Mass. DPH Deems Birthing Center at Leominster Hospital An Essential Service "Necessary for Preserving Access and Health Status Within the Hospital's Service Area."

The DPH finding follows a jampacked public hearing where more than 200 residents, policymakers, caregivers and community advocates turned out to deliver four hours of compelling testimony in unanimous opposition to UMass Memorial Health's decision to close the Birthing Center and endanger the lives of mothers and newborns in the region

According to the Community United Coalition and the Massachusetts Nurses Association the finding of the DPH letter contains an extensive list of demands for UMass Memorial to meet as part of a detailed plan in response to the concerns raised by the community, such as how UMass can ensure adequate transportation and access to care, provide healthcare equity for the most vulnerable residents impacted, as well as for the corporation to provide evidence to justify what the community contends were numerous false claims UMass made to justify the closing

With these findings in hand, community advocates, area legislators and the Mass Nurses Association will now look to UMass and the Healey administration to do whatever is necessary to maintain this vital service

LEOMINSTER, Mass., Aug. 9, 2023 /PRNewswire/ -- The Massachusetts Department of Public Health has issued its findings regarding UMass Memorial Health's controversial plan to close the Birthing Center at Leominster Hospital, deeming the program an essential service "necessary for preserving access and health status within the hospital's service area."  The full DPH letter can be found here.

The DPH finding follows a jampacked public hearing where more than 200 residents, policymakers, caregivers and community advocates turned out to deliver close to four hours of compelling testimony in unanimous opposition to UMass Memorial Health's decision to close the Birthing Center and endanger the lives of mothers and newborns in the region.

"The DPH has made it clear that our birthing center is vital to protecting our community, and especially the most vulnerable members of our poor and BIPOC communities, who will stand to suffer the most if this center closes," said Irene Hernandez, a member of the Pocasset Wampanoag Tribe of the Pokanoket Nation and co-chair of Community United to Save Our Birthing Center, a broad-based coalition of residents, public officials, caregivers and community advocates formed to fight the closure. "These are the mothers and newborns who will be harmed and could die as a result of this cruel decision by UMass Memorial.  We now call upon Dr. Dickson, the DPH and the Healey administration to save this service and protect our community."

In making this determination the DPH is requiring  UMass Memorial Health to provide a detailed plan that responds to all the concerns raised at the hearing, including how the hospital can ensure appropriate transportation for those who lack such access, accurate information on travel times for those placed at risk, how they intend to address numerous concerns raised about ensuring equitable access for vulnerable communities including the poor and people of color. They have also asked for UMass Memorial to provide evidence of efforts they have made to staff the facility, as well as to detail solutions they considered as an alternative to closing the unit, along with information as to why they rejected alternative solutions.  Opponents to the closure contend that no alternative solution was ever considered, and that no effort was ever made with hospital staff, members of the community or local officials prior to announcing the closing to discuss or consider any viable alternatives.

In fact, opponents to the closure made an overwhelming case to DPH at the hearing that there is no safe or adequate alternative that UMass Memorial could implement that can or will compensate for the loss of this vital service.  The only result will be that 500 – 700 mothers a year would have their lives and their newborns lives placed in jeopardy due to the lack of local access to maternity care.

"DPH has confirmed what we already know: two Gateway cities need this labor and delivery unit," said State Senator John Cronin (D-Fitchburg), a member of the Northern Worcester County delegation and the community coalition.  "We hope this determination is a wakeup call to UMass Memorial and that Dr. Dickson engages with the state so we can partner to keep this unit open."

"We must preserve this Birthing Center at Leominster Hospital. This is a critical access point, because in labor, minutes matter and it can be the difference between life and death," said State Rep. Natalie Higgins (D-Leominster), a member of the Northern Worcester County delegation and the community coalition. "Severe maternal morbidity rates have doubled in the last decade, while Hospital executives shuttered 10 birthing centers, I hope DPH and the Healey Administration use every tool available to preserve this Birthing Center."

"The Birthing Center at Leominster Hospital is imperative to protect the lives of the hundreds of thousands of residents in North Central Mass. Its closure would have a devastating impact on this community," said State Rep. Michael Kushmerek (D-Fitchburg). "Our work remains committed to preserving the longevity of such an essential unit and ensuring that DPH understands the importance of this unit on the future of our region."

"I am relieved but not in the least bit surprised at the Department of Public Health's decision'" said Tara Corey, a nurse who works in the Birthing Center and member of the community coalition. "I am proud of the community for providing the testimony to prove that the Birthing Center is essential to DPH and I hope this will open the eyes of those who have the power to reverse this decision." 

Advocates for the Birthing Center made a strong case that the Birthing Center must be maintained, including labor, delivery, postpartum and nursery care for families living in communities of Northern Worcester County.  The hearing also provided an opportunity for local officials and others to provide powerful data and information that invalidated each and every claim made by UMass Memorial Health as a rationale for the closing, including:

• Shortage of staff to operate the facility – testimony was provided showing that nurses have documentation of dozens of qualified nurses who sought positions on the unit who were turned away without being interviewed or hired.  Current nurses on staff, through their union, also offered numerous strategies for the cross training of staff to cover holes in the schedule, strategies that the HealthAlliance administrators refused to pursue.  And finally, as soon as the closure was announced, UMass found the resources to hire 12 temporary staff to operate the unit through the closing. 
• Lack of Obstetrical Coverage – the legislative delegation and the nurses on the unit offered testimony regarding information from local providers who have been willing and continue to offer a plan to provide obstetrical coverage to maintain the unit. Again, the hospital has refused those overtures and instead seeks to shutter the service.
• Declining Birth Rates – the Hospital has also pivoted to declining birth rates as a rationale but the data the legislative delegation has provided confirmed the region's population is growing and young families are growing. Our birth rate competes and exceeds the state's birth rate. Beyond that, challenging the notion that the "market has spoken" and has chosen other hospitals, is disproven by UMass Health Alliance's own data. Leominster Hospital, until this year when the Hospital Administration began implementing the closure, was the largest provider of birthing services for North Central Mass families. And we would argue, any plan that would place 500 – 700 women a year in such peril is on its face, immoral and in direct violation of our oath to do no harm.

DPH Report on Increase in Maternal Morbidity Underscores Need for Administration to Save Service

The Coalition's position on the closing was further buoyed by the release last week of an alarming report by the Massachusetts Department of Public Health showing a dramatic increase in the rate of serious complications and maternal child deaths from labor and delivery in our state over the last 10 years. DPH researchers found that rates of severe maternal morbidity climbed from 52.3 per 10,000 deliveries in 2011 to 100.4 per 10,000 deliveries in 2020, an average increase of 8.9 percent each year. It also found that women of color continue to face higher rates of complications, with black women consistently experiencing the highest rates. Compared to white non-Hispanic women, black non-Hispanic women experienced 2.3 times higher rates of complications on average during the study period, and Hispanic and Asian/Pacific Islander women experienced rates 1.2 times higher. This is the very population placed most at risk by the proposed closure of the Birthing Center at Leominster Hospital, the only facility serving the two Gateway Cities of Leominster and Fitchburg.

A quote by Governor Maura Healey in the press release about the DPH report clearly articulates the same concerns about the need for access to services like the Birthing Center that opponents to the closure made at the DPH public hearing, when she stated, "This report shows that there is much more work that we need to do to address racial and gender inequities in health care. It is essential that everyone has access to comprehensive, high-quality and inclusive maternal health care.  We can and must do better for mothers, for kids and for families – and our administration is committed to doing just that."

With the DPH findings in hand, the Community United to Save Our Birthing Center Coalition and others who oppose the closing will be looking to the Healey administration to honor that commitment by providing whatever support is needed to preserve the Birthing Center to ensure continued access to safe maternity care in Northern Worcester County.   

The period of time covered in the new DPH maternal child health report is the same period when the state saw community hospitals close 10 programs providing maternity care.  These were closures that occurred despite the fact that the DPH declared those services essential to preserving the health of those communities. 

According to a White Paper on maternal services in Massachusetts published by MNA's Congress on Nursing Practice, the decision by UMass to close this service follows a trend by other healthcare corporations in the state to close vital community-based programs and services as a means of funneling their patients to larger and more profitable major medical centers. Maternity services have been a specific target for these closures across the nation.

As part of the campaign, the Community United Coalition has launched a petition drive for community members and supporters to register their support for the Birthing Center, which will be shared with UMass Memorial Health, the Department of Public Health and other officials, urging them to rescind this dangerous plan, and to preserve this vital service.  Click here to view the petition: bit.ly/LeominsterMaternity.

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SOURCE Massachusetts Nurses Association