PeaceHealth Shouldn’t Own Birth

Don’t close the Birth Center

PeaceHealth dislikes solving Nurse Midwifery Birth Center problems. Unless this changes, the birth center will close. It almost closed in 2007 when PeaceHealth forgot to include the birth center in its relocation plans for RiverBend. 

The solution then? Closure. The consumer group, Lane County Friends of the Birth Center, emerged to hold PeaceHealth accountable to its mission and values. In the nine years since re-opening, more than 1,000 babies have been born there.

The problem this time is Women’s Care’s decision to discontinue providing obstetric consultation for the birth center. Confronted with this challenge and without seeking input from staff or the consumer group, PeaceHealth made a closure decision. Plans for expanding services and staffing were exchanged overnight for doom and gloom scenarios justified with inaccurate numbers and faulty context. 

Mission-driven leadership would look at solutions to Women’s Care exiting. Solving this problem is an opportunity to replace an obstetric partner with a track record of imposing risk policies, which disqualify women from birthing at the birth center. These policies are behind PeaceHealth’s incorrect assertions about low numbers of births. 

A good place to start problem solving is with the STORQ contract. This contract ensures obstetric coverage at the hospital for pregnant women in need of care who arrive without a previously established provider. The birth center could be included in this contract. Alternatively, get rid of the contract. Hire sufficient in-house obstetric coverage and include birth center transfers. Solutions to this problem exist. 

As for business model rationales, mission-driven leadership can begin with work at the state level to ensure proper billing codes exist for birth and lactation services at birth centers. Right now, PeaceHealth writes these services off. It knows how to take issues to Salem and come home with government rules in line with its priorities. It just doesn’t want to for the birth center.

An ethical business model would review the effects of aggressive obstetric risk policies on birth center numbers. A review would reveal the absence of collaborative decision making built on understanding and respect for the midwifery profession. It would take into consideration that women, who are unnecessarily sent to the hospital, have also had unwanted, unnecessary interventions with associated risks. 

Gone are the leaders who answered the consumer call in 2007. There was engagement, a lot of haggling, and through it relationships were built alongside the new birth center. When the site was blessed as a sacred space for generations to come and with special recognition for capital campaign donors, the commitment appeared to be genuine.

Current PeaceHealth leaders not only ignore the community outcry but bully and block. Canceling this year’s annual birth center birthday party was petty. Sending a security guard to bar women and young children from delivering flowers and cards was an embarrassment. 

The consumer group fares no better. The PeaceHealth Patient and Family Advisory Council refused our request to come to its recent meeting. We fare no better with PeaceHealth senior leadership who refuse to meaningfully acknowledge or work with us.

If PeaceHealth closes the Nurse Midwifery Birth Center, what does it matter? For one, it will have single-handedly destroyed one of the country’s oldest, most well-established midwifery-led models of care. The birth center is a pioneer with a national reputation built and earned over decades. It is also the only local practice with no limits on serving OHP-insured women. The reputation and passionate support it inspires stand on a foundation of evidence-based care for all aspects of pregnancy, birth, postpartum and lactation care. It is not boastful but factual to assert that no local obstetric practice comes close to offering this level of care. 

Gone, too, will be true midwifery-led care at the prenatal clinic housed inside the Community Health Clinic on Charnelton. This clinic serves Medicaid-insured pregnant women. Women’s Care may take this contract. If so, the risk-oriented, interventionist obstetric approach that helps drive, not correct, high cesarean rates, breastfeeding struggles, and postpartum complications will replace the current wellness or midwifery model.

The Center for Medicare and Medicaid Innovation promotes cost-effective, excellent birth outcomes for women and babies. To improve maternal and infant outcomes including reducing premature births and low birth weights, it recommends more midwifery-led birth centers. This should dictate problem solving by PeaceHealth and our local, Medicaid-funded health department. 

A replacement for Women’s Care should be found, and the Nurse Midwifery Birth Center should not only remain open, it should expand. Further, midwifery-led (not obstetric-led) services should continue at the prenatal clinic.

Katharine Gallagher is a founding member of Lane County Friends of the Birth Center. She recently re-joined the consumer group as an active member. 

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