Cape Cod Healthcare to cut back on midwife services

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Christine Legere
 
| Cape Cod Times

HYANNIS — Six months after closing the maternity unit at Falmouth Hospital, Cape Cod Healthcare plans to cut the availability of midwives at Cape Cod Hospital’s birthing unit.

Organization officials characterize the plan as a “restructuring” and an “expansion” of current services, since they will be adding a certified physician dedicated to the unit.

But the Massachusetts Nurses Association, the union that represents nurses and health care workers, says the plan will reduce a woman’s choice of birthing experience.

Starting Nov. 16, the availability of midwives in the hospital’s maternity unit will be cut in half on weekdays.

Their hours will be limited to 7 p.m. to 7 a.m. Monday through Friday. They will be available around the clock in the unit only on weekends.

“The absence of midwives during weekday shifts means that expectant mothers who have chosen to be under the care of a midwife will no longer have access to those same care providers during their labor and delivery — unless a soon-to-be mother is lucky enough to go into labor either at night or on a weekend,” the state nurses association said in a statement. 

Cape Cod Healthcare also issued a statement on the restructuring of its obstetrics and maternity program.

“The program now includes a more patient-centered approach by ensuring on-site presence of board-certified obstetricians during the highest acuity times on the unit,” the statement says. “The expansion of physician coverage will continue to be supplemented by Cape Cod Healthcare nurse midwives who provide support on evenings and weekends at Cape Cod Hospital. Working as a team, these highly trained physicians and midwives will assure that each and every mother receives the appropriate level of care given their unique set of circumstances.”

The hospital’s Family Birthplace team includes 11 obstetricians and six certified nurse midwives.

During a conference call Wednesday, Michael Lauf, president and CEO of Cape Cod Healthcare, said the hospital’s birthing unit “has never been a midwife-centered program.” 

“It has always been a physician-centered program supplemented by our talented midwives,” he said. Women using the birth unit have never been guaranteed a midwife during labor and delivery, Lauf said.

All patients have the opportunity for a holistic approach to the birth experience whether it is via a midwife or a physician, he said. 

Nurses at Cape Cod Hospital say there has been no clear communication with the public about the coming changes, according to the state nurses association’s statement.

“When Cape Cod Healthcare closed the maternity unit at Falmouth, we knew we would see a significant increase in deliveries in Hyannis,” Michelle Walsh, a nurse in the obstetrics unit at the hospital, said in the statement.

“At the very least we have been expecting to deliver 300 more babies this year,” Walsh said. “Little did we know Cape Cod Healthcare would make things worse by cutting patients’ access to midwives at a time when the Cape’s lone maternity unit is already understaffed and overwhelmed.”

According to statistics provided by the state nurses union, the number of births at the Hyannis hospital from April through August increased about 43% from the same period last year. 

Part of the increase is likely related to the closure of the maternity unit at Falmouth Hospital in April, the union says in its statement, and to the increase in population on the Cape as people temporarily relocate from more heavily populated areas because of the coronavirus pandemic.

The closure of the nine-bed Falmouth maternity unit last spring had prompted outcry from nurses and other health care workers as well as the public.

Katherine Kuusela, a Realtor who launched an online petition drive shortly after Cape Cod Healthcare announced its plan to close the Falmouth unit, found news of changes to Cape Cod Hospital’s maternity unit disturbing.

“I understand the position the hospital is in where they’re not making money, but I don’t know how you can cut all these critical services while running ads about how you’re so committed to providing top-notch health care for women,” Kuusela said Wednesday. “It’s an all-out shame. It seems they aren’t committed to women’s health or they wouldn’t be making the cuts to all the critical programs women need.”

The Hyannis hospital has five full-time midwives and one per diem midwife. They refrained from commenting, since they hope they will have the opportunity to first discuss the plan with hospital officials.

Follow Christine Legere on Twitter: @ChrisLegereCCT.



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