcomes, such as an increase in the cesarean section rate beyond appropriate levels. We therefore invite Beverly Hospital's experts to share its perspective on this issue in a town meeting, at a date and time to be mutually agreed upon. Together, we can gather a panel of experts on all sides of this issue and let the community make an informed judgment. A representative from our campaign will contact you to follow up on this invitation. Should you accept, we will work together finalize a date.
In Conclusion
It is unfortunate that the hospital postponed communications with leaders from the community before the Board voted on December 15. A meeting before the vote would have afforded the opportunity for us to clarify that we not only want the Birth Center to remain open, but that we want also want it to continue to provide care in accordance with the birth center model. We decry the lack of transparency on the part of the Board and administration on an issue that has been shown to be highly important to the community.
The Birth Center will remain open: this is good news and we applaud this decision. As you ponder the advisability of formulating any changes to the protocols at the North Shore Birth Center, however, please keep as your primary concern the health and safety of mothers and babies. Show the community your commitment to optimizing patient outcomes by continuing to accept the use of handheld Dopplers as the form of fetal monitoring at NSBC, and by maintaining NSBC's CABC accreditation. Alternatively, if you truly believe EFM is associated with clinically beneficial outcomes, join us at a town hall meeting where you will have the opportunity to demonstrate to the community why Beverly Hospital has decided to ignore the most current evidence-based research by requiring routine EFM. We invite you to come share your perspective and information at the proposed town meeting.

Sincerely,
Mira Clark, Rebecca Hains, Amy Kreydin, Sarah Shamel, Christa Terry, and Nicole Altieri
On behalf of the Campaign to Save the North Shore Birth Center